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UMASS MEMORIAL HEALTH CARE TRAUMA PROGRAM. Pediatric Brain Injury Rehabilitation in Central Massachusetts- Adding Insult to Injury Michael P. Hirsh, MD, FACS, FAAP Director, Pediatric Trauma Services UMMHC. UMASS MEMORIAL HEALTH CARE TRAUMA PROGRAM.
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UMASS MEMORIAL HEALTH CARE TRAUMA PROGRAM Pediatric Brain Injury Rehabilitation in Central Massachusetts- Adding Insult to Injury Michael P. Hirsh, MD, FACS, FAAP Director, Pediatric Trauma Services UMMHC
UMASS MEMORIAL HEALTH CARE TRAUMA PROGRAM Trauma Center Factoids • Established 1979 • First Hospital-Based Helicopter Aeromedical Service (New England Life Flight, or NELF) in 1981 • First American College of Surgeons (ACS) accredited Level 1 Center in Mass. (1991) • Became Dual Level 1 Pediatric/Adult Trauma Center in 2005 (one of two) • Admitting 2500 pts/year (Pediatric: 550<18yo, 350 <15)
UMASS MEMORIAL HEALTH CARE TRAUMA PROGRAM Adult Rehabilitation FEATURES • Physiatry team lead by Dr. Faren Williams • Unique relationships with local adult rehabilitation partners such as Fairlawn (Health South), Whittier • Multi-disciplinary Discharge Planning rounds with DC planners, SW, rehab team, Trauma Team
UMASS MEMORIAL HEALTH CARE TRAUMA PROGRAM Pediatric Rehabilitation Problems • Pedi Rehab in Central Mass. nonexistent for Patients less than 15yo. • Patients discharged to sites in Boston, New Hampshire, Connecticut • Live-in facilities for parent in these sites limited • Families in these situations have additional stressors of child-care, work obligations, travel expenses, boarding expenses and school issues • Travel to these facilities difficult for Central Mass. Families • Patients sent to these outside facilities frequently do not return- this affects our follow-up, outcomes analysis, and billing. • Realizing these problems, our LOS on inpatient kids with rehab needs goes up • Some unaddressed rehab needs fall back on local school systems to fix
Pediatric Brain Injury Rehabilitation in Central Massachusetts- Adding Insult to Injury Pediatric Rehabilitation Remedial Measures for UMMHC Pediatric Trauma Program • Find LOCAL Pediatric Rehab partner for transfer agreements and possible in-patient coverage • Find DISTANT Pedi Rehab partner with facilities to allow parents to room-in • DEVELOP DAY FACILITIES for local families with kids with BI • ? Consider development of small inpatient rehab cluster as transitional area for Pedi trauma patients
Pediatric Brain Injury Rehabilitation in Central Massachusetts- Adding Insult to Injury Pediatric Rehabilitation challenges in Central Mass. • Can Brain Commission garner support ($ or leverage) to help local rehab facilities expand services to include kids needing inpatient, outpatient and day service help? • Can Insurers be pushed to cover neuro-cognitive rehab for BI in kids? • Can additional help to BI families be uncovered? (Transportation, tutoring, boarding, • Can school systems reintegrating BI kids be given extra support?