Masterclass: Life of a Rehabilitation Physio

Question 1

Outline the roles of members in a multidisciplinary team

Answer 1

Medical Doctor:
- Oversees medical care, prescribes medication and monitors medical status. Consulted for overall medical decisions and progress assessments

Occupational therapist (OT):
- Assesses and modifies activities of daily living (ADLs), focuses on upper limb rehabilitation and performs home assessments

Social Worker:
- Supports discharge planning, arranges community services (e.g. Meals on Wheels), and provides emotional support. Also coordinates guardianship if needed

Rehabilitation Consultant:
- Specialist doctor who assesses rehabilitation potential and oversees the rehabilitation plan

Nurse:
- Manages daily needs (medication, toileting), provides patient monitoring, and ensures care coordination

Speech Pathologist:
- Works on communication strategies, manages dysphagia with tailored diets and ensures safe swallowing practices

Dietician:
- Evaluates and ensures nutrititional status, prescribes appropriate diets, and supports energy levels for rehabilitation

Discharge Coordinator:
- Organises and plans for patient discharge, coordinating with all team members to ensure a smooth transition

Question 2

Outline when each is required and what information you would get from each in the context of a case
a. MD, OT, Social worker, rehabilitation consultant, Nurse, speech pathologist, dietician, D/C coordinator

Answer 2

Medical Doctor: consulted for medical stability and acute issues. Provides details on medications, lab results and imaging findings

OT: required when patients need help with self-care tasks. Provides assessments on ADLs and equipment recommendations

Social Worker: needed if there are psychosocial concerns or complex discharge plans. Offers insights into patient support networks

Rehabilitation Consultant: engaged when planning or reassessing the rehab journey. Delivers expert advice on the potential and limitations of rehabilitation

Nurse: engaged daily for patient care and monitoring. Provides updates on daily activities and physical/medical status

Speech pathologist: Needed when communication or swallowing difficulties are present. Delivers detailed assessments and intervention plans.

Dietician: engaged if there are nutritional concerns. Provides an analysis of dietary needs and energy levels

Discharge Coordinator:
- Involved in planning the discharge and arranging follow up care. Supplies timelines and service recommendations

Question 3

Identify when a patient is not suitable to be transferred from an acute ward to rehabilitation.

Answer 3

A patient is unsuitable for transfer if they are medically unstable (e.g. ongoing infections, unmonitored seizures, or uncontrolled heart failure), have unresolved acute medical issues, or are unable to participate in rehab due to severe cognitive or behavioural limitations

10-point admission criteria

Question 4

Prioritise patients and when you would see them during the day based on a case or brief case descriptions

Answer 4

Priority 1 (Immediate) - significant safety concern (e.g. deteriorating with resp concern)

Priority 2 (2 x per day) - Really need rehab to get back to baseline. Risk of decline or falls.

Priority 3 (1 x day) - those able to do things independently, or maybe an MS patient who fatigues quickly.

Priority 4 (2-3x per week) - general check up to get them moving

Priority 5 (not for Rx)

Question 5

Identify tasks that can be delegated to allied health assistants.

Answer 5

Tasks include basic exercises, monitoring vital signs during sessions, assisting with ADLs, setting up equipment, or supervising mobility tasks already assessed as safe

Question 6

Set physiotherapy related discharge goals, considerations to timeframes and destination based on a case.

Answer 6

Setting goals: establish goals related to functional independence (e.g. stair navigation or walking safely with aids)

Timeframes: consider the patient’s rehab progress and realistic timelines

Destination: Adapt the goals depending on whether the patient is going home or to a care facility. Ensure family involvement and proper equipment setup

“What does this patient need to physically be able to do to get home safely?”

Question 7

Describe when COMPACKS would be used in the context of a case.

Answer 7

Patient needs low level community support after D/C. Includes assistance with personal care, domestic assistance, transport and social support…

Question 8

Describe when transition care would be used in the context of a case.

Answer 8

Short-term specialised care and support to help regain functional independence after a hospital stay. For high care needs Short stay in an aged care home where 24/7 care and support is available may be the best place to recover. ACAT Assessment

Question 9

Describe when the Commonwealth Home support Program, would be used in the context of a case.

Answer 9

For older people
ACAT (aged care assessment team) assessment required to determine eligibility
Includes help with housework, personal care, meals and food preparation, transport, shopping, allied health, social support and planned respite

Question 10

Describe when Homecare packages, would be used in the context of a case.

Answer 10

Are designed for those with more complex care needs that go beyond what the Commonwealth Home Support Programme.

Question 11

Describe when NDIS would be used in the context of a case.

Answer 11

For people under 65 with significant disabilities requiring individualised support plans