Medical Complexity and Unplanned Hospitalizations
ReMed serves individuals with a variety of medically complex needs, and provides strong physician and nursing support to address those needs. In 2013, three diagnostic categories were identified as reasons for the majority of unplanned hospital admissions; these were Urinary Tract Infections, Upper Respiratory Infections/Pneumonia; and Cellulites. In 2014, the Nursing Committee developed and with the review and approval of the Medical Directors, implemented “Early Intervention Protocols” for each client who had recurrent issues/hospitalizations precipitated by these three diagnoses. These protocols included increased hydration schedules, use of pulmonary vests, frequent monitoring of vital signs and pulse ox levels, monitoring skin status and prevention measures and identifying the parameters which would indicate the need to start early intervention antibiotic protocols. The goal of the early intervention protocols is to avoid hospitalizations and minimize Emergency Department utilization.
In 2018, Early Intervention Protocols were utilized in 74 episodes of care, with only 6 of these requiring further treatment in a hospital setting. Similarly, our neurobehavioral team has expertise in the management of complex behavioral issues including aggression, co-occurring mental health issues or addiction. As a result of these protocols, client programming remains uninterrupted, deconditioning and other hospital related complications are avoided and overall adverse impact on the client, the family/support system, and the funder is minimized.
ReMed is committed to advancing the field of brain injury rehabilitation. Many of ReMed’s clinicians serve on national committees and boards to help develop and promote best practices. ReMed partners with experts and participates in research opportunities, and has been a primary driver in the development of a National Outcomes Database using the MPAI-4 as the benchmark outcomes measurement tool.
ReMed has been involved in two recent and important research projects related to outcomes in Post Acute Brain Injury Rehabilitation.
“Post Inpatient Brain Injury Rehab Outcomes: Report from the National OutcomeInfo Database” (Click here for article)
"Progress Assessed With the Mayo-Portland Adaptability Inventory in 604 Participants in 4 Types of Post–Inpatient Rehabilitation Brain Injury Programs" (Click here for article)