Cost Effectiveness of Neurological Rehabilitation
|
|
- Cora Maxwell
- 5 years ago
- Views:
Transcription
1 1 Cost Effectiveness of Neurological Rehabilitation Professor Anthony B Ward North Staffordshire Rehabilitation Centre Stoke on Trent, UK
2 more complex needs ACUTE CARE ITU Neurosurgery Orthopaedics Neuropsychiatric service NEUROLOGICAL REHABILITATION INPATIENT UNIT highly complex needs TERTIARY UNIT (e.g. neurobehavioural unit) A&E less complex needs DGH ward Hospital Acute brain injury Supported discharge Hospital at home Early community rehabilitation Community reintegration Enhanced participation DEA supported return to work Community REHABILITATION MEDICINE SPECIALIST COMMUNITY SERVICES Multi-disciplinary multi-agency Brain Injury Team Collin C, Ward A B. Rehabilitation Medicine 2011 & Beyond. RCP London Integrated care planning Long term support Single point of contact Join health and social service planning Multi-agency care
3 ACUTE CARE ITU Neurosurgery Orthopaedics REHABILITATION MEDICINE INPATIENT SERVICE Neurological rehabilitation unit A&E DGH ward REHABILITATION MEDICINE SUPRA-REGIONAL SPINAL INJURY CENTRE Acute spinal cord injury SPINAL INJURY CENTRE specialist outpatient follow-up Supported discharge Hospital at home Early community rehabilitation Community reintegration Enhanced participation DEA supported return to work Hospital Community REHABILITATION MEDICINE SPECIALIST COMMUNITY SERVICES Collin C, Ward A B. Rehabilitation Medicine 2011 & Beyond. RCP London Integrated care planning Long term support Single point of contact Join health and social service planning Multi-agency care
4 Specialised Rehabilitation Complex issues Variable goals, variable outcomes Benefits seen not always in health care independence Multi-professional activity is one profession more effective/cost-effective than another? Team and individual competencies & professional boundaries do they matter?
5 Rehabilitation Effectiveness Evidence-based treatments Relevant outcomes Service efficacy Practice-based evidence Resource utilisation Cost-effectiveness
6 Rehabilitation Effectiveness Evidence-based treatments Relevant outcomes Service efficacy Practice-based evidence Resource utilisation Cost-effectiveness
7 Measurement Problems Outcomes dependent on team activities & treatment algorithm Separating impact of one intervention E.g. contribution of ITB over physical treatments? Longer initial hospital stays appear bad, but result in long term savings in cost of care 1 Turner-Stokes L. Brain Injury 2007; 21 (10):
8 Are We Measuring the Right Things? Activities/QUALYs Northwick Park Dependency score (NPDS) Prediction of dependency Northwick Park Care Needs assessment (NPCNA) Detection of changes Retrospective analysis of 297 patients following severe TBI FIM vs. Barthel vs. NPDS/NPCNA NPDS/NPCNA detected changes associated with substantial care savings, especially in high dependency patients Floor effects of FIM negative Turner-Stokes L, Paul S, Williams H. JNNP 2006
9 Rehabilitation Medicine Works Well recognised benefits for early rehabilitation 1 Prompt response on ill effects of immobility & complications 1, 2 Educating acute staff of areas where rehabilitation is of major benefit 3 Money spent on rehabilitation recovered with 5-9 fold savings 4 Rehabilitation in all phases of health condition effective &?cost-effective 4 Community based programmes effective 4 1. Verplancke D, Snape S, Salisbury CF, Jones PW, Ward AB. Clin Rehabil 2005; 19 (2): Didier JP. Springer Verlag; p476. Paris: p Krauth C, et al. Gesundheitsökonomische Evaluation von Rehabilitationsprogrammen im Förderschwerpunkt Rehabilitationswissenschaften Rehabilitation 2005; 44: pp e46-e Gutenbrunner C, Ward AB, Chamberlain MA. The White Book on PRM in Europe. J Rehabil Med 2007; Suppl.1: S69.
