Disclosures: Joel P. Castellanos, MD: No financial relationships or conflicts of interest

Objective: To establish an inpatient PM&R consult service at an Academic Medical Center

Design: Quality Improvement Project Setting : An Academic Medical Center with Level 1 Trauma Center and Stroke Certification with 808 Beds Participants : N/A

Interventions: Approval and administration support was obtained for an inpatient PM&R consult service. After this, meetings with leadership from inpatient teams were set up to explain the role of the consult service. Along with this, meetings with the local acute rehab unit medical directors were also held to start to build a more cohesive local rehab network. Educational meetings were also set up with case management and therapies.

Main Outcome Measures: Previous to the initiation of this inpatient PM&R service, local acute inpatient rehabilitation unit clinical liasons would evaluate potential rehabilitation patients, and with the aid of their respective medical directors, and make decisions on whether to admit these patients. After discharge from acute care, regardless of discharge location, there was no outpatient PM&R follow up for these patients.

Results: A new focus on management of agitation, neurogenic bowel and bladder, spasticity, pain, and contracture and pressure ulcer prevention quickly made the consult service a well-received addition to the inpatient wards. Within three months of the initiation of the service, the average consult list averaged between 15-25 patients with approximately 3-4 new consults per day. Subjectively, patients appreciated a physician who was focused on their overall function and independence and would continue to follow them as an outpatient to address their rehabilitation needs. Conclusions: An inpatient PM&R consult service is sometimes wrongly viewed as simply a rehabilitation gate keeper. This project demonstrated the usefulness and success of an inpatient PM&R consult service at an academic institution that does not have an affiliated acute inpatient rehab unit by managing common problems in the rehabilitation patient populations and continuing to provide comprehensive rehabilitation care as an outpatient.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/starting-an-inpatient-pmr-consult-service-at-an-academic-institution-without-an-acute-inpatient-rehabilitation-unit/