Inpatient Rehabilitation Program is a Bridge to Life After Traumatic Injuries

Children, adolescents and teenagers are increasingly surviving life-altering tragedies thanks to pioneering medical advancements. Physical medicine and rehabilitation (PM&R) physicians, like those at Shriners Children’s Northern California, are there to support and rehabilitate children recovering from physical trauma.

The aftermath and complications from automobile accidents, catastrophic sports injuries, near drownings, house fires and falls are just a few of the many traumas physicians Loren Davidson, M.D., medical director of the pediatric rehabilitation program and Maya Evans, M.D., medical director of the inpatient rehabilitation program, see at Shriners Children’s Northern California.

For many of the pediatric patients who survive shocking physical trauma and bodily injury, rehabilitation means healing the body, mind and spirit. With the support of Shriners Children’s, many patients focus on regaining life skills that will allow them to transition from being a patient at the hospital to engaging with their wider community.

“We are the bridge from this horrible, traumatic, life-altering event, to the life after,” said Dr. Evans. “In our inpatient rehabilitation program, we have kids who have gone through something where they could have died. And, oftentimes, they have family members that did die. Our job is to help them get back to life after that. When you consider the position patients were in prior to their stay at Shriners Children’s, inpatient rehabilitation is magic.”

Highly Specialized, Multi-Disciplinary Rehabilitation Care

The inpatient rehabilitation program at Shriners Children’s Northern California is led by physical medicine and rehabilitation physicians – also known as physiatrists – who hold additional certifications in specialty pediatric care.

Dr. Davidson works with Dr. Evans to lead the Sacramento region’s only pediatric rehabilitation program. Dr. Davidson is one of the nation’s medical leaders specializing in PM&R, and Dr. Evans is widely recognized for her expertise in spina bifida care and rehabilitation after traumatic brain injury.

The inpatient rehabilitation program is built on the foundational belief that these traumatically-injured patients do best when care is provided by a multi-disciplinary team of specially trained pediatric healthcare providers who have the expertise, tools, and time to provide personal and individual care to each patient.

The multi-disciplinary team at Shriners Children’s Northern California incudes physical therapists, recreational therapists, occupational therapists, speech therapists, nurses, child life specialists, social workers, neuropsychologists, care managers and school teachers. Orthotics are also available for children needing artificial limbs and braces. This entire team is focused on supporting patient health and healing, both physical and emotional.

“What makes us different is the expertise and collaboration you have on our inpatient rehabilitation care teams,” said Dr. Davidson. “We seek out medical professionals who help us meet all the child’s needs, no matter how specialized. Our team includes highly trained, highly specialized medical professionals, like Caron Nogen, Ph.D., and Hannah Greenbaum, Ph.D., who are pediatric neuropsychologists. They are specially trained to treat the mental, cognitive and behavioral issues of brain disorders in children, adolescents and teens.”

Dr. Davidson said patient progress and individual care plans are routinely reviewed by all members of the patient’s medical team, with everyone asking the question, “What does the patient need?”

Dr. Davidson stressed that ensuring children have the right care at the right time is critical to patient success.

“We have the right people and we create the environment at Shriners Children’s for those medical specialists to have the maximum impact in their area of specialty care,” Dr. Davidson said. “We have weekly meetings with our physicians, surgeons, nurses, physical therapists, recreational therapists and other health care specialists to assess patient progress and continue to create their critical care plan. Everyone on the patient’s care team has a seat at the table. Everyone is committed to the health of the whole child, and everyone is working together for the benefit of that kid.”

Timely Treatment and Proven Results

This kind of collaboration across all disciplines and departments at Shriners Children’s Northern California allows patients to be admitted to the inpatient rehabilitation unit (IRU) faster than at other institutions. This ensures that data-informed individual treatment plans are designed and implemented quickly so patients don’t lose precious recovery opportunities. This program design also ensures an environment where patients feel seen, heard, supported and encouraged to thrive.

Shriners Children’s Northern California participates in a national database that includes outcomes data from inpatient rehabilitation units across the nation. The most recent data shows patients experience higher functional gains during their inpatient rehabilitation stay at Shriners Children’s Northern California when compared to children in other programs throughout the nation. This data indicates that the inpatient rehabilitation program at Shriners Children’s Northern California is one of the top performing programs in the nation for patient outcomes. The program is recognized for specialized distinction by the Joint Commission for National Quality Approval.

Working Hard, Having Fun and Building a New Life

Dr. Evans underscores the commitment that inpatient rehabilitation demands of patients and their families.

“Our patients are working with a physical, occupational or speech therapist on their care team for at least three hours a day, six days a week, in addition to extra time with other team members. It’s hard work. They may be learning how to speak again, how to walk again, how to brush their teeth or wash their face again. They are working on skills to achieve as much independence as possible,” Dr. Evans said.

“Brain injury patients are particularly attuned to their loved ones,” Dr. Evans said.

It’s the patient’s loved ones who will provide care and support when the patient heads home, so the Shriners Children’s Northern California IRU team works with their families to incorporate activities into the rehabilitation program. For some families, being able to gather around the table to share a meal is a priority. Some families love music, and others love to dance. Whatever is most important to the patient and family becomes a priority and is incorporated into rehabilitation therapy activities and goals.

“Our program is different because everyone at our hospital is focused on kids. We are a pediatric hospital, so we bring that compassion and care into the IRU and into our work with all our patients, including our brain injury patients,” Dr. Evans said. “We create an environment that taps into fun and joy for kids. It’s a lot of work, but it’s also fun."

“We want our patients to heal and to feel like themselves again,” Dr. Davidson explained. “We are committed to their recovery and their long-term care, and we are committed to seeing them build a new life.”

Shriners Children’s Longstanding Commitment to Inpatient Rehabilitation

The Shriners Children’s healthcare system has three longstanding inpatient rehabilitation programs in Sacramento, Chicago and Philadelphia. These child-centered intensive rehabilitation programs provide multi-disciplinary therapeutic care.

At Shriners Children’s Northern California, that care has expanded to include other diagnoses, including traumatic brain injury, because the need is so great. The hospital has one of the few inpatient rehabilitation programs west of the Mississippi to specialize in pediatric traumatic brain injury rehabilitation.