Evaluating Siebens domain management model for inpatient rehabilitation to increase functional dependence and discharge rate to home in geriatric patients

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Study evaluated the use of the Siebens Domain Management Model (SDMM) during geriatric inpatient rehabilitation (IR) to increase functional independence and dispositions to home in geriatric (aged 75 years or older). The SDMM involved weekly adjustments of IR care focused on potential barriers to discharge home. The preintervention group (2010) involved 429 geriatric patients who were on average admitted to IR 8.2 days after the onset of acute care hospitalization. The postintervention group (2012) included 524 geriatric patients who were on average admitted to IR 5.5 days after acute care. A comparison was made between the 2010 preintervention group and 2012 postintervention group discharge Functional Independence Measure (FIM) efficiency scores, length of stay (LOS), and rates of discharge to home/community, acute care, and long-term care (LTC). Preintervention and postintervention group admission FIM scores were similar, but the preintervention group had on average 2.6 days greater LOS during IR and greater time to onset of IR from acute care. Preintervention FIM efficiency was 2.1, whereas postintervention FIM efficiency was 2.76. There were significantly more discharges to the community in the postintervention group (74.4 percent) than the preintervention group (58.5 percent). There were significantly fewer patients discharged to LTC in the postintervention group. Findings suggest that the use of the SDMM during IR in geriatric patients is associated with increased functional independence and discharges to home/community and reduced institutionalization.

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