Multidisciplinary rehabilitation team

Brown, W.J. Pharmacist participation on a multidisciplinary rehabilitation team. Am. J. Hosp. Pharm. 1994, 51, 91-92. 

The problem of LBP is selected to present important models that could be used by the entire multidisciplinary rehabilitation team for the measurement, modeling, and analysis of human performance [Kondraske, 1990], The inability to relate LBP to anatomic findings and the difficulties in quantifying pain have directed much effort toward quantification of spinal performance. The problem is made even more complex by the increasing demand of the healthcare system to quantify the level of impairment of patients reporting back pain without objective findings. 

The Multidisciplinary Approach. At one time, the company physician and occupational health nurse bore the primary responsibility for the health and safety of workers in their workplace. Although that physician-nurse team has expanded to include other disciplines, clinical services are stiU an important part of occupational health and safety programs. Some of the services provided by health care professionals include preemployment physicals, health assessments, and health surveillance through intermittent medical examinations and basic laboratory testing. Health education and counsehng usually falls to occupational health professionals, as do treatment, rehabilitation, and referral. 

Figure 2 Multidisciplinary plan of patient care in the ventilator rehabilitation unit at Temple University Hospital. Patients daily care is divided into four components medical, nursing, respiratoiy, and rehabilitative. All four groups deliver the care as indicated daily. Team members meet for discharge planning once a week and communicate with outpatient resources and the outpatient clinic staff. Source From Criner GJ. Respir Care Clin N Am 2002 8 580.

CAVC units include multidisciplinary teams and are led by a physician, preferably a respiratory or rehabilitation specialist with experience in LTMV. Nurses provide medications, airway care hygiene, and skin care. Respiratory therapists supervise all aspects of ventilation, in collaboration with the physician. Other team members, such as occupational and physical therapists, supervise exercise, mobility, and communication issues. Detailed descriptions of the multidisciplinaiy team are found elsewhere in this text. 

Rehabilitation hospitals admit VAIs who require therapy before reentering the community. They must be able to participate in three hours or more of physical therapy per day. Most admissions are from acute care hospitals (85%), and the mean length of stay is approximately 30 days. Many patients (20%) are discharged to a skilled nursing facility (SNF) (30). Patients participate actively, with minimum restrictions and maximum therapy by the multidisciplinary team that often includes physical, occupational, and respiratory therapist, prosthetist-orthotist, rehabilitation nurse, speech pathologist, psychologist, social worker, and vocational counselor (31). 

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