Rehab @ Home

Service overview

The Rehab@Home is an admitted service providing specialist rehabilitation assessment and management of patients in a home based setting.  The service provides a 7 day rehabilitation service from a team including a Rehab Physician, Nursing, Allied Health and Pharmacy. Telephone after hours support is be provided as required, 24 hours a day.

The service assists clients to achieve their goals of care in their own home.  Patients are be admitted to the program from acute or subacute wards, short stay units, and external hospitals or from the community.  The service will be directed to patients who have activity and participation limitations resulting from recent or chronic impairments and where therapy can be safely and more effectively delivered in a home environment. The Rehab@Home service operates with a patient-centered and goal directed-model. Patients actively participate in their own goal setting and review, and are assigned a key contact person to facilitate close communication with the treating team.

Team members

• Rehabilitation Consultant
• Rehabilitation Registrar
• Nurses
• Physiotherapists
• Occupational Therapists
• Social Workers
• Other Allied Health disciplines can be accessed as required

Service delivery

• 7 days per week, minimum of daily sessions
• Program duration is usually 2 – 3 weeks
• Out of hours support accessible via St George’s Hospital After Hours Coordinator
• In person and telehealth sessions available

Eligibility criteria

Patient resides in the City of Yarra, City of Boroondara or City of Darebin. Out of area regions can be discussed on individual basis

The patient requires rehabilitation goals

The patient’s goals are achievable within a 2-3 week admission

The patient is clinically and medically stable

Referral process

Internal SVHM referrals are to made via the Electronic Patient Journey Board

External referrals can be made via fax 9231 8461 or email svhm.rehabathome@svha.org.au

Contact details 

Rehab @ Home Phone: 9231 8008