Scott Webb (Host): The Outpatient Day Rehabilitation Program at Franciscan Health is a comprehensive and coordinated program where patients can receive virtually all the rehab treatment that they need under one roof.

And joining me today to discuss the benefits of the Outpatient Day Rehab Program is Dr. Sachin Mehta. He's the Medical Director of the Inpatient and Outpatient Rehabilitation Center at Franciscan Health Indianapolis.

 This is the Franciscan Health Doc Pod. I'm Scott Webb. Dr. Mehta, it's so nice to have you back again today. We're going to talk about the Outpatient Day Rehabilitation Program and what that means and what you do and how folks, you know, can benefit from this. So, let's just start here. Give us an overview of the Outpatient Day Rehab Program.

Dr. Sachin Mehta: Yeah, thank you, Scott. When someone has an injury or illness and they're hospitalized, you know, oftentimes the goal of being in the hospital is to get better and get home, or even inpatient rehabilitation, the goal is to get home. But what if someone's ready to go home, but they're not really ready to get back into the community?

They're not ready to go back to drive, go back to work, go back to school, go back and do their hobbies, such as, you know, playing a sport or gardening. So, what an outpatient rehabilitation day rehab program is is a comprehensive approach to outpatient therapy, you know, traditional outpatient therapy, oftentimes at the strip mall where someone may get a little bit of physical therapy and then they may go somewhere else and see their physicians. But in the day rehab model, it's a all their therapy services are done under the same roof. Patients can receive physical therapy, occupational therapy, speech therapy. The program is overseen by rehabilitation physicians called physiatrists, which is what I am. There's rehabilitation nurses, case managers, neuropsychologists, neuro-optometrists. So if we've had an illness such as a brain injury, or a stroke, or a concussion, Parkinson's disease, spinal cord injuries, MS, multiple sclerosis, or long COVID syndrome, patients often benefit from a more coordinated approach to outpatient rehabilitation. +

The benefit of this program is that the entire team meets on a weekly basis face to face. So that way, we can make adjustments to the rehabilitation program in real time. So if someone needs to change their medications, or is not sleeping very well, or is having pain impacting their rehabilitation recovery, we can address those things very quickly. You know, if they need a brace for their ankle, or a brace for their wrist, or a special type of prosthetic after an amputation, we can address their needs really quickly in a coordinated approach, which improves our quality and kind of separates our program from the traditional outpatient therapy program.

Host: Yeah, I see what you mean, the traditional programs, and it does really sound like, you know, one-stop shopping, everything kind of under one roof, and coordinated, and comprehensive, and multidisciplinary, and all those buzzwords, of course. So, who qualifies to participate in this type of program, and what types of conditions are best treated in this program?

Dr. Sachin Mehta: So, really anybody who would benefit from a comprehensive outpatient program would likely benefit from an outpatient day rehab program. So again, if someone has had an injury or an illness, such as a stroke, and they were in the hospital and now they're able to return home, the goal of the outpatient day rehab program is that let's get back to walking. Let's get back to running. Let's try to walk with different types of equipment and maybe eventually come off the equipment. Let's get back to, again, driving. So, we have a dedicated driver's rehab program as part of our day rehab program. So really anybody that has an illness or an injury that requires a coordinated multidisciplinary approach would qualify for a day rehab program.

And so, the typical conditions we treat are some of the ones I mentioned earlier, such as a stroke, a traumatic brain injury, a concussion where maybe the symptoms aren't recovering very fast so that we can get them into balance therapy, vision therapy, cognitive therapy. We can coordinate with our social workers directly with their employers and their athletic trainers to get them back to their sport. Other conditions include spinal cord injuries, Parkinson's disease, multiple sclerosis, if someone's had an amputation of their arm or leg, a coordinated approach with physical therapists, occupational therapists, rehabilitation physicians, and nurse practitioners, and the prosthetist is a really good approach to making sure we're acknowledging all their needs and optimizing their return to function.

Host: Yeah. Just wondering on average, if you can put a number to it, on average, how long do patients participate in the program?

Dr. Sachin Mehta: Since it's an individualized program, where we're taking the patient's individualized injury and illness plus their individualized goals, there's no standard number of days in this program. Our average length of stay is anywhere from four to six weeks to, you know, four to six months that someone can participate. And the important thing is to realize is that we also give these patients a home exercise program. So in between when they're getting two to three days of therapy a week, we do give them a lot of "homework" to do. And then once they're done with the program, we give them an extensive home exercise program. And then, the goal is that some of those exercises will become too easy and then they can re-enroll in the day rehab program to upgrade their home exercises. And we can continue to go back and forth with an outpatient program followed by an aggressive, intense home exercise program.

Host: Yeah, I like that. So, you've got the outpatient day program and then they continue at home and they can sort of renew or re-up, so that they're not just sort of left on their own to figure things out. Just as we finish up here, talk about the main benefits again of participating in a rehab program like this, and maybe how is it different from other programs in the area.

Dr. Sachin Mehta: Sure. So, the main benefits of participating in a day rehab model is the coordinated approach. It's not just going to be one physical therapist or one doctor or one occupational therapist making a lot of decisions on their own. The team meets together weekly. The entire team can meet and discuss, "Hey, this is going well. We're struggling with this. Patient is not sleeping at night and they're too tired to do therapy. So, you know, Dr. X, can you please put somebody on the sleep medicine, which will allow them to participate in the therapy better." So, we're able to bounce these ideas back and forth and ask," Is the patient ready to go back to work? Are they ready to go back to driving? Are they ready to go back to gardening? Are they accomplishing their goals?"

So, the benefit of the program is the team approach to the rehab process where all of the providers are working together to optimize the function and quality life of our patients who have suffered a devastating injury. And that's kind of what separates us from the traditional outpatient therapy where someone will just go and maybe get one hour of a certain therapy discipline and then go right home. And then, that therapist may have no communication with a doctor or another provider. But in a day rehab model, that communication is the key with the ultimate goal, again, to repeat, is to optimize quality life and restore our functional abilities so our patients can go back to doing the things they were doing before they got hurt in the first place.

Host: Yeah, I see what you mean. There's a Wendy's here in my town. Well, it was a Wendy's at one time and then it became a rehab place. And it's just one of those things like you were saying, kind of in the strip mall approach where you go for PT and that's great. And maybe the PT is awesome, but if you need other things like OT or whatever it might be, well, then you've got to go somewhere else, of course. And as you're saying here in the Franciscan model, the day rehab program, it's, as I said, one-stop shopping. Everything's under one roof and you guys are coordinating this and working together and communicating, and it's multidisciplinary. A lot of benefits, right?

Dr. Sachin Mehta: That's exactly right. Spot on, Scott.

Host: That's perfect. Well, it's always good to have you on. You're an awesome guest. Thank you so much and you stay well.

Dr. Sachin Mehta: Thank you, Scott.

Host: And for more information on rehabilitation at Franciscan Health, go to franciscanhealth.org and search rehab programs. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.