Communication Breakdown? Request A Family Conference
[ photo by Rodnae ]
Behind the scenes of the medical team conference.
In the world of acute inpatient rehab, what sets us apart from many other medical settings is the interdisciplinary team that provides care. With that comes a lot of conferences! Medicare requires every patient be discussed every week with the entire interdisciplinary team. This includes the physical medicine and rehabilitation physician (me), the case manager, nurse, PT, OT, and speech therapist. In addition, the neuropsychologist and dietician will also attend.
These conferences are fast paced, allowing each representative from the team to give an update on how the patient is doing from both the medical and functional standpoint. We discuss discharge plans, necessary appointments, durable medical equipment (DME) needed and the barriers to discharge. At the end of the conference, for each patient, we either set a tentative discharge date or make adjustments to the already set discharge date.
While the entire medical team conference is sometimes long in total duration, the length of time for each patient discussed is actually quite short, around five minutes on average. Only the necessary details are given for each patient. These meetings are meant to be efficient, providing only the necessary details to report on one’s overall progress and help gauge if the discharge plan and date are on the right trajectory.
In addition, multiple patients are usually discussed, thus allowing individual patients or family members in the room would be a violation of HIPPA rules. The reason I wanted to take the time to explain what happens in the team conference is that I often will have patients and/or their family members request to attend the team conference. I understand the desire to attend these weekly updates, but these meetings are not designed for the family to attend. Following the medical team conference, your loved one’s case manager will provide a summary of the conference to the patient and appointed family member.
Not getting the answers you need? Request a family conference.
Instead of requesting to attend the weekly team conference, what I recommend in the situations where family members want an overall picture of how their loved one is doing is to request a family conference. The family conference is essentially the individual team conference with an expansion of the details on how the patient is doing, both medically and physically. The recommendations for level of care needed upon discharge can be made during this time with a more detailed rationale by the therapists and physician as to why the particular recommendations are made. This is a chance for family members to ask about any medical questions or concerns, including questions on medications and any new medical changes. The case manager is also present during these conferences and can help to provide guidance on selecting home health care agencies, skilled nursing facilities or any other additional care options after discharge from acute rehabilitation.
The family conference does not happen with every family. Many family members are able to have all of their questions answered over time with different conversations with the individual therapists, physicians, nurses and case manager. If you, as a family member, feel that you just cannot put all of the pieces together on how your loved one is doing with rehabilitation or on just what you need to be planning for the discharge, do not hesitate to request a family conference with the treating team. With the details you are able to gather from the family conference, you can begin to make plans for the next steps after rehabilitation. If questions remain and additional direction is needed, I can step in and help to guide you in your decision making process!
Have you been involved in a family conference? What part of it did you find most valuable? Share your experience in the Comments section.
© 2021 Jessica Kluetz, DO