Clinical Team

What professions might we see on a team?

• physiatry

• nursing

• physical therapy

• occupational therapy

• social work

• psychology

• neuropsychology

• recreation therapy

The team is the “cornerstone of ___________ and __________ which focuses on _________________”

physical medicine and rehabilitation; restoring patient capabilities

What is IDT?

the interdisciplinary team

Why choose an interdisciplinary team?

• Decisions made in a group > those made independently

• Cost effective and more productive

Origins of the rehabilitation team

Came about from people in WWII who were injured and needed help from different professions

What are the benefits of IDT?

LOWER

- length of stay

- costs

- mortality

HIGHER

- compliance (doing what they're supposed to do)

- px satisfaction

- job satisfaction (for professionals bc you have a team to rely on)

- safety

Physiatrist

• specialized doctor

• PM&R setting/specialty

• this person consults us for our services

• MD or DO (doctor of osteopathy)

• trained in coordinated care and collaboration with therapists

Nurse

• take vitals

• medication management

• charting/documentation

• there's training to be a rehab nurse

• - these px are generally medically stable, so imminent med issues may not be there

• reinforce all the therapy goals (ex: cue px to use their iPad, or to reinforce goals for swallowing tx)

• px will have the most interaction with them!

• there for safety too

• bowel and bladder schedule (w/ TBI/spinal cord px)

Social work/case manager

• coordinate care

• access resources with px

• in-tune with community organizations

• can also provide supportive therapy

Physical therapy

• gross muscle movements

• gait/ambulation

• wheelchairs and other adaptive equipment

• - prosthetics, devices used in the home

• - shower chairs, ramps

• DME (durable medical equipment)

• restorative therapy

Occupational therapy

• helps the px with ADLs

• - going to the bathroom, cooking, etc.

• fine movements

• balance, perception

• occupation is anything you choose to do

• with cooking:

• - SLPs may help with short-term/working memory functions

• - OTs help them with safety and the actions

What do SLPs and OTs do regarding AAC?

AAC

- SLP leads the charge in device selection, or whatever the output is going to be, phrases, icons, etc.

- OT helps patient access the device

--> use a stylus, set up the device

Neuropsychology

- family, educational history

- baseline IQ measures

- testing to see "Who was this person before their injury?"

- possibly provide supportive therapy to help couples/families communicate better or understand the diagnosis or prognosis

Recreation therapy

help patients do what they want to do!

can help out with paralympics

training people to have fun again and adapt new abilities to the recreational setting

What are other allied health professions we might work with?

respiratory therapist (trachs/speaking valves)

dietician - determines what food is in the diet based on the diet modification we've recommended

vocational rehab counselor - helps people with disabilities find professions/education

certified nurse assistant - can also help reinforce goals and oral hygiene

What is the medical model?

Hierarchy is...

1. physician

2. nurses

3. discharge planner

4. therapists

This is still widely used bc it's very efficient, but may not be the most beneficial for px with more complex complications

What is the multidisciplinary model?

px and family is in the middle

professionals on the team work independently with them

What is the interdisciplinary team?

px and family are in the middle

professionals on the team work with the px and family AND collaborate with one another

What is the transdisciplinary model?

px and family are in the middle

professionals on the team don't just work together, but one professional can step into another position (like SLPs would step in for OT)

...kinda controversial

What are some more take home points?

sometimes SLPs get overlooked...

we work on things that are invisible

BUT speak up and advocate for what we do!!!

show off our expertise in communication and cognition

We can help with so much and other people don't always know that!