Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr;63(4):201-207.
doi: 10.1038/s41393-024-01058-6. Epub 2025 Jan 24.

Patient flow problems affecting in-patient spinal cord injury rehabilitation in the Netherlands

Linda M M van der Schriek  1   2 , Marcel W M Post  3   4 , Catja A Dijkstra  5 , Peter W New  6   7   8 , Janneke M Stolwijk-Swüste  3   5
Affiliations

Patient flow problems affecting in-patient spinal cord injury rehabilitation in the Netherlands

Linda M M van der Schriek et al. Spinal Cord. 2025 Apr.

Abstract

Study design: Prospective cohort study.

Objectives: To describe barriers to admission to and discharge from an inpatient rehabilitation unit for patients with newly acquired spinal cord injury or disease (SCI/D) and to identify modifiable factors whereby patient flow can be optimized.

Setting: Netherlands.

Methods: In-patients with newly acquired SCI/D referred to a rehabilitation centre in the Netherlands between December 2018 and December 2019 were included. Demographic, clinical characteristics and information about waiting days and causes of delay were recorded. Descriptive analysis was used.

Results: In total, 105 patients were included; 33 patients (31%) were female, mean age was 59 years, 60% had a non-traumatic SCI/D, 42% of the SCI/D were tetraplegia and 62% were AIS D at referral. No significant differences in demographic or clinical characteristics were found between patients with and without a barrier to admission. Most common admission barriers were bed availability and capacity of nursing and other health staff. The most frequent discharge barriers were delay in care approval, lack of availability of nursing home places and waiting for home modifications.

Conclusion: Most frequent admission barriers were availability of beds and staffing capacity; most discharge barriers were problems with home modifications, waiting for care approval or a nursing home place. Recommendations for reducing these barriers are recognizing a potential problem at an early stage, timely communication with patient and/or family about options for discharge, while simultaneously initiating a home modification plan and exploring temporary accommodation options.

PubMed Disclaimer

Conflict of interest statement

Competing interests: The authors declare no competing interests.

References

    1. Trzeciak S, Rivers EP. Emergency department overcrowding in the United States: an emerging threat to patient safety and public health. Emerg Med. J. 2003;20:402–5. - DOI - PubMed - PMC
    1. Bernstein SL, Aronsky D, Duseja R, Epstein S, Handel D, Hwang U, et al. The effect of emergency department crowding on clinically oriented outcomes. Acad Emerg Med. 2009;16:1–10. - DOI - PubMed
    1. Eitel DR, Rudkin SE, Malvehy MA, Killeen JP, Pines JM. Improving service quality by understanding emergency department flow: a white paper and position statement prepared for the American academy of emergency medicine. J Emerg Med. 2010;38:70–9. - DOI - PubMed
    1. New P, Akram M. Time-series analysis of the barriers for admission into a spinal rehabilitation unit. Spinal Cord. 2016;54:126–32. - DOI - PubMed
    1. Andrews LB, Stocking C, Krizek L, Gottlieb L, Krizek C, Vargish T, et al. An alternative strategy for studying adverse events in medical care. Lancet. 1997;349:309–13. - DOI - PubMed

LinkOut - more resources