10 Benefits of RM Reduces complications e.g. physical effects of neurological injury, immobility, etc. Optimises patients physical & social functioning Identifies cognitive & emotional aspects of TBI even in absence of physical sequelae Improves chances of independent living at home & return to work Concentrates therapy More therapy input associated with shorter hospital stays & improved outcomes Right environment & skill mix of trained therapists Turner-Stokes L. Clinical Rehabilitation 2002; 16 (Suppl. 1): Stroke Units Trialists Collaboration. British Medical Journal 1997; 314: Bernspang B, Asplund K, Erikson S, Fugl-Meyer AR. Stroke 1987; 18: Indrevidavik B, et al,. Stroke, 22:
11 Participation in Society After Rehabilitation Reduction in care Social benefits Getting out of house Personal & family relations Independence Community mobility Driving Use of assistive technology Occupational Work Informal/voluntary Collin C, Ward A B. Rehabilitation Medicine, 2011 & Beyond. RCP London. 2010
12 Rehabilitation Effectiveness Evidence-based treatments Relevant outcomes Service efficacy Practice-based evidence Resource utilisation Cost-effectiveness
13 UK Rehabilitation Outcomes Consortium Measures activity in rehabilitation units Developed in collaboration with Australian system Learning from international models Develop cost-effectiveness model Turner-Stokes L, Poppleton R, Williams H, et al. Disability & Rehabilitation 2012; 34 (22):
14 Data Definition BSRM 2010 UKROC Data reporting requirements Full Dataset Full Dataset Commissioning Currency Level 1 Multi-level weighted tariff 5 tier Level 2a Multi-level weighted tariff 5 tier SPECIALISED Level 1a: Tertiary services High physical dependency Level 1b: Tertiary services Physical / cognitive/behavioural Level 2a: Extended catchment - Mixed caseload Minimum dataset Level 2b 3 or 5-tier tariff NON-SPECIALISED Level 2b: Local specialist rehabilitation services None Standard per diem HRG rates (reference costs) NON-SPECIALIST Level 3a: Other specialist services (e.g. stroke rehab) Level 3b: Generic rehabilitation services Complexity of caseload Patients requiring rehabilitation
15 Costings Example Model base rate notional bed day cost bands of complexity Bed day cost: Base rate = 400 Complexity group V. heavy (13-15) Heavy (10-12) Medium (7-9) Low (4-6) V low (0-3) Variable Portion of cost 75 % (= 300 in this example) Banded by RCS scores x Banding Factor* Non-variable portion of cost 25 % (= 100 in this example) Non -Banded = Banded cost Costing multiplier *Banding factor based on proportionate staff inputs for each complexity group derived from casemix analysis Applied to the variable portion of the OBD costs
16 Cost Benefits after Stroke Rehabilitation Direct costs of treating stroke patients Spasticity vs. without spasticity Retrospective analysis of 232 patients treated over 1 year Mean age 73 years, M:F 52:48 Mean cost spasticity vs. No spasticity $84,195 $21,845 (p <0.001) Conclusion Direct costs for 12 month stroke survivors 4x higher Lundström E, et al. Stroke 2010; 41 (2):
17 Costs of Care for Adults Informal care costs 4 times higher than formal costs Informal care costs significantly higher for those with sudden onset conditions & hidden/ mixed impairments Healthcare costs significantly associated with Sudden onset condition Greater dependency in activities of daily living Longer condition duration Greater dependency significantly associated with increased social care costs Jackson D, McCrone P, Turner-Stokes L. Jnl. Rehab Med 2013; 45 (7):
18 Rehabilitation Effectiveness Evidence-based treatments Relevant outcomes Service efficacy Practice-based evidence Resource utilisation Cost-effectiveness
19 Strongest Recommendations for Cost Benefits (GRADE Classification) Basis of research evidence available (from both RCT- & non-rctbased literature) and potential for cost-benefits, recommend: Early intensive rehabilitation, starting as soon as possible after onset 1-4 Specialist programmes for all those with complex needs 5, 6 Specialist vocational programmes for those with potential to return to work 6,7 1. Turner-Stokes L, et al. Cochrane Review: Multi-disciplinary rehabilitation for ABI in adults of working age. 2008; Issue Turner-Stokes L. J Rehabil Med 2008;40(9): Cope N, Hall K. Arch Phys Med Rehabil 1982; 63(9): Engberg AW, Liebach A, Nordenbo A. Acta Neurol Scand 2006;113(3): th World Health Assembly, Doc A58/17. Geneva: WHO, Black DC. Working for a healthier tomorrow. London: TSO, Waddell G, et al. Vocational Rehabilitation: What works, for whom, and when? 1 st edn. London: TSO; 2008.
