Schwab Rehabilitation Hospital and Care network

Patient carefive (5) residents per year are admitted to the physical medicine and Rehabilitation program for three (3) years of training (total of 15 residents each year). In 2022 we received over 600 applications for 5 positions. Schwab residents are recognized as graduating with the ability to Care for persons with a variety of disabling conditions, including stroke, spinal cord injury, traumatic and nontraumatic brain injury, complex medical conditions, as well as a broad range of other neuromuscular and musculoskeletal conditions. Residents take Care of patients across a spectrum of ages. In addition to disabling conditions, many of the patients at Schwab are affected (even premorbidly) by one or more social determinants of health. The residents learn how to integrate barriers presented by social detriments of health into a comprehensive treatment plan for their patients.many of the residents are accepted for sub-specialty fellowships to further hone their skills in management of specialty Rehabilitation conditions, including pain medicine, spinal cord injury medicine, brain injury medicine, and sports medicine.schwab residents are involved in Hospital committees, and quality and patient safety focused process improvement projects. Schwab's residency program was awarded the 2020 dewitt c. baldwin jr. award, presented by the acgme and the arnold p. gold foundation to recognize institutions with accredited residency/fellowship programs that are exemplary in fostering a respectful, supportive environment for medical education and the delivery of patient Care, which leads to the personal and professional development of learners. Out of 700 sponsoring institutions, Schwab was one of six institutions selected to be surveyed and interviewed for the award. Schwab was 1 of 3 winners. In 2021, the acgme and the gold foundation requested that Schwab present a seminar entitled fostering human is him in medical education for the annual meeting. Nursing Care is provided 24/7 by rns, lpns, & cnas. The staff are supervised and assisted by nurse managers and supervisors. 20% of eligible rn staff are certified in Rehabilitation nursing. Nurses complete comprehensive assessments upon admission and follow-up assessments on every shift. Basic Care includes medication administration, wound Care, safety assessment and fall prevention, bladder and bowel management, advocacy and patient education, and carryover of what is learned in the therapy arena onto the nursing unit. More complicated Care may include respiratory Care, tracheotomy Care, dialysis, tube feedings and iv therapy. The nursing department had several papers and posters selected in 2019 and 2020 for presentation at national conferences, such as the association of Rehabilitation nurses. Rehabilitation services staff members participate in research projects, team conferences, interdisciplinary Hospital committees, and attend meetings of various professional organizations. Several physiatrists and Hospital leaders serve on boards of local, state and national organizations. Therapists keep current with best practices by attending professional continuing education courses and by sharing knowledge via in-services to the department as well as to other disciplines. The therapy department has successfully started offering ceu programs, open to the public, which are very well attended and continue to show that Schwab therapists are reviewed as amongst the most competent treating patients with complex disabling conditions. Staff nurse engagement - staff nurses are engaged with nursing leadership through the professional practice council to continually improve the patient Care provided. Hourly rounding is conducted on every patient to assure that needs are being met, especially in areas such as pain control fall prevention, and toileting. Change of shift report is done at the bedside, in collaboration with the patient/family, when available, to promote safety, team work and collaborative goals setting. Informal interdisciplinary rounds are done by therapy, nursing and physicians daily, and formal team meetings are scheduled for each patient weekly with an interdisciplinary approach to the Care of the patient. The patient and family are invited to participate in their own goalsetting. The bedside medication verification (bmv) - bar code scanning on medication and patient wrist bands - continues to be used to assure that the right medication is administered to the right patient. This process has proven to substantially reduce common errors in medication administration and has been used at Schwab for over four (4) years. Nurses are encouraged to continue their education and attain specialty certifications. Additionally, our nurses participate in a self-directed, evidence based practice council and a clinical ladder program which encourages projects to direct standards of Care and positively impact patient outcomes on their units. Several of our nurses are also recipients of the daisy award, a national program recognizing the compassionate Care provided to patients.

