Chapter 26: Hospital and Pediatric Rehabilitation Services Flashcards
Acute Care (Acute rehabilitation)
Those wherein therapy services are ordered directly from a medical service or unit
Example: Intensive care neurology and neurosurgery, oncology or cancer care, general surgery, orthopedics, heart and pulmonary services, and, in many children’s hospitals, transplant services).
Pediatric Rehabilitation Services
Often located within a specific location of the hospital that may include special facilities with bedrooms and bathrooms to enable effective independence training with lifts, mobility devices, and other durable medical equipment
Spaces for individual and group intervention, socialization, and group engagements are often available as well
Outpatient Services
Include both regularly scheduled specialty clinics that address children and families ongoing needs, and individual child services in community-based satellite clinics or school-based programs.
American Medical Association’s Current Procedural Terminology (CPT) Codes & Healthcare Common Procedure Coding System (HCPCS)
his system uses preestablished rates of reimbursement for diagnostic groups using the Healthcare Common Procedure Coding System (HCPCS) for billing that is based on the American Medical Association’s Current Procedural Terminology (CPT) codes.
Payers do take these guidelines into consideration when authorizing care for inpatient stays.
The OT should be aware of payment limitations when providing care and clearly communicate with families when establishing treatment plans and scope of services being anticipated and provided.
Centers or Medicare and Medicaid Services (CMMS)
Designate requirements for services that are organized and paid to provide “medical rehabilitation.”
To meet CMS guidelines for rehabilitation, rules are placed on such systems that mandate specific program emphasis, dedicated space and personnel, admission and discharge procedures, service intensity, goal setting, and monitoring of progress toward goals.
Child life Specialists
Attend to children’s emotional and developmental needs. They may help reduce the stresses of a hospital stay by assisting families in coping with the hospital experience by providing information about play, child development, and adjustment to illness, disease, and disability.
Child Protective Services
OT’s are required to report any suspicion of abuse to designated personnel within the hospital setting, who, when appropriate, contact community support services such as law enforcement personnel
Children’s hospitals
Hospital-based services may include either or both inpatient and outpatient care for the ill and injured, as well as prevention or wellness programs designed to reduce the need for future care.
Hospitals in which pediatric patients are served generally fall into three categories: general hospitals, trauma centers, and children’s hospitals
Most rehabilitation programs also pursue voluntary accreditation by groups such as the
Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the Commission on Accreditation of Rehabilitation Facilities (CARF) as well as government agencies, such as the Occupational Safety and Health Administration (OSHA) that set standards regarding hospital operations.
Compensatory Techniques
In the rehabilitative approach, occupational therapists teach clients compensatory techniques that use existing skills to restore occupational performance.
Critical care units/ Intensive Care Units
Critically ill patients who require continuous monitoring and frequent medical attention and patients who often need special equipment to maintain or monitor vital functions are admitted to one of these
Neonatal intensive care units
Often in hospitals that offer labor and delivery services that include OT
Pediatric intensive care units
ICU for kids
Dependence
Book says this is negative soooo?
Levels of Independence
Describe varying degrees of dependence on personal assistance, adaptive environments, and the use of assistive technology (AT) device
Interdependence
Important consideration among family members when concerned with the integration of an individual back into his or her home
Interreliance
Term to express shared needs between family members may be termed
General acute care
Tend to be designated by medical specialty
Children of various ages, with different types of conditions and treatments, may be served in the same acute care unit.
Similarly, children requiring different types of surgery may be admitted to the same general surgical unit for preoperative and postoperative care.
Designating units in this manner generally enables physicians and other members of the medical team to use their patient-care time and equipment more efficiently.
General hospitals
Strive to serve the needs of the community in which they are located.
Given specific local populations, a wide variety of patients can be served in this type of hospital and this often includes the entire lifespan from infants to geriatrics.
OTs may serve both pediatric and adult patients.
Hospitals that offer labor and delivery services often have neonatal intensive care services that include OT services
Guided learning
OT uses instructional aids, such as visual supports, visual modeling, touch cues, or verbal instruction.
Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs)
have proliferated, and many families are now insured in these and other managed care plans.
Prospective payment options
created within Medicare to better estimate and contain costs, can have strong impacts on reimbursement for services. This system uses preestablished rates of reimbursement for diagnostic groups using the Healthcare Common Procedure Coding System (HCPCS) for billing that is based on the American Medical Association’s Current Procedural Terminology (CPT) codes.
Residential/Intensive day-treatment programs
Characterize another form of outpatient pediatric rehabilitation service.
These extended care programs focus on direct assistance with community reentry and participation.
Simulated or actual environments become the training site for skills that enable community participation and effective performance toward goals of independent living, education, and work activities.
Interdisciplinary
(also referred to as interprofessional) care within a hospital or medical system is common and mandated by most regulatory mechanisms.
Success depends on a shared mission focused on energy and creativity.
The team holds family conferences on admission, at key decision points during the hospitalization, and at discharge to ensure communication and clarification of care recommendations with the family and local care providers.
Also conducts weekly rounds to review the progress of each child and discuss any changes in treatment plans that are designed for each problem.
