Fact Sheet: Selecting a Rehabilitation Center for Spinal Cord Injury
The following are guidelines which may be helpful in evaluating rehabilitation facilities for the treatment of a new spinal cord injury (SCI). Whenever possible, it is advisable to visit any center that you are considering and ask to see the program in action.
Is the center CARF accredited for SCI? The Commission on Accreditation of Rehabilitation Facilities (CARF) offers several types of accreditation, so it is important to be specific. Accreditation for General Rehabilitation (or other non-SCI programs) is good, but does not indicate any special expertise in the care of SCI. A center that is accredited for spinal cord injury has met a series of standards that are considered important in the care of these patients.
The CARF requirements for SCI are listed below. If a center is not accredited, it may be helpful to ask which of these services are available.
CARF recommends a minimum of 30 new SCI admissions per year in order to maintain a viable SCI program.
How many SCI patients are currently in the hospital? In addition to the medical staff, patients benefit from interaction with other SCI patients. Is there a designated area (beds) within the nursing unit where SCI patients are assigned?
The rehabilitation team should consist of at least a rehabilitation nurse, physical therapist, occupational therapist, social worker, physician, respiratory therapist and recreational therapist. Each of these should have special training or experience with SCI because it is significantly different from other disabilities.
Does the physician who will be in charge of the rehabilitation program have special interest and competence in the care of SCI? Is there twenty- four hour physician coverage seven days per week?
Is there an organized program for urological examination (including Urodynamics) and bladder management? Is it under the direction of a Urologist (or other qualified physician) with special interest and competence in the care of SCI?
Is there access to a supply of specialized wheelchairs, cushions and other equipment which can be used for trial until individual needs can be determined?
Is there a formally organized program (with mandatory attendance) for education of the patient and family about the unique medical problems of SCI, including such things as:
Since most SCI's are young adults and SCI has a significant effect on sexual function, accurate information is essential.
Are specialists available for consultation (if needed) in specialities such as Neurosurgery, Orthopedics, Urology, Plastic Surgery, Internal Medicine, Pulmonary Medicine, General Surgery, and Pediatrics?
Is there immediate access to and safe transport to acute hospital services in the event of medical emergencies?
Is there an organized program to help patients adapt to activities outside the hospital? This includes supervised community excursions, and provisions for overnight therapeutic home visits prior to discharge.
The following services should be provided by the rehabilitation center staff or through consultation arrangements:
Is there an organized program for long term follow-up to maintain and/or improve health status after discharge? The SCI program should provide follow-up care for patients remaining in the geographical service area. A specific written plan should be provided for each patient on discharge.
Developed by: Shirley McCluer, MD, Medical Director, Arkansas Spinal Cord Commission. Date: March 1993.
Published by: Arkansas Spinal Cord Commission, 1501 North University, Suite 470, Little Rock, AR 72207. Phone: (501) 296-1788 (voice) / 296-1794 (tdd)