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Adult rehabilitation consult service created

Oct. 10, 2013, 8:51 AM

The Department of Physical Medicine and Rehabilitation (PM&R) has started an adult inpatient consultation service to evaluate patients who may need rehabilitation and assist with the transition from inpatient care to post-acute rehabilitation facilities.

The adult service, begun in September, is led by Juan Cabrera, M.D., assistant professor of PM&R, who also takes the role of medical director for Vanderbilt University Hospital Inpatient Rehabilitation Services.

Juan Cabrera, M.D.

“The ultimate goal is getting patients where they need to be at the most appropriate time,” Cabrera said. “That means rounding on the patient, consulting with their other providers, knowing their needs personally and communicating well with all members of the treatment team.”

The service will start primarily with trauma patients, given the high volume of patients requiring post-acute rehabilitation, and then build to other inpatient services at VUH as needed. Eventually, PM&R residents will also be included as part of the required clinical experiences training.

“The service will educate current providers and service lines about PM&R and how it can be incorporated early in a patient’s hospital course. As a consequence, we anticipate that it will help facilitate patient flow and decrease length of stay, which benefits the patients and hospital,” Cabrera said.

Ideally, a PM&R consult should be requested within the first few days of a patient’s hospitalization.

“It’s most beneficial to be part of their care from the beginning. It might be difficult to predict disposition recommendations at that point, but recommendations can be made for various issues that will have an impact on making that patient ready for their discharge disposition, whether that be inpatient rehabilitation, skilled nursing facility, home or other long-term care facilities,” said Cabrera.

Cabrera emphasized the efficiency the consult service brings.

“The assumption is that patients have to be ready to leave the hospital before rehabilitation is consulted. But if we can get involved early and get to know the patient and their needs, we can facilitate the transfer sooner and with less anxiety for all involved,” he said.

Providers can now make a referral to the PM&R inpatient consultation service through Wiz orders, or can contact Cabrera directly with any questions.

“This is an important step as we continue to work on strengthening rehabilitation services across VUMC,” said Walter Frontera, M.D., Ph.D., chair of the Department of PM&R.

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