The challenge to adapt. A specialty care facility refocuses its services to promote continuity of care

Because clients now spend less time than before in acute care hospitals, specialty care institutions have had to modify and expand their services to meet new needs. They must not only provide new kinds of care; they must also assist clients and their families in making the often confusing transition from acute care to rehabilitation and, finally, to the community. In the past few years, the St. Lawrence Rehabilitation Center, Lawrenceville, NJ, has been making just such changes. In response to a systematic review of its services, the center established its Social Work Services Department in 1987. Seven program managers are the core of the department. They encourage patient and family participation in St. Lawrence services, advocate for them in a variety of contexts, help define treatment goals, and ensure that clients, families, and treatment teams keep these goals in mind. St. Lawrence has also updated its admissions process, creating an Admissions Team whose role is to locate appropriate referrals and to expedite patients' admission to the center. Whereas the earlier process typically took several weeks to complete, St. Lawrence now has an intake system capable of a 24-hour turnaround. The center has also expanded its outpatient services, hiring an outpatient program manager, developing a full range of rehabilitative services, and establishing an orientation program that keeps outpatients abreast of the services available to them at St. Lawrence.