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 Delta 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:

1. Exploring whether Kaweah Delta could become a vendor for durable medical equipment in order to improve the timing of delivery and the accuracy of the equipment that our patients need at home upon discharge.
2. Adding a specialist to the team who can help us better organize the care provided to patients with cognitive impairments that affect their behavior
3. Interviewing patients during their stay to determine if there are concerns that could be addressed in order to improve the patient’s experience
4. Improving access to care by making sure patients get to the right type of inpatient and outpatient care for their needs
5. Helping nurses have more time for their patients by improving the tools used to determine the patients a nurse will care for each shift.

PROGRAM OUTCOMES

In 2020:

Patient Satisfaction

• Patient surveys place our services in the top 35% of rehabilitation programs in the nation. 80% of patients gave the program the highest scores possible on the survey.

Results

• 86% of patients returned home, better than the national average of 78%.
• Our average length of stay of 13.6 days was lower than the national average of 14.5 days
• Patient progress was similar to the national average.
• The program has served 442 patients in the past year.

Stroke

• 86% of patients returned home, better than the national average of 77%.
• Our average length of stay of 14 days was lower than the national average of 16 days.
• Patient progress was better than the national average.
• The program has served 184 stroke patients in the past year.

Orthopedic

• 92% of patients returned home, better than the national average of 82 %.
• Our average length of stay of 13 days was the same as the national average of 13 days
• Patient progress was the same as the national average
• The program has served 49 orthopedic patients in the past year.

Cardiac

• 93% of patients returned home, better than the national average of 83%.
• Our average length of stay of 10 days was below the national average of 11.
• Patient progress was similar to the national average.
• The program has served 76 cardiac patients in the past year.

Amputee

• 94% of patients returned home, better than the national average of 78%.
• Our average length of stay of 12 days was the lower than the national average of 13 days
• Patient progress was similar to the national average.
• The program has served 45 amputee patients in the past year.

Spinal Cord

• 80% of patients returned home, same as the national average of 80%.
• Our average length of stay of 14 days was below the national average of 16 days.
• Patient progress was better than the national average.
• The program has served 46 spinal cord patients in the past year.

Questions/feedback? 559-624-3700