20 Conclusion Cost-effectiveness elusive Cannot compare against no treatment These patients are already expensive! Enough evidence to show effectiveness of treatments Need to have right tools to demonstrate both But, also need better practice based efficacy standards Once decision made to treat, cost benefit from goal specific treatment Some treatments cost-effective Rehabilitation probably cost-effective, but more data needed
21 Thank You
Commissioning Speciliased Rehabilitation
The North West London Hospitals NHS Trust Commissioning Speciliased Rehabilitation Prof Lynne Turner-Stokes On behalf of the UKROC programme RRU, Northwick Park Hospital Department of Palliative Care,
More informationSpecialist neuro-rehabilitation services: providing for patients with complex rehabilitation needs
Specialist neuro-rehabilitation services: providing for patients with complex rehabilitation needs Background Specialist rehabilitation services play a vital role in management of patients admitted to
More informationPublications from the UKROC Programme
Publications from the UKROC Programme Published peer reviewed papers Turner-Stokes L, Turner-Stokes T. The use of standardised outcome measures in rehabilitation centres in the UK Clinical Rehabilitation
More informationA National Model of Care for Paediatric Healthcare Services in Ireland Chapter 44: Paediatric Specialist Rehabilitation
A National Model of Care for Paediatric Healthcare Services in Ireland Chapter 44: Paediatric Specialist Rehabilitation Clinical Strategy and Programmes Division Table of Contents 44.1 Introduction 2 44.2
More informationClinical Psychology Profession Specific Audit of Stroke Care
Clinical Psychology Profession Specific Audit of Stroke Care Clinical Casenote Audit Clinical site code. Age (in years).. Patient ID. Date of admission to unit.. Gender.. Inpatient location: Acute Rehabilitation
More informationNATIONAL REHABILITATION HOSPITAL (NRH) THE SPINAL CORD SYSTEM OF CARE (SCSC) PROGRAMME INPATIENT SCOPE OF SERVICE
NATIONAL REHABILITATION HOSPITAL (NRH) THE SPINAL CORD SYSTEM OF CARE (SCSC) PROGRAMME INPATIENT SCOPE OF SERVICE NATIONAL REHABILITATION HOSPITAL SCOPE OF SERVICE FOR THE SPINAL CORD SYSTEM OF CARE PROGRAMME
More informationThe UK FAM items Self-serviceTraining Course
The UK FAM items Self-serviceTraining Course Course originator: Prof Lynne Turner-Stokes DM FRCP Regional Rehabilitation Unit Northwick Park Hospital Watford Road, Harrow, Middlesex. HA1 3UJ Background
More informationRehabilitation - Reducing costs and hospital stay. Dr Elizabeth Aitken Consultant Physician
Rehabilitation - Reducing costs and hospital stay Dr Elizabeth Aitken Consultant Physician What factors affect outcome? Comorbidities Cardiac Respiratory Neurological Nutritional issues Diabetes Anaemia
More informationThe Northwick Park Therapy Dependency Assessment scale: a psychometric analysis from a large multicentre neurorehabilitation dataset
http://informahealthcare.com/dre ISSN 0963-8288 print/issn 1464-5165 online Disabil Rehabil, 2015; 37(21): 1976 1983! 2015 Informa UK Ltd. DOI: 10.3109/09638288.2014.998779 ASSESSMENT PROCEDURE The Northwick
More informationCasa Colina Centers for Rehabilitation: A unique physician-directed model of care that works
Casa Colina Centers for Rehabilitation: A unique physician-directed model of care that works Emily R. Rosario, PhD Why is Casa Colina unique? Continuum of care offering medical and rehabilitation services
More informationFreedom of Information Act Request Physiotherapy Services for Neurological Conditions
Freedom of Information Act Request Physiotherapy Services for Neurological Conditions 1. In total how many physiotherapists does C&V UHB employ? s services 33 qualified paediatric physiotherapy staff in
More informationNATIONAL REHABILITATION HOSPITAL SPINAL CORD SYSTEM OF CARE (SCSC) OUTPATIENT SCOPE OF SERVICE
