Direct Access Priority Process (DAPP)

Direct Access Priority Process (DAPP)

The RCA’s Direct Access Priority Process (DAPP), originally developed in 2015, supports early identification of individuals with restorative potential who require inpatient and/or community-based rehabilitative care and facilitates referrals directly from the community or emergency department. This streamlined process helps individuals receive timely access to rehabilitation by providing health practitioners with a direct pathway to rehab services and removing acute care as the sole point of access to rehabilitative care beds.

The ALC Leading Practices Guide (2021) outlines that processes should be in place to transition directly to the next level of care, including DAPP. Regional implementation of DAPP, as one component of the ALC leading practices, is therefore recommended.

Direct Access Priority Process (DAPP) Tools & Resources
Direct Access Priority Process (DAPP) (August 2023) Outlines referral pathways to community-based or directly to bedded rehab services by delineating the steps to assess an older adult’s change from baseline function, determining their restorative potential and providing guidance for referral to the appropriate level of rehabilitative care.
Checklist to Rule Out Acute Causes of Functional Decline (August 2023) Provides guidance on answering the following question from the DAPP: “Is there an acute medical cause for functional decline?”
Rehabilitative Care for Older Adults Living With/At Risk of Frailty: From Frailty to Resilience (December 2021) Sets out core elements and processes of care required when providing rehabilitative care to older adults living with/at risk of frailty, recommended best practices and how to implement them within specific domains of care.

This includes processes for early identification and determining restorative potential.

Baseline Functional Status (North East Specialized Geriatric Centre) Provides guidance on the determination of the nature and degree of change for older adults who have experienced functional decline compared with their baseline functional status.

The Barthel Index is included in this guidance document as part of the Baseline Functional Assessment.

Clinical Frailty Scale Guidance & Training (Dalhousie University) Provides guidance for using the Clinical Frailty Scale
DAPP Evaluation
Assess & Restore Shared Provincial Indicators (January 2018) Description and technical definitions of standardized indicators for Assess & Restore reporting.

Includes process and outcome indicators to support evaluation of the effectiveness of DAPP to inpatient & community-based rehabilitative care.