Symposium

Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)

Brain Injury

Cross-Cutting

Ethics

Geriatric Rehabilitation

Spinal Cord Injury

Stroke

I Want to Go Home! Development and Implementation of a Novel Discharge Recommendation Tool in an Acute Inpatient Rehabilitation Hospital: An Interdisciplinary Quality Improvement Project (845863)

Presenter(s)

• 

  Kelsey Watters, OTR/L

  Clinical Practice Leader for OT; Functional Cognition & Vision OT
  Shirley Ryan AbilityLab
  Chicago, Illinois

  Presentation Slides Handouts
• 

  Emily Marquez, MD

  Resident Physician
  Shirley Ryan AbilityLab
  Chicago, Illinois
• AK

  Allison Kessler, MSc, MD

  Attending Physician SCI Medicine, Assistant Professor of PM&R
  Rehabilitation Institute of Chicago, Northwestern Feinberg School of Medicine
  Chicago, Illinois
• 

  Jan Struhar, PT, DPT

  Physical Therapist
  Shirley Ryan AbilityLab
  Chicago, Illinois
• JG

  Joanne Garces

  Illinois

Non-presenting author(s)

• GS

  Gayle R. Spill, MD

  Attending Physician; Assistant Professor
  Shirley Ryan AbilityLab; Northwestern University Feinberg School of Medicine
  Chicago, Illinois

Interdisciplinary teams are tasked with providing recommendations to patients and family members discharging from inpatient rehabilitation facilities (IRFs). When families are told a patient will require “24/7 supervision” after discharge, it may limit all but institutional options for disposition. An interdisciplinary team of physicians, ethicists, therapists, and care managers at a free-standing IRF recognized the supervision recommendations offered to patients and families were narrow and conflicting, and embarked on a quality improvement project to rectify this. The team collected hospital-wide data about supervision recommendations at discharge, created a tool which proposed an alternative framework and language to improve discharge planning and conducted education sessions to introduce the tool to pilot units. Preliminary post-pilot data indicated the tool was effective in decreasing the frequency in which teams recommended “24/7 supervision” after discharge. This project is particularly unique in its bioethics framework, interdisciplinary conceptualization, and patient-centered approach.

Learning Objectives:

• Identify the ethical and clinical implications surrounding discharge planning from acute inpatient rehabilitation.
• Describe the key features of a large-scale quality improvement and implementation project within the clinical setting.
• Review the development of the proposed tool as a way to improve interdisciplinary team-based discussions in discharge planning meetings.