A specialist rehabilitation medicine service will be under the direction of a rehabilitation medicine physician (Fellow of the AFRM) and provides comprehensive, patient-centred interdisciplinary care. This care is evidenced by the establishment of achievable treatment goals, the periodic assessment and documentation of the functional status of patients, the occurrence of regular case discussion amongst treating practitioners, and attention to the optimal management of concurrent medical problems and psychosocial issues. The primary objective of care is to help patients achieve their optimal level of functioning and participation in society.

Demonstrating Governance

1. Governance

1.1 Definitions of Rehabilitation Medicine, Rehabilitation Medicine Physician, Rehabilitation Medicine service and other rehabilitation services.

Rehabilitation Medicine is that part of the science of medicine involved with the prevention and reduction of functional loss, activity limitation and participation restriction arising from impairments, the management of disability in physical, psychosocial and vocational dimensions, and improvement of function³.

Rehabilitation Medicine was recognised as a Principal Specialty by the National Specialist Qualification Advisory Committee of the Health Insurance Commission (Medicare Australia) in Australia in 1976 and is a Vocational Scope of Practice in New Zealand (NZ).

Rehabilitation Medicine Physicians⁴:

• are Fellows of the Australasian Faculty of Rehabilitation Medicine
• diagnose and assess a person’s function associated with disability or functional decline due to injury, illness, chronic disease or aging, to maximise their independence and improve and maintain quality of life
• provide specialist knowledge and expertise in the prevention, assessment, management and medical supervision of a person with a disability
• evaluate medical, social, emotional, work and recreational aspects of function
• work with children and adults using an evidence-based collaborative approach with other disciplines
• have a unique overview of the skills and expertise of other health professionals, to develop a patient-centred, individualised treatment plan in a range of settings such as public and private hospitals, community rehabilitation centres/clinics or the patient’s home

Further information outlining the scope of practice of rehabilitation medicine physicians can be found in the AFRM Rehabilitation Medicine Physician Scope of Practice for Adult Rehabilitation Medicine⁵ or AFRM Rehabilitation Medicine Physician Scope of Practice for Paediatric Medicine⁶.

Rehabilitation Medicine Services are specialist units of patient care providing comprehensive rehabilitation services for inpatients, outpatients and community, with each patient’s clinical management being under the supervision of a Rehabilitation Medicine Physician.

A rehabilitation medicine service aims to assist people with disability or functional decline due to injury, illness, chronic disease or aging to attain the highest possible level of independence (physically, psychologically, socially and economically) following that incident or illness. This is achieved through a combined and co-ordinated use of medical, nursing and allied health professional skills. The process involves individual assessment, establishment of achievable treatment goals, treatment, regular review, discharge planning, community integration and follow-up of people referred to that service.

1.2 The designated rehabilitation medicine service is directed by a rehabilitation medicine physician and each patient’s clinical management is under the supervision of a rehabilitation medicine physician.

1.3 The rehabilitation medicine service provides an organised system of care and is comprised of a team of clinicians from a variety of disciplines. The rehabilitation team is focused on the patient, with the aim being to assist the patient to achieve their maximum level of functioning, independence, and participation.

1.4 The patient and the rehabilitation team work together to establish meaningful and achievable treatment goals. The progress of the rehabilitation program is measured against those goals.

1.5 There is evidence of planned, coordinated care including clear, written admission criteria and formal planned discharge procedures and liaison with community services where appropriate.

1.6 There is measurement of functional status on admission and discharge. Functional status might also be formally assessed at intervals during the inpatient episode.

1.7 There is continual evaluation of the program and its outcomes.

1.8 The designated rehabilitation medicine service is accredited by a hospital accreditation organisation recognised in Australia or New Zealand.

Other rehabilitation services
Other rehabilitation services where patients are under the care of a medical practitioner who is not a rehabilitation medicine physician or do not meet the above criteria (1.3 -1.8) are not considered specialist rehabilitation medicine services.