Patient Care Overview
The University of Washington Traumatic Brain Injury Model System (UWTBIMS) is part of the Department of Rehabilitation Medicine. The UW Department of Rehabilitation Medicine has consistently received high rankings for rehabilitation care. In the most recent “US News and World Report” surveys, it received a #1 ranking for hospital-based rehabilitation programs. The facilities included in the UWTBIMS are Harborview Medical Center (HMC), and the University of Washington Medical Center (UWMC).
Many newly injured patients elect to stay on at either HMC or UWMC for inpatient rehabilitation. We have 49 certified rehabilitation beds contained within the two comprehensive rehabilitation units which are jointly accredited by the Commission on Accreditation of Rehabilitation Facilities as a single unit. Both rehabilitation units are fully equipped to provide services for persons with all levels of TBI. Effective rehabilitation care necessitates that inpatient and outpatient services be provided in a smooth, coordinated fashion. Planning for community reentry begins when the patient enters the health care system. Initial treatment is not confined to the acute medical and surgical management of TBI and its immediate consequences, but also provides care that helps the patient and family as they leave the hospital, establish outpatient medical care, and readjust to life within the community.
Inpatients with TBI have full and immediate access to state-of-the-art medical, diagnostic, and consultative services. The interdisciplinary team works together on patient-centered goals and meets in daily “huddles” and weekly with patients and families in problem-oriented team conferences. Educational venues for the individual with TBI and family include weekly conferences, Brain Injury manual, interactive computer resources, attendance at therapy sessions, or opportunities to observe modeling by team members especially during community outings and home visits. In addition, all of the patient rooms are “hard-wired” into the Internet and have wireless connections as well.
Progress toward the expected functional outcome is continuously assessed during rehabilitation, and the current inpatient and future outpatient treatment plans are adjusted towards the patient and family individual needs and make-up. The Rehab Nurse Care Manager develops a relationship with each patient prior to discharge and participates in the discharge process for each patient. Upon completing inpatient rehabilitation, remaining goals are addressed with outpatient services.
Rehabilitation Physiatrists: The physiatrists who manage patients with TBI at both institutions are Kathleen Bell, MD and Peter Esselman, MD, each with at least 20 years experience providing medical care to persons with TBI.
Rehabilitation Psychology: The Neuropsychology and Clinical Psychology division consists of 11 regular faculty, two post-doctoral fellows, and four part-time pre-doctoral interns. The psychologists provide diagnostic testing, supportive counseling for adjustment and other assessments to rule out psychiatric and substance use disorders.
Physical Therapy, Speech Therapy, and Occupational Therapy: Each site has designated PT, ST, and OT staff with clinical expertise in providing care for patients with TBI. The department has specialized services such for complex seating needs, assistive technology, augmentative communication and innovative gait training or upper limb training programs utilizing supported weight-bearing, functional electrical stimulation and activity-based therapy.
Social Work: There is social work staff dedicated to the rehabilitation units at each of the hospitals. The social worker role is primarily discharge planning as well as setting up outpatient care, home health care, chore workers, and contacts with other community agencies. Community agencies such as the Counseling and Referral Services for the Latino Community (CONSEJO), the Chinese Information and Service Center, the Seattle Indian Health Board are essential for the continued well-being of our patients from minority backgrounds.
Vocational Counseling: Comprehensive rehabilitation counseling services are available at both Harborview and the University of Washington Medical Centers and include counseling, vocational and educational assessment, referral and liaison with external agencies, case management, job placement, and assistance with maintaining employment. Services are provided by experienced professional rehabilitation counselors.
For a comprehensive listing of all services provided by the UW Department of Rehabilitation Medicine, including contact information, please visit the patient care section of the Department of Rehabilitation Medicine web site.