Re: Inpatient Rehab Unit Redesign

[Guest guest]

Responding to your questions, I work in a 300+ bed facility, 70 bed skilled,

30 bed rehab, acute and out pt.

we provide 7 day a week coverage for inpt care. For skilled, we see all

pts 5 days in a 7 day period, we try to get their first 5 days consecutive.

So if a pt comes in on Thurs, we would see them both Sat and Sun, etc. Most

of these pts, on skilled, are seen qd.

on rehab, we see pts saturday only, except orthopedic pts we also see on

Sunday.

We see all orthopedic pt on acutes Sat and Sun as well. (all qd). We also

see any wound care qd x 7 days (in pt and out pt) or as ordered.

As far as the flux in census, we are forturnate to have SNF, Rehab and

Acute, so staff can rotate daily to help a more busy area. Our acute care

averages 10-15 new pts a day, so they always can use help. I do use some prn

to help alleviate the burden of what to do with low census (don;t use them).

Staff mix: mostly PT/OT, few PTA/OTA; we have high turn over and movement

of pts, so a lot of evals are coming thru. We expect the staff to have about

10-12 pt visits a day.

As far as d/c planning, we work very closely with our Case Managers. Our

acute care team meets daily and one therapist attends that 1 hour long

meeting to set d/c goals/destination. I usually attend this as it helps me

know who is going where when, (how many are going to skilled or rehab or need

OP etc). On rehab we work closely with SS who acts as they case manager and

we jsut started case management on our skilled unit. .

Hope this helps

[Guest guest]

I hear that so often, OP doesn't cover weekends etc. I realize there are

specialties out there, however, especially like in our situation, where all

staff is in the same facility, I believe it horribly and just plain ol'

unfair, not to have OP cover weekends. I know some places that have OP cover

all holidays, I think this too, is unfair. Everyone covers and if you are

off in OP, try to 1. trust those around you to be able to treat your pt

and/or 2. schedule them a different day.

my 2 cents worth

- in KC

[Guest guest]

I might be one to tend to agree. I can't believe how often I hear from my OP

staff how they feel so uncomfortable with a PO TKR or in ICU. To me, this is

basic PT skills, not to down play the importance of acute (that is where I

prefer to work any day), but the needs are right there in front of you. We

get so special that we can't see the forest for the trees. My venting for

the day

[Guest guest]

Were they located in the same building? Or do you feel that should have any

impact on whether they participate in the weekend rotation or not?

[Guest guest]

Carol,

At my old facility, for as long as I was there (1987 - 1999), outpatient

therapists participated in the weekend rotation through rehab, SNF, and

acute.

Mark Dwyer

mdwyer1@...

Re: Inpatient Rehab Unit Redesign

One more question: Do your outpatient staff participate in the weekend

coverage schedule?

[Guest guest]

Thanks Pat. All of your input will be taken into account as we

reconvene tomorrow to decide how we are going to redesign our Rehab services!

Thanks a bunch everyone!!!

[Guest guest]

Thank you, thank you, thank you, Mark! That is what we have been sensing in

recent months as a " reasonable " caseload in view of increased acuity and

shorter LOS. This will help me immensely in my meeting tomorrow. Thanks

again!!

[Guest guest]

We have our outpatient therapist participate in the weekend coverage

also. I agree about trusting your fellow therapist. Plus sometimes

other staff will have a suggestion or pick up on something I have

missed that benefits the patient.

Additional $.02

Kathy berger P.T. Canton, Ohio

kcsnedde-@... wrote:

original article:/group/ptmanager/?start=8549

> I hear that so often, OP doesn't cover weekends etc. I realize there

are

> specialties out there, however, especially like in our situation,

where all

> staff is in the same facility, I believe it horribly and just plain

ol'

> unfair, not to have OP cover weekends. I know some places that have

OP cover

> all holidays, I think this too, is unfair. Everyone covers and if

you are

> off in OP, try to 1. trust those around you to be able to treat your

pt

> and/or 2. schedule them a different day.

> my 2 cents worth

> - in KC