Kory Alesch with his Rehabilitation Day Program Team
Leonard Linn with his Rehabilitation Day Program team
Cate Squires with her Rehabilitation Day Program Team
Rehabilitation Day Program
The Rehabilitation Day Program (RDP) is a part of Madonna TherapyPlus outpatient programming at our Main Campus in Lincoln and at our Omaha location. RDP is an important piece of Madonna Rehabilitation Hospitals’ specialty programs, designed to assist children and adults with rehabilitation diagnoses such as brain injury, spinal cord injury, stroke and other orthopedic or neurological illnesses and injuries. It is an intensive, transdisciplinary approach to care. The focus of this coordinated rehabilitation program is to assist patients to achieve maximum function and develop or refine the skills necessary to resume life roles and full participation in what makes life meaningful.
The RDP program is licensed as a hospital-based outpatient program. The Lincoln RDP is accredited by CARF, the Rehabilitation Accreditation Commission and the Omaha RDP is accredited by JCAHO, the Joint Commission on Accreditation of Healthcare Organizations.
The care a patient receives in RDP is individualized and follows an transdisciplinary care plan, facilitated by an outpatient nurse. Most RDP referrals come from within Madonna's inpatient level of care. When this occurs, the outpatient nurse typically visits with the patient and family while he or she is still staying at Madonna to explain what to expect and answer any questions. When a referral is made from an outside hospital or provider, contact is made with the outpatient nurse to start the referral process. Once an order is received, patients are scheduled for their first day.
The first day in RDP is focused on therapy, nursing and social work assessment, as well as treatment planning. A family member or caregiver is required to be present on the first day to meet the team and give input on the goals, needs and scheduling preferences. The day starts with outpatient admissions where registration materials are verified and signed. Depending upon each patient’s specific needs and physician orders, the individual will meet with a registered nurse, physical therapist, occupational therapist, speech-language pathologist, therapeutic recreation specialist, neuropsychologist and social worker. These professionals will take physical tests and measurements and solicit input regarding those things that are most important to the patient and family member. Each session is 30 to 60 minutes long. If necessary, a rest break may be scheduled and a lunch will be scheduled over the noon hour. A locker will be provided to store personal items and schedules for the day. After the evaluations, the patient and family will have an idea of the main goals that will be worked on and will know approximate length of stay in RDP. Before the patient leaves, they will receive a schedule of appointments for the remainder of the week.
After the first day
Once the evaluations are completed, a schedule is determined based upon the individual patient's needs, insurance benefits and preferences of the patient and family. Throughout the day, patients are involved in both individual and group therapies, as necessary. Therapies generally occur in the gym area, Independence Square, Therapeutic Pool, ADL Suite and Kitchen, Vision Room or out in the community. School and college-aged patients may spend a few hours in the Therapeutic Learning Center doing classroom activities or school homework.
Recliner chairs are provided in the RDP lounge, should a rest period be necessary. During the lunch break, patients can buy lunch in the cafeteria or bring something from home. A refrigerator and microwave are available in the RDP lounge area. After lunch, therapy resumes. The outpatient nurse is available to perform skilled procedures such as intermittent catheterization, wound care, monitoring of blood pressure or lab work (Lincoln only) as ordered by a physician. The nurse is available to answer questions or provide education and will facilitate an appointment with one of Madonna's rehabilitation physicians during the patient’s stay.
Group therapies offer further practice of community and household skills, in addition to your individual treatments. You may be scheduled for one of the following groups:
• Independent Living Skills (ILS) – Your RDP team determines if this group is beneficial to your recovery plan.
• Cooking Group –Group members work together to plan, shop and prepare a meal.
• Community Outing Group –Group members plan and attend an outing for an allotted time frame.
• Speech Therapy Groups – Will assist with communication and processing skills.
• Information Processing – Compensation strategies learned in speech therapy are practiced in group activities.
• Executive Functioning – Skills for organizing thoughts and work. Creating and completing successful plans are practiced and discussed.
• Intense Aphasia Group – Emphasizes implementing strategies for language deficits
Continuing to Work At Home
It is not unusual for the therapists to ask patients to practice specific things at home during the evenings. This "homework" is very important for reinforcing new techniques learned in therapy. Feedback to the therapists regarding how the task went at home will also help guide future treatment.
Each week the RDP treatment team meets to discuss each patient's progress, plans and goals. One team member will be assigned as the patient's primary therapist. This person will review the initial care plan and is available for any questions regarding treatment. An initial care plan is written within the first week and is updated every other week. Updated care plans will be reviewed with the patient by either the social worker or primary therapist. Additionally, a family conference will be held prior to discharge from RDP.