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The domain management model: a tool to help organize care of stroke survivors in skilled nursing facilities
Hilary Siebens1, Nancy Kelly, Charles Pu
1Physical Medicine and Rehabilitation Service and Geriatric Medicine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.
Abstract:
More rehabilitative care takes place in nursing homes than in any other setting. Skilled nursing facilities (SNFs) face increasing challenges in delivering stroke rehabilitation care. The Domain Management Model (DMM) organizes care of stroke survivors by identifying four critical domains that include all problems patients and families may face. Problems identified through the Minimum Data Set and Resident Assessment Protocols can be organized by the domains as well. In the SNF setting, the DMM can help organize rehabilitation care by assisting in the identification of all relevant clinical problems and by serving as a structured format for team meetings, problem management, and discharge summaries.
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