Making a decision about health care for you or a loved one is never easy and because physical rehabilitation is so specialized, your decision can be even more confusing. Below are some questions you should ask when searching for a rehabilitation facility or program.
- Does the facility specialize in physical rehabilitation?
Facilities completely dedicated to physical medicine and rehabilitation devote all their time, energy and fiscal resources to the rehabilitation process. Their equipment and facilities are designed and staff members chosen to help patients focus their efforts and reach their goals. Ask your prospective rehabilitation facility if their building has been converted from another use and find out if physical rehabilitation is their primary focus of care.
- Does the program provide experienced teams specializing in treatment of specific diagnoses?
Having specialized teams that treat patients with specific diagnoses such as stroke, spinal cord, brain or orthopedic injuries means that patients benefit from a higher level of knowledge and expertise. Find out which therapists and specialties comprise the treatment team, their training, and if the team is lead by a physician with specialized training or experience in your diagnosis.
- Is there adequate staff to provide an intensive physical rehabilitation program?
In an intensive program, the patient will participate in three to six hours of therapy and other structured activities per day. Such lengthy and specialized treatment requires adequate staff to work with each patient in depth, so find out about the therapist/patient and nurse/patient ratios.
- Can families observe treatment and are there established visiting hours/family visitations?
In the rehabilitation setting, family support is crucial. Families should be encouraged to become actively involved in therapy and should be trained on how to help the patient upon their return home. Formal visiting hours may be limited to evening and weekends due to the structured daytime schedule of activities, meals, rest and therapy. Discuss visiting hours and family involvement with your facility and choose an environment that supports your family's needs and desires to support the patient.
- Does the program have a good success rate in returning individuals to their home, work, or school?
A major goal of physical rehabilitation is to help patients return to productive, independent living. Ideally the facility you choose will offer a full continuum of care that includes educating the family, providing vocational training for the patient, and assisting patients with adjusting to the challenges day to day life. In addition, facilities should provide you with information about the percentage of their patients who return home following care versus those discharged to another facility. Generally, those with higher discharge home rates are more successful in rehabilitation.
- Is the program lead by physicians specializing in physical medicine and rehabilitation?
Your doctor in a rehabilitation program should be a physiatrist who specializes in physical medicine and rehabilitation who is based in or supported by a hospital. Like any other medical specialty, physical medicine and rehabilitation requires expert knowledge that only comes with specialized education, training, and experience.
- Are there arrangements for specialized medical support in the event of a new illness or major medical complication?
Facilities should have a large and active medical consulting staff with all specialties represented in the event of new illnesses or complications and should be located close to an acute care hospital in case emergency transfers or more standard medical procedures are required.
- Does the facility have a variety of rehabilitation programs that patients can ‘graduate through' as they progress?
Effective rehabilitation is based upon progressive skills development, ultimately leading to patient independence. The ability to match each level of the patient's progress with an appropriate program means that the location, team, and facility stay consistent throughout the rehabilitation process. Facilities should offer inpatient, outpatient, day hospital, and subacute programs to accommodate each level of the patient's progression.
- Does the facility have special accreditation to operate?
Physical rehabilitation facilities may be accredited by two nationally known and industry recognized bodies, the Commission on Accreditation of Rehabilitation Facilities (CARF) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
Both are independent organizations that accredit facilities and serve as quality control in the hospital and rehabilitation industries by sending trained teams to survey and evaluate facilities' programs against national standards of excellence. The best facilities are accredited by both CARF and JCAHO.