Rethinking diagnoses in rehabilitation: An educational case series

To review the diagnosis of patients transferred to rehabilitation unit.

Case series.

Five patients with functional decline were transferred from an acute care setting in a tertiary hospital to the rehabilitation unit.

Full clinical evaluation and clinical reasoning were applied in addition to multidisciplinary care. Functional outcome and discharge destination were noted in each case.

All patients had a new diagnosis that evolved during their stay in the rehabilitation unit in addition to their existing conditions. The new diagnosis helped to direct their future treatment programme. Four patients had good outcomes; they gained significant functional independence and were discharged home. One patient had an adverse outcome.

In addition to multidisciplinary care, it is important to review the medical diagnosis in the rehabilitation unit. Diagnostic errors can have profound effect on the lives of patients with already existing impairments. Rehabilitation physicians should avoid making assumptions or diagnostic biases, and reapply clinical reasoning especially in the care of individuals with functional decline in rehabilitation.