Support servicessome points of interest and highlights regarding interventions/programsthat help to fill the gaps between what participants need and what isavailable to them in the community:1. Disability resource center - support, referrals, information, and advocacy2. Domestic violence program 24 hr hotlinte, support groups, referrals to resources, information, and advocacy3. Peer mentoring - positive role modeling and support by and for people with disabilities including sci, stroke, brain injury, & amputee.4. Living independently for tomorrow (lift) is a grant funded program which allows sci patients to stay up to two weeks in an independent apartment learning to live in the world of barriers. This has transitioned to an intensive outpatient experience.

Therapyphysical therapy focuses on gross motor movements: balance, coordination, strengthening, general mobility, and pain and gait dysfunction. Physical therapists utilize interventions such as therapeutic exercise, neuromuscular re-education, gait training, and manual therapy techniques, therapeutic modalities (various forms of heat, cold, hydrotherapy, electrical stimulation, and traction). Therapists also perform wheelchair evaluations, including customized seating, fitting, and positioning, and wheelchair management including propulsion and mobility training. Schwab has a successful outpatient wheelchair evaluation program which promotes independence, ensuring the patient has a mobility device with the appropriate components to optimize their functional independence both at home and in the community. Occupational therapy focuses on activities of daily living; such as dressing, bathing, grooming, cooking, cleaning, money management, as well as working on fine motor coordination, visual-spatial deficits and sensory integration deficits. Occupational therapists utilize interventions such as therapeutic exercise, neuromuscular re-education, energy conservation techniques, vision rehab, retraining in home management, activities of daily living skills, and cognitive skill development. Speech-language pathology focuses on evaluation and treatment of swallow function, speech and language deficits, including written and verbal communication, memory, problem solving, and social interaction. Speech-language pathologists use a variety of diagnostic techniques, including video fluoroscopic swallow studies to evaluate dysphagia (swallow disorders), and a number of evidence based assessment tools to evaluate language, cognition, and memory. These therapists then utilize techniques such as oral-facial-pharlaryngeal muscular re-education, compensatory techniques with modified diet consistencies, communication strategies, cognitive retraining, and memory techniques. Audiology services are provided on an outpatient basis. Schwab has one of the only wheelchair accessible audiology booths in all of chicagoland. The audiologist serves all age ranges from infant to geriatric adults. Audiology is available to our inpatients, should a sudden hearing loss occur related to a new medical condition, otherwise patients are scheduled for visits following discharge from the Hospital. Psychology services focus on patients adjusting to living with a disability; concentrating on loss, anxiety, depression, pain management with biofeedback, role definition, and patient and family coping. In addition, they assist patients with encouragement to participate in their overall plan of care.schwab has a robust therapeutic recreation program that assist patients and families in identifying avocational activities including creative arts, relaxation strategies, games (including videogames) to ensure that patient's remember there is joy to be had in their new life. Recreation therapy also organizes outings for our inpatients to help promote confidence, build independence, and facilitate community reintegration. These trips are local and throughout the chicagoland and lower Wisconsin area. They include opportunities to use public transportation, navigation through parks, and various public places as well as outdoor sports; including canoeing, skiing, and hand cycling for those with disabilities. Schwab has a pet therapy program that is well received by patients. All therapists continually educate patients and families and make recommendations regarding discharge disposition, assistance required at home, and recommendations for next level of services required. Additional multi-disciplinary interventions include group therapy, individualized home visits, and community reintegration outings. This all helps achieve our high rate of return to home for most of our patients (85%) despite the many negative social determents they live with and face daily. Therapy services have a robust and well-respected clinical education program that has affiliations with training programs in physical therapy, occupational therapy, and communications disorder programs across all of chicagoland, as well as with numerous out-of-state programs. Dozens of students come to Schwab each year to complete the final stages of their graduate level clinical internship, supported by clinical instructors among Schwab staff therapists, and prepare for employment as entry-level clinicians.therapists hold a variety of specialty skills and certifications. Specializations held among our staff includes: apta neurological, pediatric, and orthopedic clinical specialists, vestibular, aquatic, and womens health specialists, ndt and mckenzie-trained therapists, vital stimcertifications, lee silverman voice (lsvt), and many other specialties.