Roy S. Fowler

Adapting care for the brain-damaged patient.

Rehabilitation specialists emphasize the physiological basis for behavior of many patients seen in nursing homes. In this first of a two-article series, they contrast the difference in symptoms for patients with left-and right-sided brain damage.

Pinpointing: One method of improving staff compliance with rehabilitation regimens

This project investigated the effects of a systematic pinpointing and feedback system upon staff follow-through with assignments on a rehabilitation impatient service. The number and percentage of tasks were recorded over 8 weeks. An ABAB time series reversal design was used where the baseline phases occurred during weeks 1–2 and 5–6, and the intervention occurred during weeks 3–4 and 7–8. Intervention consisted of directing chart round interactions so that assignments were given to specific team members and a list of these tasks was distributed to the team. Results indicated that team performance was significantly affected during intervention weeks. Specifically, the percentage of pinpointing increased from 40% during baseline to an intervention average of 96%. Also, team compliance increased from baseline levels averaging 44% to a mean of 87% during the intervention. The effects of such inexpensive techniques on team effectiveness and the resultant cost benefits to patients in a rehabilitation setting are reviewed.