ࡱ> AD@a bjbjZZ .20i0io  8$,$jAAAAAuuuS$U$U$U$U$U$U$')U$uuU$AA4j$DDDFAAS$DS$DD"k#Ak90;#?$$0$S#**0k#*k#u>,D$uuuU$U$uuu$*uuuuuuuuu Y k: Admission and Discharge Criteria for Pediatric Patients The goal of Pediatric rehabilitation is to assist patients in attaining the highest possible level of functional independence and quality of life and teach families to assist children with their rehabilitation as needed. In order to attain these goals, patient and families are the important participants. The goals should be applied not just during rehabilitation but for the rest of their lives. Whenever there is a decline in function with rehabilitation it slowly rises and functions improve after the patient returns home and is integrated into the community. Functional independence may decline prematurely as medical complications and musculoskeletal problems arise or with the aging process. A refresher program after a medical or surgical event is as essential as the initial acute rehabilitation program to increase function. The rehabilitation unit at Strong Memorial Hospital does not discriminate based on color, creed, age, gender or race. The Acute rehabilitation unit is not able to admit persons dependent on a ventilator. Referrals for patients who are ventilator dependent will be made and PM&R will facilitate continued rehabilitation services if the ventilator is no longer required. Patients admitted to the rehabilitation should be medically ready for admission. Admission Criteria for Comprehensive Rehabilitation Program (must meet all) Patients must be at least 6 years old (patients 5 years or younger will be considered on a case-by-case basis) and referred by their physician and evaluated for appropriateness by an attending physician or a resident under the direction of an attending physiatrist. Requires interdisciplinary team approach and coordinated program of care We provide an intensive rehabilitation program for the patient who is able to tolerate a minimum of three hours per day or eighteen hours per week of therapy services as applicable (i.e., Physical therapy, occupational therapy, speech and language therapy). Patients with recent change in ability status: Defined as a restriction in the ability to perform in the manner or within the range considered normal. This restriction calls for rehabilitative needs, which cannot be met in a less restrictive environment. Must include the following activities generally accepted as essential components of every day life. Performance of basic activities of daily living (i.e., feeding, grooming, bathing, dressing) (2) Mobility skills (home and community) May also include the following activities generally accepted as essential components of every day life. Bladder and bowel continence Language and speech Cognitive/behavioral Psychological/Social/Sexual Patient and/or family have demonstrated willingness to participate and the Patient is medically able to progress with Acute Rehabilitation therapies. Requires daily physician involvement due to complexity of disability and medical condition/s. The patients disability should be severe enough to require the services of several disciplines, including rehabilitation nursing, (education, medication usage, continence training, and skin care). Physical therapy, Occupational therapy, Recreation therapy and/or possibly speech therapy on a daily basis. Reasonable expectation for achievement of short-term goals as set by the interdisciplinary team on a weekly basis. The anticipated achievement of functional ability by the patient/family/care giver may be sufficient to allow for discharge home from the Acute Rehabilitation Unit. Not previously treated in an acute rehabilitation unit for essentially the same condition unless advanced technology or a special procedure has been performed (e.g. baclofen pump) with the expectation of change in functional level, or intervening circumstances have resulted in either a change in functional capacities or expectations for significant functional improvement. It is desirable that a realistic plan for discharge be established prior to admission. Family support, although not an admission criteria, is also highly desirable. The patients support system and after care disposition are deemed sufficient by the team to allow the patient to return to the community following rehabilitation. Patients are considered for admission regardless of financial resources, but prior authorization is required from insurances. Discharge Criteria for Pediatric Patients Discharge to home when Medically stable Family/patient education complete Safe home environment Patient is Independent in mobility and ADLs or help is available Equipment needs met Follow-up care arranged for therapy and professional services D/C transportation and clinic visits arranged Home with Outpatient therapies Patient and family preference Transportation available Adequate endurance Requires use of equipment only available in clinic setting Expertise of Therapists in the inpatient setting Home with Services Patient and family preference No transportation available Inadequate endurance Needs aide service Medical limitations Agency Choice Complete Discharge to SNF Rehab Family support insufficient for care needs or unable to provide 24 hr. care at home Slow progress and needs slow pace for further recovery Care needs too extensive for care to be delivered at home Patient needs extra time/therapy to achieve needed level of function to live at home Patient and family preference to reduce burden on family Patient is a safety risk so unable to live at home Patients bowel and bladder needs cannot be met by the care giver at home Discharge to Long Term Care facility May occur if patient/family and team agree that other discharge options are not appropriate.     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