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Inpatient Acute Rehabilitation

Program Scope

Acute rehabilitation is a short term intensive program for patients aged 16 and over who have good potential to return to home or another community setting. Patients admitted must be medically stable but still need close supervision from a physician to safely engage in rehabilitation. Active participation in three hours of therapy per day is required, so patients must have appropriate endurance, the ability to learn, and be likely to experience significant practical benefit from therapy. The patient must also be able to participate without significant risk of harming themselves or others. Psychiatric diagnoses, if present, must be stable. The program will work to accommodate requests related to cultural needs whenever these can be met in a manner that maintains respect and safety for others in the environment.

Typical diagnoses include stroke, spinal cord injury, amputation, major trauma, brain injury and neurological disorders. Some patients who have had a joint replaced due to arthritis or who have a fractured hip as well as a complicating medical condition may also be eligible. Kaweah Health Rehabilitation Hospital offers specialty care in both amputation and stroke. The amputation specialty program admits patients with above and below knee amputations on one or both legs. The stroke specialty program admits patients with strokes caused by clots or by bleeding that result in significant loss of mobility, swallowing or speech.

Program Description

Patients receive individualized attention from an interdisciplinary team, led by a physician experienced in physical medicine and rehabilitation. Rehabilitation nurses provide specialized nursing care 24 hours a day, 7 days a week. Physical and occupational therapists work closely with each patient to develop a treatment plan designed to meet the patient’s specific goals. Speech therapy is available as needed. Therapies are provided 3 hours per day, 6 days per week. An activities coordinator will work with each patient to assist with returning to life roles and leisure interests. Case management professionals provide emotional support and assistance in coordinating plans to return home. Patients and their families are informed throughout their stay of any coverage limitations imposed by their insurance company and alternative sources of funding and programs are discussed as needed. Other services, including respiratory therapy, registered dietician, chaplain visits and pharmacy are provided as needed. Services may also be provided by referral, including services such as prosthetic and orthotic fitting, durable medical equipment, and specialty consultations. Referrals are accepted from case managers, physicians and family members. The program accepts Medicare, Medi-Cal and commercial payer sources.

Strategic Plan

The rehabilitation program regularly reviews areas of strength and weakness in the program, as well as identifying areas for further growth. The result is a strategic plan that the leadership team discusses every quarter to ensure that progress is being made on our identified goals and priorities.

For the coming year, some of the key areas for focus are:

OUTSTANDING COMMUNITY HEALTH

  1. Optimize EMR (Electronic Medical Record) between inpatient and outpatient therapy.
  2. Research options for addition of Behavioral Specialist or Social Worker with behavioral mental health training.
  3. Improve communication and expectations of bowel and bladder program (aka Bumble Bee Program).
  4. Improve Quite Hall Program.

EXCELLENT SERVICE

  1. Improve patient experience and satisfaction.
  2. Actively update Kaweah Health website content for rehabilitation service lines.
  3. Increase patient activities and programs on Sundays.

IDEAL WORK ENVIRONMENT

  1. Ensure ideal work environment by expanding staff celebrations to include West Campus facilities.
  2. Improve security of facility

FINANCIAL STRENGTH

  1. Building census by increasing presence at Medical Center and optimization of EMR (Electronic Medical Record).
  2. Improve Medicare and Managed Medicare contracts.

EMPOWER THROUGH EDUCATION

  1. Empower staff through educational Lunch and Learn series.
  2. Develop Care Coordinator Role
  3. Develop education groups, i.e. nursing/therapy TEAMS per diagnosis.

ACCESSIBILITY

  1. Improve access to courtyard through Outpatient Therapy gym doors.
  2. Improve access to Dialysis Clinic at West Campus (i.e. electric golf cart for transport).
  3. Research options for bariatric pool lift to improve patient accessibility.
  4. Provide information to patients about community outreach programs available after discharge.

Program Outcomes

In 2023:

Patient Satisfaction

  • Overall recommendation: 96%, national 92%
  • Internal data with follow-up phone calls: ( patients interviewed during 7/1/23-12/31/23)
    • 98% would recommend inpatient rehab
    • 85% felt prepared for discharge

Results Calendar Year 2023 (CY2023)

  • 86% of patients returned home, better than the national average of 83%
  • Our average length of stay is 12 days, better than the national average of 13 days
  • 66% of the patients on discharge met or exceeded expected goals, that national average was 70%
  • The program has served 547 patients for the CY2023, up from 492 patients in CY 2022

Stroke

  • 84% of the patients returned home (better than the national average of 78%)
  • Our average length of stay is 15 days (same as the national average of 15 days)
  • 62% of the patients on discharge met or exceeded expected goals (national average 66 %)
  • The program served 156 stroke patients for the CY2023

Orthopedic

  • 86% of the patients returned home (national average 87%)
  • Our average length of stay was 11days ( national average 11 days)
  • 69% of patients on discharge met or exceeded goals (the national average 73 %)
  • The program served 125 patients for CY2023

Cardiac

  • 91% of the patients returned home (better than the national average of 88 %)
  • Our average length of stay was 9 days (better than the national average of 10 days)
  • 75% of our patients met or exceeded discharge goals (the national average at 76%)
  • The program served 54 patients in CY2023

Amputee

  • 93% of the patients returned home (better than the national average at 78%)
  • Our length of stay was 11 days (better than the national average of 13 days)
  • 74% of the patients on discharge met or exceeded expected goals (better than the national average of 68%)
  • The program served 44 patients in CY2023

Spinal Cord

  • 86% of the patients returned home (better than the national average of 83%)
  • Our length of stay was 13 days (better than the national average of 15 days)
  • 61% of the patients on discharge met or exceeded expected goals (national average 66 %)
  • The program served 35 patients for CY2023

Questions or feedback? Please call: 559-624-3700