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