Team size in spinal cord injury inpatient rehabilitation and patient participation in therapy sessions: The SCIRehab Project

The Journal of Spinal Cord Medicine, 2012 · DOI: 10.1179/2045772312Y.0000000065 · Published: January 1, 2012

Simple Explanation

Rehabilitation teams are thought to consist of a few professionals from different fields. However, this study shows that many more individuals are often involved in a patient's care. The study looks at how the number of clinicians involved affects how actively patients participate in their treatment sessions during spinal cord injury rehabilitation. The findings suggest that while many clinicians are involved, it's not clear if this negatively impacts patient participation or the therapeutic relationship between patient and therapist.

Study Duration

Not specified

Participants

1376 patients with traumatic SCI

Evidence Level

Prospective observational study

Key Findings

1
The average patient was treated by approximately 39 different clinicians during their inpatient rehabilitation stay.
2
The Treatment Concentration Index (TCI), measuring the degree to which treatment sessions are delivered by a few clinicians, was low overall, suggesting that patients see a variety of therapists.
3
Patient participation ratings were minimally affected by the number of sessions the patient and therapist had worked together.

Research Summary

This study investigated the size of rehabilitation teams in spinal cord injury (SCI) rehabilitation and its effect on patient participation in therapy sessions. The results showed that patients are treated by a large number of clinicians, particularly in physical therapy, occupational therapy, and nursing. The study concludes that the large size of rehabilitation teams may not necessarily lead to a lack of familiarity between patients and therapists, or negatively affect patient participation, but further research is needed to determine the impact on rehabilitation outcomes.

Practical Implications

Care Coordination

Healthcare facilities should evaluate and improve care coordination strategies to address issues arising from larger team sizes.

Therapeutic Relationship

Future studies should investigate the impact of team size on the therapeutic relationship and patient outcomes.

Resource Allocation

Rehabilitation centers should consider the impact of staffing models on patient care and outcomes.

Study Limitations

1
The omission of treatment sessions a minority of patients may have had during their admission to a non-SCI unit.
2
The narrow assessment of participation (a one-item scale, completed by the therapist only).
3
Absence of information on some members of the rehabilitation team.

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