Comprehensive integrated inpatient rehabilitation program (CIIRP)

Our CIIRP/ASP offers a team approach, which includes the Veteran and their support system (family, caregiver, etc.). Together with our doctors, therapists, nurses, prosthetist, and other professionals, our Veterans can reach an optimal level of function and independence.

CIIRP/ASP services are provided at the Dallas VA Medical Center by licensed and credentialed rehabilitation professionals including: clinical care coordinators, occupational therapists, physiatrists, prosthetists, psychologists, physical therapists, chaplains, nutritionists, nurses, orthotists, kinesiotherapists, speech language pathologists, social workers, recreational therapists and others as needed.

Our Veterans are the most important members of the rehabilitation team.

Our mission

Our mission is to maximize the health, functional independence, and quality of life for Veterans with disabilities through excellence in clinical care, education and research.

Program features

CARF accredited- inpatient medical rehabilitation
CARF accredited - amputation specialty program
Joint Commission accredited
Dedicated, specialized treatment staff
Individualized therapeutic activities
Participant and family education
Participant support group
On site access to comprehensive medical and surgical services
Onsite access to fully equipped ABC certified prosthetic lab
Individualized discharge planning
Driver evaluation and training program
Dynavision visual trainer
Functional electrical stimulation
Exoskeleton
Korebalance
ReoGo System
Wii Console

Admission criteria for CIIRP/ASP

Must be medically stable
Must be able to participate in therapy 3 hours a day, 6 days a week
Must need at least two forms of therapy (PT/OT/SLP)
Must be alert and able to follow instructions consistently
Must be motivated, capable and willing to participate in therapy
Should have potential to significantly improve function or achieve independence
Should have potential to be discharged outside institutional setting

Participants may be admitted to the CIIRP for any of the following reasons:

Functional impairments requiring assistance in self-care, mobility, thinking skills, use of adaptive equipment, energy conservation, or safety techniques
Medical complications resulting in decreased function
Limited or no previous access to a full range of comprehensive rehabilitation services

Discharge criteria for CIIRP

Our goal is for our Veterans to reach the highest level of functional independence possible, so they can return home, to work and their social lives, with few to no obstacles.

However, in some cases it may be necessary to refer Veterans to alternate discharge settings that provide more appropriate levels of care, cueing and supervision. These decisions are based on current and/or anticipated needs of each Veteran at time of discharge.

CIIRP discharge criteria includes:

Veteran/family has met either all, or the majority of the established goals
Veteran is unable to tolerate the intensity/3 hours of therapy needed in acute rehab
Veteran is not making significant functional progress, is declining in functional status, or becomes medically unstable
Veteran unable to follow Admission agreement (disclosure)
Veteran/family declines services

Outcomes compared to national benchmarks

Table

Indicators (goal)	CIIRP 2020	Nation 2020
Age of Veteran (N/A)	68	66
Length of stay (≤16)	12	21
Functional gain *(≥23.1)	25.2	23.6
Functional gain per week* (≥14.7)	15.7	12.8
Average hours of rehab per day (3.0)	3.28	N/A
Percent of goals met (≥90%)	88%	N/A
Days from impairment to admission to rehab program (3.0)	10	20
Disposition at discharge / transition / effectiveness of the program % discharged to the community (≥85%)	93%	82%
Satisfaction score(≥90%)	95%	N/A

Table

Indicators (Goal)	ASP 2020	Nation 2020
Age of Veteran (N/A)	59	67
Length of stay (≤16)	12	19
Functional Gain *(≥17.6)	25.2	23.6
Functional Gain per Week* (≥8.9)	15.7	12.8
Average Hours of Rehab per Day (3.0)	3.08	N/A
Percent of Goals Met (≥90%)	90%	N/A
Days from Referral to Admission to Rehab program (3.0)	2	N/A
Disposition at Discharge / Transition / Effectiveness of the Program% Discharged to the Community (≥85%)	100%	83%
Satisfaction score(≥90%)	100%	N/A

Family and patient satisfaction

Each Veteran is given a satisfaction survey after they have finished with their rehabilitation that considers quality of care, treatment, reaching goals, among other factors. This program has a 92% or more satisfaction rate. The following testimonials are retrieved from the Veteran satisfaction surveys:

Testimonial #1

“I was recently treated at the Dallas VA for a stroke. After several days hospitalized, I was fatigued and ready to go home and try to rehabilitate myself. I had no desire to be treated further and go to rehab. The day before my discharge from the main hospital I was visited by Elaine Parkhurst. Her enthusiasm and encouragement raised my spirits and led me to change my decision and attend the recommended therapy. I am so grateful that I did. It has been the single recommended best experience I have had within the VA in 15 years. There is a kind, patient-focused attitude exhibited by each and every member of this unit. It is displayed by every team member from Dr Colson, down through the most junior level employee. As a manager, I know how difficult it is to install a culture that is followed and “bought into” by each employee. There is no doubt that the culture of care and kindness is a reflection of superior leadership. I think this is the best unit at Dallas VA from a patient’s perspective. I am grateful for Elaine Parkhurst, Jessica Menth, Giselle Rodriguez, Josh Thompson, and Dr. Colson.”

Testimonial #2

“This has been an eye opening experience for me. I believe the CIIRP staff took the very best care of me going out of their way to fix problems I did not know I had. I will never forget this experience due to the high quality and professionalism display by this unit. The OT and PT were my guardian angels. Thank you all.”

Testimonial # 3

“I have had the best quality care in the last 2 weeks here in the hospital and in CIIRP unit. I had back surgery, since that day I have had the best care I have ever had. The CIIRP unit has been outstanding in getting me up and into therapy and ready to go home. The care that I have been given has been above any I have ever received anywhere in my 45 years...I thank the entire staff of the VANTHCS for the care I have received. It has been outstanding!”

Testimonial #4-Care Coordination with Stakeholder

“The care I received at CIIRP was absolutely outstanding. When I arrived I knew nothing. After 2 weeks interacting with the finest therapists I am not the same person. May God Bless each and every one of you. Miss Shaina, Pam, and Vicki were absolutely outstanding in caring for me and it has changed my life. Thank you so much!” Additionally, this Veteran recognized the contributions of Daphne Pogue, who provided excellent neurosurgical care coordination for her. The CIIRP program appreciates Daphne and the neurosurgical team as key CIIRP stakeholders. Daphne efficiently collaborated with the CIIRP program throughout this Veteran’s rehab process, including pre-admission and post-discharge needs. Thank you Daphne!