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NATIONAL REHABILITATION HOSPITAL TO: FROM: SUBJECT: Memorandum Susan Lewis Director, Corporate Development N. J. MacLauchlan ~~---- Director, Information Resources DEC 20 20 computer April 13, 1988 Based on my conversations with Robert Miller and Linda Skantar of the Tobacco Institute we will be able to make good use of the computer they are planning to donate to NRH. The system involved is a DEC 20 20 Main-Frame computer. This particular system would be capable of supporting one of the Patient Care Support Systems which have recently been presented to the Information Resources Steering Committee. The main attractiogs of this particular s[stem are a state of the art schedullng system and a low prlce. This gift could help NRH save even more because we would not have to buy a computer to support the system. Even if we choose a Vendor which runs on an IBM computer we will still have a need for a sophisticated computer system like the DEC. The DEC 20 20 computer is powerful enough to support our research data base and provide us with the computing power to perform statistical analysis on the research data. The DEC 20 20 computer which is being offered is a qenerous package which cgn be considered a complete hardware-system. The System consxsts of a CPU (the Central Processing Unit), I opera?ions console, 4 Disk.Drives, 1 Line Printer, and 1 Tape Drlve. Yesterday Bob Mxller called me and offered us the computer's power distribution system which greatly increases the value of the gift. When we receive this gift NRHwill save approximately $500,000 because we would have to purchase a computer with similar capabilities within the next six months to two years. Robert Miller has indicated that the Tobacco Institute is willing to pay the de-install costs. This means that our liability is limited to the cost of transportation and the reinstallation fee for installing the computer at the Medlantic Data Center. The computer is not currently under a service agreement so I would recommend that we have the un~t~cert-i-f~ed~and~pl-aced-under-a--serv~ce--contract-before-we move it. I have discussed this with Robert Miller and he agrees that we should get this done before we move the computer. T111330995

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A NATIONAL RESOURCE The National Rehabilitation Hospital is one of~e nation's newest and finest thcilities dedicated to providing inpa- tient and outpatient comprehensive medi~l rehabilitation. NRH is the only fi'eesmnding rehabililation hospital in flae W:tshin~on, I).C., area. In addition to patient carc, im mission includes re- habilitation education and refining, as well ~ research in both clinical issues and issues related to flae accessibility, quality, and cost-e~kctivcness ofrehabilltative care. An expe~a team ofl~hysicians and rehabilitation specialists has been recruited ti'om leading medical centers ~tl research K~cilities across flae nation. They are ctnnmiltcd to building strong working partnerships with other health care provide~. The stall'also se~x'es as a resource fi~r flae latest adwmces in rehabilitation approaclaes and applications oftcchnol%~' whid~ improve the options and lit~sWles of persons wilh disabilities. Their expe~ise is conaplemcnted by a consulting medical s~affof more ~han 150 communi~' physicians represenling a broad spectrum ofspecialties. N RH. a 160-bed banfer-fi'ce thcility, has been specially desi~nwd to promote patient independence in a ctnnlbrtable selling, with tmldoor decks and ~uxtens and spacious lounges banked with ~n'eene~y around a skylil atrium. The result is a supportive environment that is in itselfthen~peutic anti highly con- ducive to acquiring flae knowledge and skills necessaD: Io return to t~tmily and communi~, living. NRH is a priw~te, profit hospital located in Norfl~- west W~tshin~on, 1).C., a’[jacent to the 85 l-bed W~tshin~on Hospital (;enter. This proximity assures patienLs prompt access to emer- gency se~ices should they be needed. NRH is accredited by the .Joint Commission on Accredita- tion of H~spimls. T111330997

Wx-ve NRH? TheNational Rehabilitation(NRH) is the first and Hospital ordy fi-eestanding facility in the Washin~on metropolitan area that is dedicated solely to comprehensive medical rehabili- tation. NRH is not a clinic or a small unit in an acute-care hospilal. Rathcr, it is a modem, comfortable, 160-bed hospiud offering a full range of inpatient and outpatient medical rehabili- tation services. • The services and physi’.~ facilities at NRH are designed espe- cially tbr individuals who are physically disabled by spinal cord injury, brain in.jury, stroke, post-polio syndrome, anaputation, and other physical and neurolo~c conditions. NRH's mnltidis- ciplinary team approach tn care is aimed at helping patients to oncc again lead active and satisfying lives. • Although recently opcncd in Fchruary 1986, NRH has carried out an aggressive rcc~'uitment campaigm to bring together some of this country's u)p relent in the rehabilitation medicine. nursing, and allied health fields. Progwam directors, professo~.'s, administnttors, and others from leading universities and medical centers comprise an NRH st,-fft'whose experience and expertise is unsurpassed in the region. • NRH is rapidly developing into one of this country's respected centers fbr clinical research as well as fbr research related to the cost, quality, and accessibility of medical rehabiliu~tion. NRH is also thst becoming a nationally recog-nized resource tbr the education and traiuing of physicians and other specialists in rehabilitative cm'e. T111330998

