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Thread: Facilities for ACUTE SCI and ACUTE care for Chronically injured:

  1. #1

    Facilities for ACUTE SCI and ACUTE care for Chronically injured:

    If you were injured today, knowing all you all know, what place would be best for you to wind up in?

    I am looking for the best places to recover from the worst kind of injury.

    Who has the best plan of care?

    Mary
    1FineSpineRN

  2. #2
    Of course most people don't have a choice where they go initially for acute SCI. The new clinical practice guidelines and Early Acute SCI (see the sticky above on this forum) strongly endorse that people with new SCI should ONLY be treated at a level 1 trauma center, even if this means they be transported further than their closest ER or level 2 or 3 trauma center.

    For those who have SCI already, finding a good local hospital usually means working with their PCP so that they are going to one where a physician who knows them (usually their PCP) will be their attending physician, or at least has privileges so that they can consult. It would be important to plan this ahead of time. If your physician does not have hospital privileges at the hospital you need to go to, you may want to seek out a different physician. You should also clarify their willingness to be your advocate in these circumstances, even if they are not your admitting physician.

    I would also recommend talking to someone in nursing education or leadership ahead of time and offering to provide or facilitate education for the nursing staff on essentials such as appropriate bowel care, AD management, etc. Hospitals are VERY motivated now days to take measures to prevent UTI and pressure ulcers since Medicare will no longer pay for the longer length of stay (LOS) required due to the hospital allowing these preventable complications to occur. By the way, the hospital will have to eat it...they will not be able to bill the patient either. This new rule goes into effect October 1.

    For veterans with SCI, there are very specific VA regulations about how long you are hospitalized, and for what, that may require that you be moved to a VA SCI Center instead of being cared for at a non-SCI VA medical center. It is important that veterans be familiar with these regulations so you can insist upon this.

    (KLD)

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