Stroke Inpatient Rehabilitation Team Conferences: Leadership and Structure Improve Patient Outcomes.

Consensus on how rehabilitation teamwork and services are optimally coordinated continues to be a work in progress. One area of recent research has been inpatient-rehabilitation team conferences in stroke. The prevalence of Americans living with stroke is expected to gradually increase as the U.

Toward spanning the quality chasm: an examination of team functioning measures.

Objective: To examine the effect of 5 measures of team functioning on patient outcomes.

Design: Observational, exploratory, measurement. Team functioning surveys and patient outcomes collected 1 year apart in a clinical trial were analyzed.

Analytical review: focus on fall screening assessments.

Background: Falls and their associated injuries profoundly impact health outcomes, functional independence, and health care expenses, particularly for the ever-increasing elderly population. This systematic search and review assessed the current evidence for the role of fall screening assessments.

Objective: To review the current evidence for fall risk screening assessments in community-dwelling (outpatient), inpatient medical and surgical wards, inpatient rehabilitation centers, and postrehabilitation outpatient settings.

Polypharmacy and the role of physical medicine and rehabilitation.

Polypharmacy and inappropriate prescribing practices lead to higher rates of mortality and morbidity, particularly in vulnerable populations, such as the elderly and those with complex medical conditions. Physical medicine and physiatrists face particular challenges given the array of symptoms treated across a spectrum of conditions. This clinical review focuses on polypharmacy and the associated issue of potentially inappropriate prescribing.

Measuring team process for quality improvement.

Background: Even though team care is pivotal to stroke rehabilitation, we have few tools to measure team process. Process measures of team functioning would benefit stroke rehabilitation outcomes and quality improvement (QI).

Objective: To improve measures of team process and evaluate their potential for use in rehabilitation research and QI.

Utility of Treatment Implementation methods in clinical trial with rehabilitation teams.

Clinical trials of rehabilitation interventions pose unique challenges to researchers. Treatments can be technically complex, often requiring a multidisciplinary team of professions. This article demonstrates the application of Treatment Implementation (TI) methods in a rehabilitation team-training intervention conducted with 29 team leaders (12 medical doctors, 4 physical therapists, 3 speech-language pathologists, 2 occupational therapists, 3 kinesiotherapists, 2 registered nurses, 1 social worker, 1 program coordinator, and 1 administrator) from 15 Department of Veterans Affairs hospitals.

The interdisciplinary team and polytrauma rehabilitation: prescription for partnership.

Optimal outcomes for polytrauma survivors depend on the integration of complex medical, psychosocial, financial, educational, and vocational resources across diverse specialties and multiple medical centers, programs, and organizations and all in a setting of high public visibility and family involvement. Well-functioning teams are critical to service integration, and teams are more effective in supportive hospital environments. Here, we offer a model of team functioning relevant to polytrauma and outline a team training program to improve services.

Team training and stroke rehabilitation outcomes: a cluster randomized trial.

Objective: To test whether a team training intervention in stroke rehabilitation is associated with improved patient outcomes.

Design: A cluster randomized trial of 31 rehabilitation units comparing stroke outcomes between intervention and control groups.

Setting: Thirty-one Veterans Affairs medical centers.

Team functioning and patient outcomes in stroke rehabilitation.

Objective: To evaluate the relationship between rehabilitation team functioning and stroke patient outcomes.

Design: Prospective observational study.

Setting: Veterans Administration (VA) inpatient and subacute rehabilitation units.

Patient-focused rehabilitation team cohesiveness in veterans administration hospitals.

Objective: To quantify the relation of hospital culture, 3 levels of leadership (hospital-level administrators, discipline-specific supervisors, attending physician on the team), and physician involvement to patient-focused rehabilitation team cohesiveness.

Design: Survey research.

Setting: 48 Veterans Administration hospitals (VAHs).

Geriatrics and physical medicine and rehabilitation: common principles, complementary approaches, and 21st century demographics.

The demographic changes occurring in the United States transcend the capabilities of any specific medical specialty to provide optimum care for the elderly. This commentary discusses a statement of principles drafted by representatives of the American Academy of Physical Medicine and Rehabilitation who collaborated with members of 9 other medical and surgical specialties. In this commentary, we argue that geriatrics and physical medicine and rehabilitation (PM&R) share common principles and complementary approaches.

The influence of hospital culture on rehabilitation team functioning in VA hospitals.

A conceptual model of rehabilitation effectiveness, in which team functioning is influenced by hospital culture, has been previously suggested by several authors of this study. The current study tested the efficacy of the hospital culture portion of the model using survey data from 523 rehabilitation team members and 162 administrators from 50 participating Veterans Administration Hospitals (VAHs). We assessed four types of hospital culture (personal, dynamic, formal, and production-oriented) using an instrument developed originally for a Competing Values Model.