Dr. Hilary Siebens has made it her life’s work to change the face of our health care system to improve outcomes for patients and providers. Her unique experiences and in-depth medical research helped her develop a creative efficient 21st century organizing framework to guide whole-person/patient care.
Hilary Siebens with a patient and family in Surma, Ethiopia. Photo courtesy of W. Don McClure Jr.
While caring for thousands of patients over 30 years, Dr. Siebens practiced both geriatric primary care and rehabilitation medicine. She saw patients in all health care settings and confronted incredible work demands. She had to develop a framework to guide her thinking, data collection, and documentation about each patient, many with complicated needs.
The result was the Domain Model or Siebens Domain Management Model (SDMM) that considers the whole person/patient from four different perspectives. Together they create a whole picture, making it possible to:
get a clear picture of the person’s, or patient’s, overall health issues,
identify actionable topics and problems,
create viable treatment plans,
communicate with care partners, referring physicians, other team members, and insurers, and
follow the patient’s status and treatment over time.
The Model is based on Dr. Siebens’ personal and professional experiences, medical literature, and feedback from individuals with chronic (enduring) conditions, patients, caregivers, care partners, colleagues, and other health care providers.
The Model’s evidence base has grown through successful integration into clinical applications with positive user feedback:
guiding rehabilitation team conferences achieving improved clinical outcomes while saving on resources.
organizing rehabilitation discharge summaries, making information capture more relevant and complete.
serving as the Organizing Framework in nurse-led telephone-administered Parkinson disease care management contributing, along with other components, to improved care quality.
organizing sections of the self-care tool, the Notebook for Wellbeing & Health Care, for individuals or patients to keep their essential health information organized in one safe place.
Yale College, Biology, Magna Cum Laude with Distinction in Biology
Harvard Medical School
Johns Hopkins Hospital (internal medicine residency)
Harvard Medical School (geriatric medicine fellowship)
Tufts University/New England Medical Center (physical medicine and rehabilitation residency)
Clinical Attending Physician Appointments
Cedars-Sinai Medical Center, Los Angeles, CA
Spaulding Rehabilitation Hospital, Boston, MA
Massachusetts General Hospital, Boston, MA
University of California Irvine Medical Center, Irvine, CA
Veterans Affairs Health System, West Los Angeles and Long Beach, CA
Dr. Siebens considers the creation and dissemination of the organizing framework, the Domain Model (Siebens Domain Management Model (SDMM) or the Siebens Model of Clinical Domain Management), her life’s work and legacy contribution. Using it in her own patient care, she received appreciative feedback from patients, their families, physicians, nurses, and other colleagues and administrators. The SDMM can help clinicians take better care of their patients, and supports health care organizations as they improve care quality in today’s complex system.
Associate Clinical Professor, UCLA
Lecturer, Harvard Medical School
Professor of Medicine, UCI
Professor of Physical Medicine and Rehabilitation (PM&R), UCI
Visiting Professor, PM&R, University of Virginia
Skilled Nursing and Assessment Center, Cedars-Sinai Medical Center, Los Angeles, CA
MEEI Rehabilitation Unit, Spaulding Rehabilitation Hospital, Boston, MA
UCI Senior Health Center, University of Irvine Medical Center, Irvine, CA
Post Stroke Rehabilitation Practice Guidelines, U.S. Department of Health and Human Services, Agency for Health Care Policy and Research (1995)
Commission on Accreditation of Rehabilitation Facilities (CARF) stroke rehab standards – contributing to creation of new CARF portable profile standard focused on providing patients with their personal health information (2004)
Prevention of Fecal and Urinary Incontinence in Adults, National Institutes of Health State-of-the-Science Conference (2007)