NATIONAL REHABILITATION HOSPITAL SPINAL CORD SYSTEM OF CARE (SCSC) OUTPATIENT SCOPE OF SERVICE Introduction: The Spinal Cord System of Care (SCSC) at the National Rehabilitation Hospital (NRH) provides
More informationWAHT-T&O-006 It is the responsibility of every individual to check that this is the latest version/copy of this document.
OPERATIONAL GUIDELINES FOR OCCUPATIONAL THERAPY ASSESSMENT AND TREATMENT OF ADULTS WITH TRAUMATIC HEAD INJURY ADMITTED/TRANSFERRED OR ATTENDING A&E AT WORCESTERSHIRE ROYAL HOSPITAL This guidance does t
More informationSentinel Stroke National Audit Programme (SSNAP)
Sentinel Stroke National Audit Programme (SSNAP) Changes over Time: 4 years of data April 2013 March 2017 National results Based on stroke patients admitted to and/or discharged from hospital between April
More informationOrthopaedic Therapy Service inpatient guide. Information for patients MSK Orthopaedic Inpatients (Therapy)
Orthopaedic Therapy Service inpatient guide Information for patients MSK Orthopaedic Inpatients (Therapy) This leaflet is designed to answer any queries you may have about the Orthopaedic Therapy Service.
More informationKnowsley Community. Stroke Team.
Knowsley Community Stroke Team julia.owens@lhch.nhs.uk marie.florian@lhch.nhs.uk 0151 244 3369 Knowsley Cardiovascular Disease Service Community Cardiovascular Service Rehabilitation services One stop
More informationNational Stroke Association s Guide to Choosing Stroke. Rehabilitation Services
National Stroke Association s Guide to Choosing Stroke Rehabilitation Services Rehabilitation, often referred to as rehab, is an important part of stroke recovery. Through rehab, you: Re-learn basic skills
More informationThe Peterborough experience over the years with hip fractures. Martyn Parker Peterborough UK
The Peterborough experience over the years with hip fractures Martyn Parker Peterborough UK PETERBOROUGH HIP FRACTURE PROJECT Avoid delays to surgery Minimally invasive surgery by experienced staff Unrestricted
More informationWhat to expect following spinal cord injury. Information for patients Therapy Services
What to expect following spinal cord injury Information for patients Therapy Services Introduction This leaflet aims to explain what spinal cord injury is and what to expect over the next few months. What
More informationHow to get a Clinical Psychologist. Dr Ian Kneebone Consultant Clinical Psychologist & Visiting Reader
How to get a Clinical Psychologist Dr Ian Kneebone Consultant Clinical Psychologist & Visiting Reader How to make a case to the new clinical commissioning groups (CCG) If CCGs do not eventuate basics should
More informationMark Jayes Highly Specialist Speech and Language Therapist HEE / NIHR Clinical Doctoral Research Fellow
Mark Jayes Highly Specialist Speech and Language Therapist HEE / NIHR Clinical Doctoral Research Fellow 34% medical patients may lack capacity 1 Assessment is subjective, complex 2 Current practice is
More informationProposed Neurosciences National Structure. Accountability Framework Neurological Alliance (Feedback Loop) National Advisory Group (Neurosciences)
Accountability Framework Neurological Alliance (Feedback Loop) Proposed s National Structure National NHS England National Medical Director National Advisory Group (s) Regional NHS England Sub-Regional
More informationEvaluation of the functional independence for stroke survivors in the community
Asian J Gerontol Geriatr 2009; 4: 24 9 Evaluation of the functional independence for stroke survivors in the community ORIGINAL ARTICLE CKC Chan Bsc, DWC Chan Msc, SKM Wong MBA, MAIS, BA, PDOT ABSTRACT
More informationGeneral Medical Rehabilitation
General Medical Rehabilitation Outcomes Report 20 Rehabilitation Hospital is part of the Rehabilitation system of care, a post-acute provider of neuro-rehabilitation for over 45 years. Our 160-bed acute,
More informationBED BLOCKERS: A STUDY ON THE ELDERLY PATIENTS IN A TEACHING HOSPITAL IN INDIA
