Homehabilitation - development of a new pathway for management of slow to recover children in an inpatient rehabilitation ward.

Abstract

Purpose: Paediatric rehabilitation patients who are slow to recover present a unique challenge to support in an intensive rehabilitation setting. Traditional intensive, goal-directed rehabilitation models of care that focus on recovery do not cater for the complex presentations and poorer functional outcomes associated with catastrophic injuries in a paediatric population.

Materials and methods: A group of 24 experts from a paediatric rehabilitation setting have developed a series of consensus statements through a modified Delphi process. The primary purpose was to develop and describe a new expert consensus based model of service delivery (Homehabilitation) that supports children requiring a slower stream approach to rehabilitation in an inpatient setting.

Results: This paper provides two options for children to be supported through either an; i) intensive goal-directed model of rehabilitation or ii) a slower approach that focuses on optimising goals of comfort, participation and ease of caregiving whilst supporting a timely, safe and sustainable discharge home.

Conclusions: Developing a well-defined, slow stream model of care that focuses on optimising the patient's comfort, maximising remaining skills and providing family education will help assist children who are slow to progress. This approach provides families with a more structured and supportive discharge process.