dr jeffery saini_rehabilitation

8/10/2019 DR Jeffery Saini_Rehabilitation

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Dr. Saini Jeffery

Consultant Rehabilitation Physician

KPJ KL Rehabilitation Centre


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Origin of Quote?In Metaphysica


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Interpretations

Max Wertheimer - founder of Gestalt Theory

Team Dynamics in learning skills - synergy activity

Team models in Rehabilitation Medicine


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Rehabilitation

Process of helping a person to

reach the fullest physical, psychological, social,

vocational, avocational and educational

potential

consistent with his or her physiologic or

anatomical impairment, environmental

limitations, and desires and life plans


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Rehabilitation

Comprehensive

Patient-centred

Maximising outcomes with from limitations

Prevention and early recognition

Outpatient, inpatient and extended care programmes

Anticipated outcomes: increased independence, shortened

LOS, improved QOL


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Goal Oriented

Treatment plans are

generated from goals that

arise from problems list

developed during evaluation

Treatment plan is dynamic


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Rehabilitation Process

Multiple Health-Care Providers


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Potential for Chaos and Confusion?


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Team Communication

Comprehensive medical rehabilitation requires

interaction of various caregivers

Primary goal of interactions is communication of

patients needs and coordination of their efforts in a

synergistic manner

4 models of interactions will be discussed


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Medical Model

Physician attends to patient's

needs

If services of another

professional needed, general

or specific requests for

assistance are made

The caregiver would usuallydiscuss with referring doctor

regarding any additional

treatment identified before

proceeding


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Advantages & Disadvantages

Advantage:

clear chain of responsibility well- respected medico-legally

Disadvantages:

Multiple professionals performing multiple tasks whichmay be similar

Difficult for attending physician to coordinate resulting

in less efficient patient care


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Multi-disciplinary Team Model


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Advantages & Disadvantages

Efficient team conference with clear line of

authority and control

Still directed by attending physician

Obstacle to optimum use of other professionals'expertise, negating group synergism

Not patient-centred


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Interdisciplinary Team Model

Group decision making andgroup responsibility

Patient considered part ofplanning group and has acentral role in team'considerations

May be led by any team

member

Allow a freer exchange ofideas benefitting a groupsynergy concept


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Disadvantages

Less time efficient

Considerable training needed

Physician may be uncomfortable as he is the one

that must assume medico-legal responsibility

Difficulty in having physician complete the

appropriate prescription if the plan differs from what

the physician recalled or desired


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Transdisciplinary Team Model


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Transdiciplinary Team Model

More recent development

Encourages cross-treatment between disciplines

Justified on basis of economic market forces and inadequate

number of therapists

Consistency of information exchange with patient intrinsic to

cotreatment

? Future rehabilitation generalists

? Competency of therapists


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Most effective team model?

Lack of research

evidence

May be dependent on

practice environment

Combination of

models


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Conclusion

Comprehensive rehabilitation can be a complex task

Desired goals are not disease specific

Patient is expected to make transition from passive

observer to an active participatory role

Planning and facilitating all desired interventions can

be achieved best by multiple disciplines and then

sharing of knowledge must take place to ensure a

cohesive treatment plan is formulated


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Thank You

dr jeffery saini_rehabilitation

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