At the DCH Rehabilitation Pavilion, a Certified Rehabilitation Registered Nurse (CRRN) and/or Registered Nurse (RN) will determine appropriateness of admission based on Medicare and/or commercial insurance guidelines. Preadmission assessments include a comprehensive review of a patient's medical history, current medical condition, prior functional status, home situation and current ability to participate in a structured therapy program.
The DCH Rehabilitation Pavilion Admissions/Care Coordinators will help determine the patient's goals and care planning needs based on the preadmission assessment. Completion of insurance precertification is accomplished by the Admissions/Care Coordinator to determine rehabilitation eligibility. If admission is approved, an Admissions/Care Coordinator will talk with patients and families while they are still in acute care to answer any questions they may have and to assist in transfer to the DCH Rehabilitation Pavilion. If inpatient rehabilitation is not approved, they will recommend another level of care.
A physiatirst is a medical doctor (M.D.) certified by the American Board of Physical Medicine and Rehabilitation as a specialist in physical and rehabilitation medicine. The goal of a physiatrist is to help patients restore function and overcome physical limitations. They recommend and use non-surgical treatment options to treat physical and cognitive impairments which impact daily living.
At the DCH Rehabilitation Pavilion, the physiatrist will make rounds every day and is available 24 hours a day, 7 days a week, to manage your rehabilitation needs and provide medical oversight during your hospitalization.
Some of the functions of the physiatrist include:
Provides direction and leadership for the rehabilitation team which includes rehabilitation nursing, physical therapy, occupational therapy, speech-language pathology, case management/social services, Neuropsychology, respiratory therapy, pharmacology, dietitians and prosthetics/orthotics as indicated.
Implements a comprehensive plan of care to maximize functional outcomes.
Consult other medical doctors and Primary Care Physicians as needed.
Facilitates a weekly team conference with the rehabilitation team to follow progress, review plan of care, discharge plans & need for continued rehabilitation services.
Ongoing, daily management of medical &/or functional issues
Works with rehabilitation team to provide follow up therapy, adaptive equipment, and medical care needed at discharge to facilitate transition to community based living.
At the DCH Rehabilitation Pavilion, a nurse practitioner will assist the rehabilitation physician (physiatrist) in addresing any ongoing medical problems, as well as oversee your therapy program.
Nursing care is provided on a 24-hour basis by a nursing staff with experience and specialized training in rehabilitation.
Rehabilitation Nursing is a specialty practice within the scope of professional nursing practice. Rehabilitation nursing is the diagnosis and treatment of human responses of individuals and groups to actual or potential health problems stemming from altered functional ability and altered lifestyle. The rehabilitation nurse is an integral part of the patient and family's education. They will prepare you and your family for future self-management. Many of our registered nurses have completed their CRRN (Certified Rehabilitation Registered Nurse) advanced certification for specialized care of people who have experienced spinal cord and brain injuries, strokes, neurological and orthopedic impairments.
The goal of rehabilitation nursing is to assist individuals with disabilities and/or chronic illness to attain and maintain maximum function. Rehabilitation nurses specialize in teaching, providing hands-on nursing care, and collaborating with the patient, family, team and other care providers to ensure optimal opportunity for patient recovery.
Rehabilitation Nursing Team (CRRN, RN, LPN, PCA)
Orients you to the rehabilitation program
Provides 24-hour nursing care
Provides instruction to you and your family
Attends team conferences and keeps you and your family informed
Participates with your Case Manager in planning your discharge and assists you and your family through the transition to home.
Your nurses coordinate your care while insuring that the goals of the other rehabilitation disciplines are reinforced in all aspects of care. Rehab nurses work individually with patients on aspects of medication management, bowel and bladder training, as well as patient and family orientation and education.
Our physical therapists work with patients to help them overcome the physical effects of disease, injury, developmental abnormalities, or amputation. A physical therapist will evaluate each patient upon admission and continually reassess the patient during his or her rehab stay.
Physical therapists test and treat patients with physical limitations, develop a treatment plan, provide therapeutic interventions and help patients to be independent and reintegrate into the community or workplace.
The physical therapist monitors the patient's ability to perform functional activities (such as getting up and down from a bed, transferring, using a wheel chair, sitting, standing, and walking). He or she also monitors the motor and neurological status of patients which includes joint range of motion, muscle strength, motor control, balance, coordination, muscle tone and sensation.
