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Practice Management/Leadership

Physiatry and Internal Medicine Dyad Care Model for Inpatient Care Settings: Implementation and Impact

Saturday, October 25, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 9

    Primary Author(s)

  • Josette Hartnett, MPH (she/her/hers)

    Senior Manager of Clinical Research Compliance
    Burke Rehabilitation Hospital PM&R Program
    White Plains, New York

    • Co-Author(s)

  • DT

    Danielle Toohey, Other

    Research Occupational Therapist
    Burke Rehabilitation Hospital
    Goshen, New York

  • Malav P. Shah, MD

    Physician, Assistant Professor, Dept of Rehab Medicine, Albert Einstein College of Medicine
    Burke Rehabilitation Hospital PM&R Program
    White Plains, New York

    • Primary Author(s)

  • Mooyeon Oh-Park, MD

    Chief Medical Officer, Professor
    Burke Rehabilitation Hospital PM&R Program
    White Plains, New York

Disclosure(s):
Josette Hartnett, MPH: No financial relationships to disclose
Malav P. Shah, MD: No financial relationships to disclose
Mooyeon Oh-Park, MD: No financial relationships to disclose
Background and/or Objectives: The medical and rehabilitation complexity of patients cared at the acute inpatient rehabilitation setting has been increasing due to multiple comorbidities, age related physiologic changes, and impairments. Physiatry and internal medicine (IM) often have a complementary role in the care of patients in acute rehabilitation. There are various care models for Physiatry and IM collaborations depending on which specialty is primary and the employment status of physicians. Balancing between employment and community practice models and each specialty’s weight of decision making on patient care is of paramount importance to achieve patient and family centered evidence-based care.

Design: Health Economics and Outcomes Research.

Setting : Freestanding university-affiliated acute care IRF.

Participants : Inpatients who had an Acute Care Transfer (ACT).

Interventions: Dyad Medical Consultations.

Main Outcome Measures: Differences in ACT rates, discharge disposition and financial outcomes between time periods.

Results: Initial comparisons between pre- and post-program implementation indicated ACT rates declined (January 2024 = 12.31% vs January 2025 = 9.84%) with improvements in discharge to community rates (January 2024 = 66.50% vs January 2025 = 68.86%). Falls per 1,000 patient days remained stable.

Conclusions: Establishing a co-management model of care provides our IRF with effective prevention, early diagnosis and improved inpatient medical management. With their clinical expertise and system-based knowledge, these teams can improve outcomes and aid IRFs financially in this new era of value-based payment models.