How to Choose a Rehabilitation Program

Rehabilitation is a complex process with many factors that contribute to its success. Choosing a rehabilitation program that best suits your needs is the first step in reaching your goals. The following questions provide guidelines for making this choice. Accompanying each question is information about what the rehabilitation process is like in a Rehabilitation Institute of Chicago (RIC) program. This way, after you have reviewed this section, you will know more about what to look for in a program and whether RIC might be the right place for your recovery.

1. Does the program specialize in rehabilitation?

2. Does the program provide a continuum of care?

3. Is the program team experienced in your condition?

4. Is the program led by rehabilitation specialists?

5. Has the program demonstrated success in treating your condition?

6. Does the program provide a wide range of services?

7. Are family members involved in the program?

8. How successful is the program in returning patients home?

9. Does the program have medical support?

10. Are there staff technicians who customize equipment?

11. Are research and education components of the program?

12. Is the program a disabled rights advocate?

13. Is the program accredited?

1. Does the program specialize in rehabilitation?

When programs specialize in rehabilitation, everything, from the environment to the training of the personnel, is designed to meet the needs of patients with disabilities and their families. Nurses, for example, are trained rehabilitation nurses. They understand patients' needs during rehabilitation, such as nutritional needs, bowel and bladder function, skin care and sleeping habits, as well as the psychological recovery course of patients.

RIC was established in 1954 with the mission of providing excellent, comprehensive rehabilitation services to the physically disabled. Everything about RIC -- its people, facilities and programs -- is focused exclusively on rehabilitation for people with disabilities.

RIC is recognized as a leader in rehabilitation care. U.S. News and World Report's annual survey of rehabilitation specialists has repeatedly rated RIC as the country's top rehabilitation hospital. We are a member of Northwestern University's McGaw Medical Center, and with Northwestern Memorial Hospital form the federally-designated Midwest Regional Spinal Cord Injury Care System. RIC's Center for Stroke Rehabilitation is designated as a Rehabilitation Research and Training Center by the National Institute on Disability and Rehabilitation Research, U.S. Department of Education.

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2. Does the program provide a continuum of care?

Throughout the duration of recovery, patients' rehabilitation needs change. A strong rehabilitation program will offer a continuum of services to ensure that patients are in the right place for treatment and receive the appropriate degree of care.

In its ongoing mission to reach out to those it serves, RIC has opened additional treatment locations and created partnerships with acute care hospitals to bring first-class rehabilitation care closer to those who need it. Our founding facility, located in downtown Chicago, serves as the Flagship Hospital with 165 beds. Today, RIC has reached further and now functions as a system of care with locations throughout Chicago and the Midwest. We offer the full spectrum of rehabilitation services -- from inpatient hospitalization to outpatient therapy appointments -- so that people needing rehabilitation can receive RIC quality care in a setting that is convenient for them.

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3. Is the program team experienced in treating your condition?

Staff who have many years of experience specializing in particular conditions -- such as stroke or spinal cord injury -- can provide a higher level of expertise than clinicians who treat a variety of patients. Specialized staff may also use more innovative treatment techniques and be more sensitive to the needs of patients and their families. The benefit for the patient can be a stronger and speedier recovery.

In addition, programs that specialize in particular disabilities are able to offer patients the opportunity to interact with others who have similar disabilities. This peer support can take place through formal means, such as in groups, as well as informally, such as through an information grapevine among patients or the trading of resources. There are also notable therapeutic benefits in seeing others improve.

Since its inception, RIC has treated more patients across all diagnostic groups than any other rehabilitation hospital -- resulting in a staff which has gained specialized experience across the entire range of rehabilitation care. People come from all over the world to work at RIC and comprise the extraordinary staff who are dedicated to helping patients rebuild their bodies and their lives. Our staff includes board-certified physiatrists (rehabilitation physicians), rehabilitation nurses, physical and occupational therapists, speech/language pathologists, psychologists, chaplains, social workers, rehabilitation engineers, therapeutic recreation specialists, vocational therapists and respiratory specialists. Staff at our inpatient locations are supported by consulting physicians from all specialties who are available when necessary.

