Day treatment: Everything but an overnight stay
TBI patients can go home much earlier
At Children’s Hospital of Wisconsin in Milwaukee, children in the day treatment program arrive for breakfast, check into a patient room, and are cared for by the same staff that treated them as inpatients. They get three hours of therapy, some nursing care, and meals, but they go home at night.
The day treatment program allows Children’s Hospital to discharge the young brain injury patients when they are at a level 5 or 6 on the Rancho Los Amigos brain injury scale instead of at a much higher level, says Eileen Sherburne, RN, MSN, CRRN, rehabilitation clinical nurse.
"We recognize that the parents say the kids get better at home. It helps to get them back into their own routine. Teen-agers especially are eager to go home and be more independent," Sherburne says.
Children in the program arrive at 9 a.m., check into a room, and stay until 4 p.m. They bring their durable medical equipment and medications from home. A typical day is similar to that of an inpatient. Participants get their meals, some nursing care as needed, and three hours of therapy. They go to the school room if school is in session. They can nap in their rooms or just relax in between therapy sessions.
"The point is, if we can get them into the day program, they can go home from the hospital much earlier," Sherburne says. "We’re sending kids home earlier after their injuries. They’re medically stable and don’t need nursing care 24 hours a day, but they still need monitoring and help during the day."
Most of the program’s patients are children with cerebral palsy or traumatic brain injuries.
The hospital charges for the individual therapy sessions and the daily room rate for the hospital. There is no charge for nursing services or for medications and equipment, because the children bring them from home. Charges are $800 a day for the program, compared with $1,500 to $1,700 a day for inpatient rehab.
Care partners, cross-trained nursing assistants, provide the direct care for the day program patients. The hospital usually has three or four day patients at a time, explains Sherburne, who coordinates the day program. She communicates with the supervisor on the unit to make sure they are aware the child won’t be at the hospital in the evenings.
The length of stay in the day program depends on how quickly the child recovers, what intensity of therapy they need, how long the insurance will continue to cover it, and whether the parents need to service to be able to return to work.
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