Cookie Gender, RN, MSN, CRRN, Administrator/CNO CHRISTUS St. Michael Rehabilitation Hospital

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1 Cookie Gender, RN, MSN, CRRN, Administrator/CNO CHRISTUS St. Michael Rehabilitation Hospital FIM is a trademark of Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc.

2 1. Describe models for Interdisciplinary Diagnostic Teams 2. Describe the benefits 3. Identify barriers 4. Identify the effect on patient outcomes

3 Facility A 50 Beds Stroke, SCI, BI Patients North Wing West Wing East Wing Nursing Station

4 Stroke Team Patients Team Patients SCI Team 2 Team 1 Team 1 Team 2 BI 7-8 Patients 7-8 Patients 7-8 Patients 7-8 Patients Dedicated RNs, PT, OT, Speech Therapist, Social Worker for every 7-8 patients on average

5 Interdisciplinary team members educated on the latest Evidence Based Practice for a specific diagnosis. Ex. Brain injury care Team admission assessments coordinated.

6 80 bed freestanding Rehab Hospital 3 Patient Care Floors: 1. Stroke 2. SCI/Brain Injury 3. Ortho/General Rehab

7 60 bed freestanding Rehab Hospital 3 Patient Care Floors: 1. SCI/Ortho 2. Stroke 3. BI

8 50 bed freestanding Rehab Hospital 1. Ortho 2. Stroke 3. General Rehab 4. Brain Injury 5. SCI

9 7 BEDS 8 BEDS 7 BEDS Nursing 8 BEDS Station 8 BEDS 11 BEDS

10 Stroke/BI Team 4 Debility/SCI Team 5 Team 3 Nursing Team 6 Station Team 1 Ortho Team 2

11 Management of Rehab Units CHRISTUS St. Frances Cabrini Rehab 25 Beds 5 Beds CVA/BI Nursing Station 11 Beds 2 Beds 7 Beds Debility CVA Ortho

12 Nurse Manager office supply room conference room W Nurse's station employee lounge TLA storage room ice room 7 Main Nurse's Station PT Laundry GYM ED office Biohazard OT GYM Therapy Office Neuro/High Risk Fall/Increased Confusion Patients Orthopedic Patients Neuro/TBI/SCI Patients SCI Patients (bigger room for Hoyer)

13 CHRISTUS Spohn Rehab Center Shoreline 30 Beds R.H. L.H. R.H. L.H. R.H. L.H. R.H. L.H. SOLARIUM L.H. R.H. R.H. ELECTRIC R.H. L.H. AMB AMB AMB CLOSET SUPPLIES RM. RN 4218 STATION 4211 L.H. R.H R.H. L.H. LAYOUT KEY L.H. = Left Hemiparesis Room 4216 L.H. R.H. = Right Hemiparesis Room 4215 R.H R.H. ADR AMB = Ambulatory Pts. Only BLUE = TBI & Spinal Cord Injury Patients GREEN = Stroke Patients RED = Debility Patients

14 GYM 4310 L.H. TRANSITI- ONAL APT R.H. RN STATION 4308 L.H. LAYOUT KEY SMALL 4301 R.H. L.H. = Left Hemiparesis Room 4307 L.H. R.H. = Right Hemiparesis Room SMALL 4302 SMALL = Small room (bad for pts. w/ L.H. excess equipment) 4306 R.H. YELLOW= Ortho SMALL 4303 R.H. SUPLLIES RM L.H.

15 1. Clinicians become experts in the care of a specific diagnosis 2. Clinicians attend outside conferences related to specific diagnosis 3. Stroke team is part of continuum of care if acute hospital has a Stroke Center of Excellence designation 4. CARF specialty certification or TJC disease specific designations 5. Improved pt/family education 6. Ownership of program by clinicians 7. Increased accountability for care/treatment, education and results 8. Improved patient outcomes, e.g., FIM ratings, reduction in pressure ulcers, falls, CAUTIs, improved pt/family satisfaction 9. Market the diagnostic teams 10. Clinicians assigned to team based on preference and skill set (ie. Prior NDT training)

16 11. Improved communication between nursing and therapy 12. Staff prepared and accustom to the needs of patients with similar medical problems 13. Improved teamwork among nursing working with the same CNA and reporting off to same nurses. 14. Improved continuity of care at shift change 15. Delivery of care is streamlined 16. If semi private rooms, a roommate with a similar diagnosis can connect better

17 1. New grads may not get as much experience with different diagnosis 2. Therapists can get stuck in their treatment strategies or routines 3. Flexing off loses continuity 4. High acuity on one team may occur e.g., stroke team can switch

18 1. FIM outcomes continue to exceed region and nation 2. LOS is lower a) b) Continued reduction in hospital acquired pressure ulcers a) b) Reduction in number of falls and fall prevalence rates a) b) Patient satisfaction scores remain high 6. Physician satisfaction scores remain high 7. Zero CAUTIs

19 QUESTIONS?

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