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4. Is the program led by physicians who specialize in physical medicine and rehabilitation, and are they board-certified?

Patients with a disabling illness or injury will benefit most if their care is led by a physiatrist -- a doctor who specializes in physical medicine and rehabilitation. Quality rehabilitation programs require their physiatrists to be certified by the American Board of Physical Medicine and Rehabilitation.

RIC's full-time attending physicians are employees of the Institute and practice solely at our facilities. All of our physicians are board-certified, most in Physical Medicine and Rehabilitation, and we employ board-certified attending physicians in Pediatrics, Neurology, Rheumatology and Internal Medicine. These doctors are supported by consulting physicians in other specialties who are available as needed. In addition, RIC houses one of the country's largest medical residency programs for Physical Medicine and Rehabilitation.

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5. Has the program demonstrated success in treating your specific condition?

Successful rehabilitation programs set goals and measure performance using both feedback and objective standards like:

1. How many patients maintain improvement after hospitalization
2. How many patients go back to their communities or go home
3. What the rate of rehospitalization is
4. How many people go back to work.

Goals and progress should be well organized, standardized and readily available to patients and their families.

RIC was one of the first rehabilitation facilities to begin gathering significant data on its patients. Today, our Outcomes Management professionals gather and analyze objective performance standards and patient feedback and work with our medical and clinical teams to utilize the data in our programs.

In addition, the Outcomes Management team has developed a well known measurement tool, the RIC-Functional Assessment Scale (RIC-FAS). Our clinicians use the scale to assess the areas of care that are addressed in comprehensive rehabilitation -- a patient's ability to transfer from a wheelchair to a sofa, to understand a conversation, to speak or use another means for communication. RIC-FAS helps to establish a patient's goals, and then measures the team's progress in meeting them. It is such an effective tool that it has been adopted for use by other rehabilitation facilities all over the country.

At RIC, we take patient feedback seriously. Outcomes Management staff conduct formal patient satisfaction surveys that solicit and document reactions to RIC care, making the staff at RIC accountable for taking action if there are problems. Patients have provided us with so much information that we were able to use their feedback in the renovation of our downtown Chicago hospital.

To learn more about our quality outcomes visit the Defining Quality section of this Web site.

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6. Does the program provide a wide range of rehabilitation services?

A comprehensive rehabilitation program will address not only the physical but the emotional, psychological, social, spiritual, vocational and geographic needs of its patients and families. Since all patients' needs are different, services should be plentiful and diverse. That way patients can have access to the services that are best suited to their recovery.

RIC was founded with the mission of providing excellent comprehensive rehabilitation care, helping people affected by disability pursue healthy and fulfilling lives. Our services span across all levels of rehabilitation care, and our staff is a team of professionals, each trained in a discipline that allows them to make major contributions to the lives of individuals with disabilities.

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7. Does the staff understand family concerns?

The need for rehabilitation affects the lives of a patient's entire family. A good rehabilitation program, therefore, will make family members partners in the recovery process. Family education, counseling, discharge planning services and opportunities to take part in treatment are essential elements of a strong program.

At RIC, we understand that family participation plays a powerful part in recovery. That's why the foundation for all of our programs are patient and family education, and support services.

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8. How successful is the rehabilitation center in returning patients home?

The goal of excellent rehabilitation is to help people regain function and lead as independent and fulfilling lives as possible. For many people this means going home. Any program's success in returning patients home is affected by the types of disabilities it treats, the severity and complexity of its patients' conditions, in addition to its therapeutic effectiveness.

Beyond this, however, is the issue of how a program discharges its patients. The family should be made part of the team so that they know what to do after their family member leaves the hospital. A top notch rehabilitation program makes sure that patients and families have access to all the necessary resources after discharge.

RIC is renowned for its expertise in caring for the most complicated and challenging disabling conditions. Despite this factor, an extremely high percentage of our patients return home after discharge.

