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B - What Does the E-Scan Tell Us

Figure 6.0 Total FTE of Service Providers, for INPATIENTS AND OUTPATIENTS ACROSS Sites (n = 13). 0 10 20 30 40 50 Family Practitioner Physician Internist* Neurologist* Occupational Therapist Physiatrist Physiotherapist Psychologist Psychiatrist* Rehab Therapist Service Providers Speech Language Pathologist Social Worker TR Specialist Urologist Full-time Equivalent (FTE) Outpatients Inpatients *Internists, Neurologists and Psychiatrists are consultants. Understanding staffing ratios, for rehabilitation services, is complex. However, the FTE/bed ratio is one method to compare across environments (Figure 7.0). The high nursing staff ratio clearly points out the extensive services required by this patient population, for personal care, bowel and bladder, and (often) pressure ulcer management, during inpatient rehabilitation; in addition to dispensing of medication and other nursing services received in rehabilitation. Figure 7.0 Total FTE of Key Health Profesionals/ Total Number of SCI-specific Beds. In addition to the health professionals providing rehabilitation services, across the 13 sites, there are 41 (18.9 FTE) members of administration (e.g., Directors, Medical Directors, Program Leaders, etc.), 38 (24.6 FTE) managers (e.g., unit managers, coordinators, etc.), and 32 (26.2 FTE) service agents (e.g., directors’ assistants, secretaries, intake coordinators, etc.). Eighty-nine administrators are dedicated to inpatients, 66 to outpatients, and six to outreach. There are six (1.2 FTE) administrators consultative to service, with four consultative to inpatients, and four to outpatients. At present, there are no administrators consultative to outreach. With the changing patient demographic, and focus on patient flow and integrated care across the care continuum, a refocus on how administrative services are allocated is needed, to produce optimal results within modern models of healthcare. What Types of Resources do Canadian Rehabilitation Sites Use for Assessment and Service Delivery? In order to gain a clear understanding of the underlying neurological pathology of SCI, it is essential to have a full spectrum of electrodiagnostic testing, to help inform patients of their health status and potential for neurological recovery. Most sites are well resourced for imaging, electrodiagnostic and laboratory services, with the exception of sestamibi scanning for thyroid or heart disease (Figures 8.0, 9.0, and 10.0). This is not surprising, as most rehabilitation sites are embedded inside a larger, general hospital or healthcare corporation. Figure 8.0 Imaging Services for SCI Rehabilitation Sites (n = 13). Full-Time Equivalent (FTE)/Number of Beds Service Providers *Internists, Neurologists and Psychiatrists are consultants. 0 .1 .2 .3 .4 .5 .6 .7 .8 Nurse (RNA/RPN) Nurse (RN) Family Practitioner Physician Occupational Therapist Physiatrist Physiotherapist Rehab Therapist Speech Language Pathologist Social Worker TR Specialist Internist* Neurologist* Psychologist Psychiatrist* Urologist 0 2 4 6 8 10 12 14 16 Bone Density Bone Scan CT fMRI Gallium Sestamibi MRI PET Renal/Bladder Ultrasound Swallowing Study Tomography Ultrasound Imaging Services Doppler Ultrasound (n = 12) Video Urodynamics X-ray Number of Sites* On-Site Off-Site Internal Off-Site External *Some sites reported services both on- and off-site. WHAT DOES THE E-SCAN TELL US 43


B - What Does the E-Scan Tell Us
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