Adelphi Centre for the Rehabilitation of Post-Comatose Patients with Severe Brain Injuries

Project location: Italy, Rome
Project start date: December 2010 - Project end date: April 2011
Project number: 2010-70
Beneficiary: Roboris Foundation ONLUS

INTERIM REPORT III

Timeline of the present activity report:

From 01/03/2011 to 18/02/2012

The Adelphi Centre project for the rehabilitation of post comatose patients with severe brain injuries (ABI) suffered a period of considerable slow down which forced its planned completion date to be put back. This was due to the fact that the Lazio Region took much longer than expected to confirm the inclusion of its funding for the Centre in its 2012 budget. The agreement between the ROBORIS Foundation and the Lazio Region in fact provides for the Region to finance all the Adelphi Centre's operating expenses (personnel, various services, utilities consumption, etc.). A Protocol Agreement which commits the Region to providing the funds within an established timeframe and at set conditions has only just been signed.

As a result the project has been put back by a year. It will now be completed at the end of April 2012 instead of the end of April 2011, as previously planned. The Centre's first patients will be admitted in April 2012.

In the intervening period from the end of February 2011 to February 2012 the Centre has focused primarily on the purchase of medical equipment and furnishings as well as fine tuning the information system.

The medical equipment purchased consisted mainly of an Emergency Trolley and special armchairs for the Day Hospital and minor medical equipments.

The Emergency Trolley (see Fig. 1) is equipped with all the appliances needed to treat patients in emergency situations, i.e. electrocardiograph, defibrillator, oxygen tank and masks, etc. The Trolley is also stocked with drugs and medication needed to treat first aid situations. The Trolley meets all the requirements set out in the health rules and regulations governing rehabilitation centres, with particular regard to patients with ABI, as in the case of the Adelphi Centre.

The special armchairs for the Day Hospital (see Fig. 2) are for the use of patients to rest between therapy sessions; for example after a session of water therapy in the Centre's medical pool patients can rest before starting a session of physiotherapy on the machines in the gymnasium or on the special couch in the physiotherapy room.

Furniture was also purchased for the dining room (see Fig. 3), recreation room, gymnasium, the men and women's changing cubicles attached to the medical pool, the staff changing cubicles (nurses, therapists, assistants, etc.), the storage area for patients' personal belongings, etc.

The kitchen was also fitted out. As regards the kitchen (see Fig. 4) we would like to point out that it has been equipped for the use of patients as well as for the daily catering needs. In fact it is equipped with power-driven hanging kitchen units which wheelchair patients can lower to their level. Furthermore, the cooking hobs are of the induction type which means that they do not cause burns if accidentally touched when in use. This allows the hobs to be used by patients who do not have total control over their movements. Also, all the lower parts of the basic kitchen units are open to allow easier access for wheelchair users.

As regards the information system, the software has been modified and personalised to meet the specific needs of the Centre. In particular, improvements have been made to the Resource Reservations software.

Given that the characteristics of the patients treated are especially complex, a computer system for the management of individual rehabilitation programs requires capability of preparing and memorizing individual rehabilitation treatment plans and printing reports for each patient. The system also needs to elaborate the input of the diverse medical personnel involved in patient treatment as well as keeping a track of the medical and physiotherapy appliances used.

The program which manages "Resource Reservations" allows users to access and reserve the services provided in the various rehabilitation facilities. It is the first important point of contact between the Centre and patients and their families. The quantity and the quality of the data to be treated, together with the necessity of providing timely and accurate information, are the capability of the information system. Specifically, the system permits the scheduling of the various facilities (gymnasium, medical basin, doctors' rooms, etc.) and their assignment to the single operators (doctors, physiotherapists, etc.) The system's strength will lie above all in it's ability to manage a large number of different specialists with varying and changeable appointment schedules. The reservation of a facility and its assignment to a particular specialist will be facilitated by the use of a an intuitive and user-friendly computer system.

The ADELPHI Day Centre aims to combine rehabilitative health care with interventions in the areas of social interactions and relationships by putting into place measures to create a synergy between rehabilitation, social and educational activities on the one hand and family involvement on the other.

The involvement of a patient's family is indispensable. The operating model of the Centre will be based also on the involvement of family members from the early stages of user input. This will allow for a joint programme to be put into place thanks to the sharing of treatment methods between all the professionals concerned.

The information system is a fundamental part to obtain all this.

The project's future plans also envisage:

- a meeting room with a stage, amplifier, microphone, screen, chairs, etc.

- a relaxation room with TV, HiFi, video recorder, etc.

Also other work needs to be carried out such as installing an automatic door in the medical basin room to simplify access for the handicapped and building a storeroom in the space below ground level.. There are also plans for a car park.

Finally, the back garden will have new plants, benches, fencing, and special paving will be laid, suitable for wheelchair users.