Social work and case management treatment time during inpatient spinal cord injury rehabilitation

Abstract

Background: There is a lack of published evidence regarding the amount and type of social work and case management (SW/CM) services that an individual with traumatic spinal cord injury (SCI) receives during acute inpatient rehabilitation. Such information is needed to assist in resource planning, benchmarking, and research on interventions and outcomes. Methods: As part of the SCIRehab study social workers and case managers at six inpatient rehabilitation facilities documented details (including time spent) about the interventions provided to 600 patients with traumatic SCI during acute inpatient rehabilitation. Associations between patient and injury characteristics and time spent on these activities were examined. Results: Patients received a mean total of 10 hours of SW/CM services, with a mean of 72.8 total minutes per week. The majority of the patients received SW/CM time spent on interdisciplinary conferencing on the patient's behalf (96%), discharge planning and services (89%), financial planning (67%), community/inhouse services (66%), supportive counseling (56%), and initial assessment (54%). A minority of the patients received peer advocacy (12%), classes (24%), and education topics (30%). Total hours per stay and minutes per week varied by level of injury group. The most time per week was dedicated to patients with high tetraplegia ASIA Impairment Scale (AIS) A-C and the least to patients with C5-C8 AIS A-C. The patient and injury characteristics studied did not explain the variance seen in time spent on specific SW/CM services. Conclusions: These descriptive data may be helpful in resource planning to anticipate and address individual patient needs and to plan for department-level training and hiring. These data also may pave the way to studying relationships of interventions with patient outcomes.

Inpatient treatment time across disciplines in spinal cord injury rehabilitation

“…51,52 All independent variables were checked for colinearity, and if any pair was highly correlated (r > 0.75), only one of the pair was allowed to enter the models. The discipline-specific articles that follow in this series describe the intensity of specific activities/interventions provided by each treating discipline; [28][29][30][31][32][33][34] this article only addresses time for all therapeutic activities combined.…”

Relationship of patient characteristics and rehabilitation services to outcomes following spinal cord injury: The SCIRehab Project

“…An earlier set of papers in this journal reported on the predictors of therapy hours by discipline 6 and hours of major therapy type within each discipline. [18][19][20][21][22][23][24] Rehabilitation outcomes are multi-determined, and the nature and quantity of therapies may have a limited role in shaping outcomes. An extensive literature has explored the relationship of various outcomes, especially functional status, to level and completeness of injury, 25 gender, 26 age, 27,28 race/ethnic group, 29 and co-morbidities.…”

The SCIRehab project: analyzing multidisciplinary inpatient spinal cord injury rehabilitation treatment — second phase

“…The following series of manuscripts offer an overview of the multidisciplinary SCI rehabilitation process 11 and a detailed analysis of treatments provided by physical therapy, 12 occupational therapy, 13 therapeutic recreation, 14 speech language pathology, 15 psychology, 16 nursing, 17 and social work/case management. 18 The data presented cover interventions received by the 600 patients enrolled during the first year of the SCIRehab Project at six collaborating SCI rehabilitation facilities led by Craig Hospital, Englewood, CO and including Carolinas Rehabilitation, Charlotte, NC; The Mount Sinai Medical Center, New York, NY; National Rehabilitation Hospital, Washington, DC; Rehabilitation Institute of Chicago, Chicago, IL; and Shepherd Center, Atlanta, GA. A total of 141 938 treatment sessions are included in the 107 804 hours of therapy and education analyzed in this series of articles. Tables report the amount of inpatient rehabilitation treatment time provided to patients with SCI and to four subgroups based on level and completeness of injury, by each discipline overall and for 87 specific activities defining the work of the seven disciplines.…”