ISPUB.COM The Internet Journal of Health Volume 11 Number 1 BED BLOCKERS: A STUDY ON THE ELDERLY PATIENTS IN A TEACHING HOSPITAL IN INDIA P N., N Shinge, P S. Citation P N., N Shinge, P S.. BED BLOCKERS:
More informationResource impact report: Eating disorders: recognition and treatment (NG69)
Resource impact report: Eating disorders: recognition and treatment (NG69) Published: May 2017 Summary This report looks at the resource impact of implementing NICE s guideline on eating disorders: recognition
More informationThe role of multidisciplinary team care in stroke rehabilitation
Stroke rehabilitation z Multidisciplinary care The role of multidisciplinary team care in stroke rehabilitation David J Clarke MSc, PhD, RN Co-ordinated multidisciplinary team working has made a significant
More informationLIFE-CHANGING CARE INPATIENT CARE
LIFE-CHANGING CARE INPATIENT CARE Helping Patients Get the Most out of Rehab When a stroke, accident or other traumatic incident turns a person s world upside down, there s a place in Indiana where he
More informationAppendix E : Evidence table 9 Rehabilitation: Other Key Documents
Appendix E : Evidence table 9 Rehabilitation: Other Key Documents 1. Cameron et al. Geriatric rehabilitation following following fractures in older people: a systematic review. Health Technology Assessment
More informationSurgery saved my life. Rehab is restoring my future.
The Best Way Back Baylor Institute for Rehabilitation offers care for the most challenging and medically complex patients, including those with traumatic brain injury, traumatic spinal cord injury and
More informationRealising the potential of AHPs to support those with cancer in the future
Realising the potential of AHPs to support those with cancer in the future June Davis National cancer rehabilitation lead Macmillan Cancer Support 1 st June 2016 The shifting pattern of survival Total
More informationI tell my patients, If I can do it, you can do it. Lea Stewart
I tell my patients, If I can do it, you can do it. Lea Stewart Baylor Institute for Rehabilitation Lea Stewart A traffic accident threw Lea Stewart around the back of a pick-up truck, leaving the life-long
More informationVisiting Professional Programme: Rheumatology
Visiting Professional Programme: Rheumatology 1 Introduction The Guy s and St Thomas NHS Foundation Trust Rheumatology Programme is designed to provide international visiting professionals with the opportunity
More informationS tandardised clinical information, gathered routinely in a
723 PAPER Evaluating neurorehabilitation: lessons from routine data collection J A Freeman, J C Hobart, E D Playford, B Undy, A J Thompson... See end of article for authors affiliations... Correspondence
More informationI tell my patients, If I can do it, you can do it. Lea Stewart
I tell my patients, If I can do it, you can do it. Lea Stewart Baylor Institute for Rehabilitation Lea Stewart A traffic accident threw Lea Stewart around the back of a pick-up truck, leaving the life-long
More informationNZ Organised Stroke Rehabilitation Service Specifications (in-patient and community)
NZ Organised Stroke Rehabilitation Service Specifications (in-patient and community) Prepared by the National Stroke Network to outline minimum and strongly recommended standards for DHBs. Date: December
More informationCITY HOSPITAL SUNDERLAND FOUNDATION TRUST PORTFOLIO OF LEARNING OPPORTUNITIES
CITY HOSPITAL SUNDERLAND FOUNDATION TRUST PORTFOLIO OF LEARNING OPPORTUNITIES NEUROLOGICAL PHYSIOTHERAPY TEAM Added to Northumbria University Practice Placements Website July 2011 1 Contents Welcome Introduction
More informationInterventions to reduce emergency hospital admissions for falls. Cath Lewis. Liverpool Public Health Observatory
Interventions to reduce emergency hospital admissions for falls Cath Lewis Liverpool Public Health Observatory Observatory Report Series number 81 clewis@liverpool.ac.uk January 2010 ACKNOWLEDGEMENTS Fran
More informationAppendix 3: Specialist Rehabilitation Prescription Proforma (example).
