title: Inpatient rehabilitation of patients requiring hemodialysis: improving efficiency of care.
abstract: OBJECTIVE
  To determine if reducing missed therapy sessions by patients requiring hemodialysis will reduce the length of stay (LOS) and improve the efficiency of care in an inpatient rehabilitation unit.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Inpatient rehabilitation unit at a university medical center.
  
  
  METHODS
  All patients discharged from the Albany Medical Center rehabilitation unit between January 1, 2003, and June 30, 2004. The total number of patients was 955, 40 of whom required hemodialysis.
  
  
  METHODS
  On January 1, 2003, Albany Medical Center began providing hemodialysis in the late afternoon, allowing patients to complete a full 3-hour program without missing therapy sessions to attend dialysis. We compared the outcomes of 915 patients who did not require hemodialysis with the outcomes of 40 patients who required hemodialysis. We also compared the outcomes of patients treated on the rehabilitation unit in 2003-2004 to the outcomes of patients treated on the rehabilitation unit before dialysis was available at times that did not conflict with therapy (calendar year 2001).
  
  
  METHODS
  LOS, improvement on the FIM instrument, and FIM efficiency score.
  
  
  RESULTS
  The LOS of the hemodialysis patients changed from 16.0 in 2001 to 12.1 in 2003-2004 (P<.05), and the FIM efficiency score of the hemodialysis patients improved from 1.8 in 2001 to 2.9 in 2003-2004 (P<.05). The FIM efficiency score of the nondialysis group in 2003-2004 was 4.0. This was significantly greater (P<.05) than that of dialysis patients in 2003-2004.
  
  
  CONCLUSIONS
  A program to reduce conflicts between medical treatments such as hemodialysis and therapy sessions may result in reduced LOS and improved efficiency on an inpatient rehabilitation unit.
authors.affiliation: Albany Medical College, Albany, NY 12208, USA. forresg@mail.amc.edu
authors.forename: George
authors.initials: G
authors.lastname: Forrest
authors.forename: Masato
authors.initials: M
authors.lastname: Nagao
authors.forename: Anjum
authors.initials: A
authors.lastname: Iqbal
authors.forename: Rishi
authors.initials: R
authors.lastname: Kakar
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D017063:Outcome Assessment, Health Care; D006435:Renal Dialysis; D012189:Retrospective Studies; D017678:Sex Distribution