From the beginning of your stay with us, your team will work with you and your family to create a discharge plan. Our discharge planning staff targets your needs according to your goals and environment. We make sure that departures are well planned, and that patients and families are well prepared for going home, or to another level of care.

But our patients may remain our patients when they leave. Patients frequently continue to use RIC services like outpatient therapy, job training and placement assistance, peer support and counseling, and resource services to link them with various community groups and organizations that provide a wide range of services.

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9. Does the program have medical support in the case of a complication or new illness?

Inpatient rehabilitation programs should have access to immediate emergency care. They should be located close to an acute care hospital in the event a patient needs to be transferred. In addition, a strong program will have consulting physicians from all specialties who are available when necessary.

All of RIC's inpatient programs are within or adjacent to an acute care hospital. Should an emergency occur, the patient is transferred swiftly and easily. In addition, RIC has relationships with more than 125 physicians in various specialties who provide expert consultations when needed to meet the patient's recovery needs.

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10. Are there technicians on the treatment team who fabricate the equipment patients need to gain independence, or is equipment provided by outside vendors?

Whether it be a wheelchair or a prosthesis, many patients require equipment designed exclusively to meet their needs. To design and fabricate high-quality customized equipment requires an understanding of a patient's disability and lifestyle (for example, a patient may want to get back to sports or playing an instrument). Programs that either make or adapt their own equipment on site, rather than contracting with outside companies, encourage more communication and teamwork between therapists, patients and the builders of equipment. This results in equipment which promotes a patient's independence to its fullest.

RIC's own rehabilitation engineering and prosthetics and orthotics departments work with treatment teams to build and tailor equipment to meet each patient's unique needs. We customize wheelchairs, walkers, braces, canes and more. It only makes sense that a tall person with a spinal cord injury needs a wheelchair specially sized, or a musician with an artificial limb needs unique, adaptive equipment to continue playing.

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11. Are research and education components of the program?

Facilities involved in research are committed to creating new treatments and devices that promote recovery and independence for people with disabilities. The same is true of facilities involved in the education of healthcare professionals. Patients being cared for in a research and teaching institution often benefit from the most up-to-date and advanced practices in the field.

RIC's mission includes a commitment to four main elements: excellent patient care, research, education and advocacy.

Thousands of papers and articles have been written by our researchers, physicians, nurses and therapists. These articles often highlight our research efforts; $4 million in private donations and grants annually support research activities at RIC. We know the value of research; it has led to many discoveries about the healing process. Armed with our discoveries we can treat people more effectively.

In addition, we are a training center for future rehabilitation physicians and other medical professionals. Annually, we educate more than 8,000 medical students, residents, research fellows and other health care professionals.

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12. Does the program advocate for the rights of people with disabilities?

Just as research and education at a rehabilitation program reflect a strong commitment to the quality of life for people with disabilities, so does a program that actively advocates for its patients. For example, effective advocacy efforts address assimilation (integrating into the community), acceptance (attitudes toward people with disabilities), and access (functioning in the physical and societal environment). These issues do not directly relate to physical improvement, but they have a lot to do with quality of life once patients leave the program. Programs that take a lead in advocacy can make a real difference -- in empowering people with disabilities and in educating those who are able-bodied.

RIC's ongoing work fighting discrimination against people with disabilities led to the creation, in 1980, of Access Living, a service and advocacy organization operated by and for people with disabilities. Access Living now offers information, referrals and service in the areas of housing, education, disability rights, independent living and services for the hearing impaired.

And we practice what we preach; our treatment areas, patient units, restrooms, recreation areas, drinking fountains, telephones and elevators are accessible. Therapy areas include such features as simulated kitchens, bedrooms, baths, laundry rooms and cars, to give patients the opportunity to practice activities of daily living in realistic settings.

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13. Is the program accredited?

The Commission on Accreditation of Rehabilitation Facilities (CARF) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) are independent organizations that serve as quality control intermediaries. Rehabilitation programs are not required to be accredited by CARF and JCAHO. Those that voluntarily accept their standards make quality service a top priority.

RIC'S exceptional level of care earned accreditation with commendation from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). RIC has also earned voluntary accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF).

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