They will also assess and address the patient's level of physical endurance for performing functional tasks and mobility. Physical therapists also recommend equipment such as wheelchairs, braces, walkers and canes to maximize the patient's function and safety.
Occupational therapists work with patients to improve their ability to perform tasks in their daily living and working environments. They also help patients to develop, recover or maintain daily living and work skills. Occupational Therapy utilizes rehabilitative and adaptive techniques that enable individuals to become more self-sufficient in activities of daily living in the home, work place and at leisure. Our occupational therapists evaluate and treat persons who require restoration/retraining of strength, movement or coordination, instruction in daily living activities and the use of assistive devices. Occupational Therapists will:
teach self-care (dressing, bathing, grooming) and independent living skills.
- teach functional transfers (tub, shower, toilet, car).
- provide and train patients in the use of adaptive equipment (dressing aids, eating utensils, etc)
- fabricate and fit splints.
- assess home furnishing arrangements and recommend changes to promote safety and conserve energy.
- teach upper body strengthening and coordination.
teach cognitive and perceptual skills.
The certified Speech-Language pathologists at the DCH Rehabilitation Pavilion evaluate and treat disorders of swallowing, communication, and cognition for both children and adults. Speech Therapy identifies, evaluates and treats a wide range of speech, language, cognitive, and swallowing disorders.
Speech- language pathologist use computer technology, voice or speech language services and other training to help people develop effective communication skills.
Additional Programs provided by Speech-Language Pathology:
* Cognitive Rehabilitation
(specifically utilizing BrainTrain's Captain's Log)
* VitalStim Swallowing Program
* Dysphagia Program
Several of our speech-language pathologists have additional competencies and/or certification in VitalStim, FEES, the Academy of Neurologic Communication Disorders and Sciences, and BrainTrain's Computerized Cognitive Software.
Case Manager/Social Worker
Case managers at the DCH Rehabilitation Pavilion consist of a Certified Rehabilitation Registered Nurse and a master level social worker. They work one on one with patient and families to provide options for discharge planning. They are involved in your care on admission to the DCH Rehabilitation Pavilion, and are the primary people responsible for your discharge planning.
Case managers are familiar with community resources, and will help direct you to proper agencies based on your individual needs. A case manager or social worker will help with your discharge plans and make sure you have everything you need when you go home. We want our patients and families to be as prepared as possible when they leave our facility. That's why our case management department's primary focus is your discharge plan.
Our case managers provide discharge planning, assist with adjustment to your disability and coordinate your follow-up services.
A registered dietitian screens each patient for potential nutritional problems. Based on this screen, the registered dietitian will then develop and implement a nutritional plan specific for each individual. They also provide nutritional counseling and diet-related education to patients and their families to promote a healthy lifestyle. They help prevent and treat illnesses by promoting healthy eating habits and suggesting diet modifications. Dietitians at the DCH Rehabilitation teach a weekly class to encourage good nutrition after discharge.
A neuropsychologist is a psychologist who specializes in studying brain behavior. They are extensively trained in the pathology, anatomy and physiology of the nervous system. The role of the neuropsychologist is to identify effects of neurological changes in the brain, and assist with treatment of those deficits. They contribute to the rehabilitation team with cognitive an psychological evalutaions, treatment, rehabilitation and disability determination.
Respiratory therapists evaluate, treat and care for patients with breathing and other cardiopulmonary problems, such as COPD, asthma, pneumonia, congestive heart failure and other diseases affecting the lungs. Practicing under the direction of the physician, the respiratory therapists assume primary responsibility for all respiratory care, therapeutic treatments, diagnostic procedures and patient education.
At the DCH Rehabilitation Pavilion, respiratory therapists are available 24 hours a day to provide care to our patients with respiratory problems. Some of the duties of the respiratory therapist include:
Setting up and monitoring of oxygen
Chest physiotherapy or pulmonary toileting
Aerosol medications and treatments
Monitoring blood gases and oxygen saturation levels
Diagnostic testing to evaluate breathing capacity
Educating patients and families on respiratory disease management, medications and treatment
Prosthetists and orthotists provide care to patients with partial or total loss of a limb. They design, fabricate and fit the patients with prosthetic devices (artificial limbs).
Orthotists provide care to patients with disabling conditions of the limbs and spine. They design, construct and fit the patients with orthoses, which are devices such as braces, splints or arch supports that either stabilize or optimize movement of the limb according to the need.
Both fields combine knowledge of medicine, engineering and materials science to provide appropriate devices, allowing patients to mobilize and function more safely.