New Zealand Rehabilitation Association, Inc.

In June of this year I travelled with my wife Michelle, and 3 month old son Josh, to Stockholm in Sweden, not on some fanatical ABBA related pilgrimage (I’ll leave that to my parents generation), but to study a radically different approach to spinal cord rehabilitation – the Spinalis model. When planning our trip I asked my travel agent for advice about travelling with newborns.  Sure, she said, ...Don’t!  The Burwood Academy’s lead researcher, Anne Sinnott, also travelled to Sweden at the same time, but wisely avoided travelling with us to avoid any possibility of ‘nanny’ duties being requested!

Rehab Station Spinalis was established in 1991 by Dr Claes Hultling and Dr Richard Levi and this public, private and charitable cooperative is the most radical embodiment of independent living in practice internationally.  Like his contemporary, the late Prof Alan Clarke, Claes is a medical professional who has radically re-thought rehabilitation following a personal experience of spinal cord impairment.  Like Alan, Claes detested the interventionist, paternalistic approach of mainstream rehabilitation and its stifling, suffocating effect on the recovering human spirit – his motto “No #$@**** mercy!”  Claes was determined to create an atmosphere where people could learn to discover the enjoyment of being alive for themselves. He is adamant that you must appeal to the full senses of the person in rehabilitation through taste, colour, smell, texture, music & conversation and create a passion for living. During his own rehab, Claes continued with his “normal life” as much as possible, including getting married 6 weeks after his high level neck injury, and helicoptering every weekend to his family home on the island of Landsort in the Swedish Archipelego!  When the OT’s told him of their plans to get him a wheelchair accessible van, Claes turned up with a Porsche instead!!
 
Dr’s Hulting and Levi are believers in keeping tensions within a model to maintain focus.  The quartet of parties that compose Rehab Station Spinalis have different drivers and stakeholders, but all agree that the process must be indivisible from the patients' perspective. This dynamic mix manages to keep the focus on the patient through the constant and obvious mix, and clash, of views and interests represented.  The Spinalis Foundation is the primary consumer voice, with Rehab Station (privately run) having an understanding of customer experience and the public entities being, well, being typical public entities. The Spinalis Clinic and Rehab Station exist on the common site, with staff being indivisible from each other (all wear T-Shirts with Rehab Station Spinalis on them).  There is no obvious sign of hierarchy or rank as this is recognised as not being in any interest of the patient.  A simple name badge suffices to identify doctor from duty nurse. The CEO of Rehab Station, Mats Pernhem, comes from a hospitality background and is working to ensure that the patient experience is consistently delivered, in much the same way as hotel franchises do. Together they offer 27 inpatient beds and an extensive outpatient programme that has a strong focus on health, exercise and wellbeing.  The clinic uses paid peer workers in a de-medicalised environment that promotes patient ownership of space.

The Spinalis / Rehab Station environment is impressive, full of colour, vibrancy, energy... life.  Health professionals fade into the background of a bustle of patient activity, yet constantly work side by side with paid "Rehab Instruktors", all with disabilities.  Here, the skills, experience and understanding of disabled persons are not just sought through token consultation; they are actively valued and purchased.  Everything about Spinalis is carefully considered and constructed, from the natural materials, ambiance and feel of the place, to the way in which medical and rehabilitation staff members engage with patients. The focus is on providing positive real life experiences, and on a speedy return home.  Most of the Spinalis clients come from the Stockholm area and the programme looks to move them from the inpatient setting back to their homes as soon as possible.  For many people, this results in a return home at about the 3 month post injury mark.  Once home, they return to Spinalis as outpatients about three times per week. The Spinalis team have succeeded in creating a wonderfully integrated programme that gets people back to their lives quickly.

How was this possible?  Because people who lived the experience of disability took ownership of the resourcing and creation of services, health professionals were employed to provide quality services to their customers, and the two parties work effectively together for a common goal. 

Given the partnership setting that we are all used to here in Aotearoa between Crown and Maori, one wonders why we can’t achieve similar results for New Zealanders with disabilities?

For more information of Rehab Station Spinalis visit www.spinalis.se or www.praktikertjanst.se/upload/Rehab_Station.pdf  and for the Burwood Academy visit www.burwood.org.nz.

The Burwood Academy acknowledges the support of ACC and the Canterbury District Health Board in making this visit possible.