Acute Rehabilitation Earns Top 10 Percent Award

Last July Cephas Mubata, a medical physicist at Dixie Regional Medical Center, was driving in Nevada when a car accident left him with a spinal cord injury. He was flown to Las Vegas from the accident scene, and a month later to Salt Lake City to continue his recovery.

But when it came time for acute rehabilitation — re-learning the skills that would allow him to go home and function on his own — Mubata chose to come back to Dixie Regional.

It was a good decision. Not only was Mubata able to return to St. George with his wife and three children, he was able to receive some of the best care available anywhere in the country. Dixie Regional’s acute rehab unit was recently recognized by Uniform Data System as being in the top 10 percent of the 797 inpatient rehab facilities surveyed nationally. “That is significant. Huge. Amazing,” said Marla Shelby-Drabner, acute rehab manager at Dixie Regional.

Acute rehabilitation is an intensive, inpatient service that helps patients regain function and the ability to go home. The average length of stay is driven by diagnosis, but most patients stay between two to four weeks.

Acute rehab facilities that participated in the Uniform Data System survey were judged and scored using five criteria: overall patient improvement, improvement per patient, improvement per day, whether the patient was discharged to the community (as opposed to another care facility), and whether the patient had to be readmitted to the hospital.

Dr. Rusty Moore, medical director for acute rehab, says the secret to the unit’s success is a whole person approach. Acute rehab brings together many disciplines, including physical therapy, occupational therapy, nursing, social work, and speech therapy. At Dixie Regional, care is integrated.

“The team treats the whole patient,” said Dr. Moore. “We break down life tasks — showering, feeding yourself, walking —into the different pieces and then put them back together in a way that allows the patient to get back to normal movement patterns.”

Organizing care according to patient tasks, as opposed to caregiver tasks, is a unique approach. “In most places, care is broken up as nursing does this, physical therapy does this, occupational therapy does this,” said Shelby-Drabner. “Here, if a patient needs to go to the bathroom while working with the physical therapist, the physical therapist takes them rather than calling for a nurse or occupational therapist. Having the patient develop that skill is everyone’s goal because it is part of the patient’s overall plan.”

According to Shelby-Drabner, those care plans are coordinated using a book for each patient. “Everybody reads the book every day,” she said. “It tells the nurses and aids and therapists whether Mr. Jones needs to walk to dinner, or Mr. Smith needs help putting on a shirt, or who is at risk for falls.”

Coordination of care extends even past a patient’s stay in acute rehab. “One thing that they really helped with was the transition home,” said Mubata. “They met with my wife and me, discussed our fears and worries, and then coordinated with home care workers. They addressed every angle they could think of.”

That care has allowed Mubata to return home and to return to his job at Dixie Regional, where he helps care for cancer patients by calculating radiation doses and calibrating the machines, settings, and output for cancer treatments. Although his spinal injury still confines him to a wheelchair, Mubata continues to regain more and more use of his hands and arms. “Everything is turning out okay,” he reported happily.

“We do things here in a unique way. Our team has great chemistry and a great desire to do what is best for each individual patient,” said Dr. Moore. “I’ve often thought ‘Wouldn’t it be great if at some point somebody outside noticed?’”

And now somebody has.