Abstract
At the convalescent rehabilitation ward at the acute period hospital, the ideal way of the team approach such as: 1) the way of concerning a patient and a family in case of the switchover from the acute period to being convalescent, 2) the cooperation with the other department staff, 3) the cooperation among the rehabilitation staff, is a primary role. We introduced “the convalescent rehabilitation critical path (plan)” at the same time as establishing a convalescent rehabilitation ward, and then we revised it while using.
We organized a ward critical path examination meeting, because we thought that it was possible to do a rehabilitation team approach in heading for the common purpose to aim at the goal which patient himself set while pursuing the specialty of each numerous type of job.
The each representative revised a critical path regularly, and we repeated the detailed change of about 1year and revised a critical path four times in July, September October, 2003, February, 2004. In the process of revising the critical path, we asked staff members of rehabilitation ward to complete a questionnaire survey, and we used their answers as feedback to improve the pathway. After revising this critical path four times, we learned that there are several important pieces of information necessary for comprehensive rehabilitation servicing to the home support. First, the patient needs to set goals by himself. Similarly, staff members also need to set last goals. Second, staff members need to know the correct progress status of the rehabilitation. Third, staff members need to monitor the directionality of the leaving hospital and the hospital transfer from the convalescent rehabilitation ward. Moreover, in order to embody a team approach, it is important that each person in chage establishes goals and evaluates the situation, and that we confirm patients' ADL status and evaluate about the validity of the last goal during the staff meetings of the patient participatory type, and that we always review the ideal way of the team.
