CASE Study How RehaCom is used in practice Introduction Frau Wartenberg is a (PTA) PT Assistentin, which is the German equivalent of a Doctor’s sister. She is an exception in terms of her training, in that she works as an Occupational Therapist (OT), but is qualified as a Psychologist. Frau Wartenberg has been a PTA for 20 years at the NRZ Magdeburg (www.mediankliniken.de), Neurological Rehabilitation Centre. This rehabilitation centre is based at one of 22 Median state clinics (hospitals) all over Germany, and was founded by the late Professor Hans Regel. The latter worked alongside Hasomed GmbH in the early 1990s to help develop RehaCom, Hasomed’s pioneering software for cognitive rehabilitation. Frau Wartenberg, therefore, has known RehaCom for a very long time. Frau Wartenberg’s use of RehaCom At the moment patients stay for an average of 35 days, and use two computers in a room which allows 3 patients to be seen in an hour i.e. 20 minutes per patient. In a 4 hour morning session, therefore, Frau Wartenberg can usually see an average of 10 patients, depending of course on the nature of the cognitive disturbance (more severely injured patients require more therapist time than others).
Clinic challenges The main constraints and challenges within the NRZ Magdeburg Neurological Rehabilitation Centre are currently as follows: 1. Financial – The government budget available for cognitive rehabilitation insurance payouts is ever shrinking 2. Patient demand – the number of incidents of stroke and head injury are increasing all the time in Germany, indeed worldwide, and the clinic is required, therefore, to treat more patients than ever before . 3. Human resources – The therapist will always be essential to cognitive rehabilitation. Currently there is a limit to the number of therapists allocated by the Government to the clinic 4. Complexity – At the NRZ Magdeburg Neurological Rehabilitation Centre, the whole spectrum of brain injuries – from stroke to aneurism to head injuries and MS – is treated. Patients are also treated across the whole spectrum of cognitive disorder severity – from acute patients to levels B and C and also day patients. The therapist’s role is therefore varied, complex and demanding, including not just cognitive rehabilitation work, but also diagnostics and group work The implications The implications of the above challenges at the NRZ Magdeburg Neurological Rehabilitation Centre are as follows 1. Repeat visits - The financial constraints described above mean that patients often have to go back to work before they are ready. Sometimes this leads to them becoming overstretched in their jobs and having to return to the clinic for a second phase of rehabilitation 2. Time – The financial constraints described above mean that patients cannot stay as long at the clinic as the therapists would like to be able to do their job effectively, and the latter are under pressure to deliver the same results in a shorter space of time 1
3. Stress – The combined challenges of increased patient demand, reduced time to carry out therapy, the growing complexity of the therapist’s role and a limit to the number of extra therapists that can be taken on at the clinic inevitably mean that the therapist’s role is increasingly stressful. The solution Therapists are greatly in need of tools in general which make their jobs easier and less stressful. Now, more than ever, Cognitive Rehabilitation Centres and their therapists need an effective cognitive rehabilitation tool in particular which saves them time, allowing them to treat a growing volume and complexity of patients in an ever decreasing time period. Importantly, though, effective cognitive rehabilitation (effective = improved cognitive functions that are translated into everyday life) can only happen through a trained and experienced therapist. This means that any solution to the challenges described above can only ever be an “Enabler” used alongside an experienced therapist i.e. a tool which enables the therapist to carry out effective cognitive rehabilitation as quickly and easily as possible. RehaCom the Enabler RehaCom is not the ANSWER to cognitive rehabilitation it is THE ENABLER. A good therapist already has the knowledge of how to work alongside the patient to improve their cognitive functions and develop strategies to translate these improvements into everyday life. What RehaCom does is provide the materials and tools for these improvements and strategies, and this makes the therapist’s life much easier. Frau Wartenberg has known this for some time, and has found RehaCom to be a great enabler since it was first adopted back in the early 1990s. Now, more than ever, and in the face of the current challenges, a good therapist is required to use RehaCom to its full potential and realise all the benefits it is capable of. A word of caution RehaCom has a vast capability covering more than 20 different cognitive procedures and many different difficulty levels for each. As such, it requires an experienced therapist to fully understand and exploit its capabilities. But RehaCom is so intuitive as to be deceptively simple.
Anatomical Concepts (UK) Ltd 8-10 Dunrobin Court Cyldebank Business Park Clydebank G81 2QP T: +44(0)141-952-2323 E: info@rehacom.co.uk Web: http://anatomicalconcepts.com web: http://rehacom.co.uk
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BENEFITS OF REHACOM BY ROLE IN THE PURCHASE DECISION The therapist - Makes their job easier •
Allows them to see a number of patients at one time, and more patients within the same time period
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Allows them to do a number of different things at the same time because they don’t have to sit constantly with the patient, therefore making their job easier
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Provides the materials for the development of strategies with the patient to translate cognitive improvements into real life
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Facilitates cognitive improvements and confidence building through varying difficulty levels for each procedure
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Ensures patients cannot “cheat” the software, and therefore gives a certain degree of control over the rehabilitation and its effectiveness
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Delivers performance graphs for each patient, making it easier to implement effective strategies and saving time
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Allows them to customise the rehabilitation programme to each patient – choosing from a range of procedures and difficulty levels and adapting the age and language settings for maximum effect
The patient – Enables cognitive rehabilitation •
Importantly, it allows the patient to quickly recognise and accept their cognitive deficiencies, which is the first step in cognitive rehabilitation.
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Allows them to learn by doing, which is more effective, because when you have to relearn your cognitive functions from scratch, you only believe something when you experience it for yourself, a bit like a child who tries out new things
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RehaCom gives feedback, both visual and audio, which helps them to recognise, accept and acknowledge their cognitive deficiencies, which is a vital part of the rehabilitation process
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Enables effective cognitive rehabilitation which is then translated into real life i.e. they can get their life back
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It is also an individual programme, in that it can be customised by the therapists to the age of the patient, and their mother tongue, since RehaCom is available in 15 different languages
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It allows patients to work against themselves and improve their abilities gradually
The Director of the clinic – saves money, improves quality •
Allows more patients to be treated within a shorter space of time, and without having to employ more therapist, therefore saving money
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Cognitive rehabilitation is more effective and of a higher quality, which is the main aim of the clinic
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Cognitive rehabilitation using RehaCom is far more effective than other enablers i.e. pen and paper
The IT Manager – fits onto current systems, saves time •
RehaCom can be networked to be available to all therapists, all rooms and all patients at the same time, maximising availability
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RehaCom data is stored on a central database, allowing records to be stored of what patients have done, when and with what results
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RehaCom can be administered centrally from the server, saving the IT Manager time
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