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REHABILITATION--A COLLABORATIVE PROCESS Thecomprehensive process considers medical rehabili~ltion each patient's ph):sical, emotional, social, and w~cational needs wiflfin ~e framework of the patient's pemonal goals. To ensure the success of the process, ~e National Rehabilitation I lospital utilizes a collaborative team al)pmad~ flint involves the patien~ the ~unily; the refen'ing physician; fl~e NRH physician; • e insun~nce representative; and other pmt~ssionals such as physical ~empis~, occupational thcn~pists, psycholo~sts, w~ca- tional rehabilitation counselor, spccch-langmage patholoOs~s, social worke~, and therapeutic recreation specialists. The collective goal of the intc~xlisciplinm), team is to initiate and coordinate ~empeufic measures to promote optimal pedbrmance capability and to prevent potential complications ~ssociated with disability. NRH physicians, specialisls t~ined and certified in physical medicine and rehabilitation, direct each patient's team. Depending on thc paticnfs needs and goals, each rehabilitation team may incoq~on~tc hcalth care pro~ssionals from the fbllowing areas: • audiology • dental care • dietetics "driver cvaluation and mdning • durable mcdical equipment* "laborato~ • medical specials' consul~tion "neumpsycholog~ • nutritional services • occupational therapy "orthodcs* • p~to~d care • pha~acy • physimtl therapy • podiatric consultation • prosthetics* • psychology • vadiolo~ • rehabilitation en~neering ' relaal)ilitafion nursing • respiratory care • social work • speech-la%~age pathology. "sm~6cal consultation • the~-apeutic recreation - wwationai rehabiliuitkm Each of these service areas is comprehensive in scope, yet adaptable to the specific needs of each patient. *()rthotic_% pmsthetics and durable mediafl equipment arc provided flmmgh NASCOTI] an innovativcjoint venture between the Denver-based Smtt Orthopedics, Inc., and the Nali~mal Rehabilitation Seta'ices Coqxwation. The ’'ertifipd fwt|lt~r{sls nnd prt~stheti~t~ on the RA~;(:O'I'I" st:~ffnr~, h~rhly sk]llotl irl collaborative evaluation and prescrlptitm-directed fabrication. Their profes- sional marc extends to the ongoing munittu'ing of a person's pr%wess and to prompt servicingofequipment. N:kSCO'IT sen'ices are ofl~..red boda at NRH and in FairFax, Vi ,rginia. T111331000

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INPATIENT AND OUTPATIENT PROGRAMS As one of the nation's newest specia!.ty h. ospitals de .dicated to comprehensive medical rehabihtat~on, the National Rehabilitation Hospital specializes in the treatment o~ • spinal cord injury • ta'aumatic brain injur), • stroke "post-polio syndlx)me NRH also provides services ibr persons with: - amputation • arthritis • cerebral palsy • Guillain-Barr~ syndJx)me • multiple sclerosis - multiple traumatic injuries • muscular dystrophy • neurological disorders • neuromuscular disorders • orthopedic conditions • pain • Parkinson's disease • rheumatok)gical conditions • scoliosis • spina bifida Inpatient services are offered as individualized, goal-directed, comprehensive programs. Outpatient services are available as comprehensive, special- ized team progrmns or as a selected NRH single-therapy service. Tl11331003

TI-Ir REFERRAL AND ADMISSION PROCESS NRH has a convenient and prompt admissions process. Admissions decisions are generally made wiflfin 2,1 hours, and dae Admissions Coordinator updates flae refim,-fl source throughout the process. Pafien~ may be relented by physicians, hospieals, insurance companies, community agencies, o~er he~fl~ care professionals, flunky membe~, or onesel£ The admissions process involves assessment ofan individu- al's appropriateness tbr rehabilitation sen,ices based on potential to pro~'ess toward achievable goals of improved peffo~ancc and function. Pafim~m must he at le~kst 12 yem, old; medically ~lpahle ofpa~icipafingin an acute medical rehabilitation progn'am; and, in most ~es, have a diagmosed ph):sic~ impai~ mcnL The admissions proccss also includcs a financial re,flew to identify Ihndlng sources. Any physician who rcfb~ a paticnt [~om his or her officc practice or an acute-~re setting is gn~mmd comlesy privileges visitation, cha~ acce~, anti pm~icipation in management deci- sions at hi-weeMy patient-stuffing confbrences. Atier dischm~gc, • e patient is returned to flae physician for continuing care. With fl~c patient's pc~ission, a member of the rchabili~- tion team will co~vespond with the rcfemd source periodically during the rehabili~tfion pr%wam and at thc time of discharge. If requested, NRH s~tffmembe~ may also seta'e ~ts COllsul~tn~ tO • e refe~i snurce tbilowing discharge. This pamacmhip approach with the retinal source is an impo~mt part of the philosophy of patient care at NRH. Outpatient se~wices may be tbr either comprehensive reha- bilitation pro~ms or tbr single-therapy se~'ices. Criteria admission to the outpatient progwam are similar to those fbr the h~pafient pr%~-ams. Medical histo~T will be reviewed by a physician prior to scheduling an appointment. In some cases, a general clinical screening is required. Inquiries and refusal for inpatient or OUtl3atient services shonld be directed to the Admissions O~ce, (202) 877-1152. T111331004