Appendix 3: Specialist Rehabilitation Prescription Proforma (example). For patients with complex rehabilitation needs requiring Specialist (Level 1 or 2) Rehab services. The specialist rehabilitation Prescription
More informationStandards of excellence
The Accreditation Canada Stroke Distinction program was launched in March 2010 to offer a rigorous and highly specialized process above and beyond the requirements of Qmentum. The comprehensive Stroke
More informationFunctional Outcomes of Cancer Patients in an Inpatient Rehabilitation Setting
Original Article 197 Functional Outcomes of Cancer Patients in an Inpatient Rehabilitation Setting San San Tay, 1 MBBS, MMed (Int Med), MRCP (UK), Yee Sien Ng, 1 MBBS, MRCP (UK), Peter AC Lim, 1 MBBS,
More informationEmployment after Traumatic Brain Injury (TBI): A cohort comparison study. Aim of feasibility study. Inclusion Criteria
Employment after Traumatic Brain Injury (TBI): A cohort comparison study Julie Phillips, Occupational Therapist University of Nottingham/ Nottingham Traumatic Brain Injury Service Return to work after
More informationLLANDUDNO HOSPITAL PROJECT CYCLE ONE REPORT FOR REHABILITATION PROJECT TEAM: ASSESSMENT OF POTENTIAL SOLUTIONS FOR DEVELOPING SERVICES MARCH 2010
LLANDUDNO HOSPITAL PROJECT CYCLE ONE REPORT FOR REHABILITATION PROJECT TEAM: ASSESSMENT OF POTENTIAL SOLUTIONS FOR DEVELOPING SERVICES MARCH 2010 SITUATION The Rehabilitation Project Team has been established
More informationBreakfast Club Lecture Series 2018
Breakfast Club Lecture Series 2018 The Summer Foundation is proud to announce the Breakfast Club professional development lecture series for 2018 on brain injury rehabilitation, providing information about
More informationA. Service Specification
A. Service Specification Service Specification No: 1767 Service Adult Highly Specialist Pain Management Services Commissioner Lead For local completion Lead For local completion 1. Scope 1.1 Prescribed
More informationPREVIOUS EMPLOYMENT. Associate OT : CJ Occupational Therapy * Assessment and treatment for adults with neurological conditions
CURRICULUM VITAE Katie Hanagarth Green Owl Therapy Office 3, 36 Greenhill Street Stratford-upon-Avon CV37 6LE Tel: 01789 413960 / 07966 573317 Email: katie@greenowltherapy.co.uk - Web: www.greenowltherapy.co.uk
More informationInpatient Rehab in Acute Care or Rehab Hospitals* Dedicated Rehab Unit
Outpatient & Community I n p a t I e n t Institutional Setting Inpatient Rehab in Acute Care or Rehab Hospitals* Acute Care Integrated Specialized Units Transitional Care in Acute Care, LTC or CCC Not
More informationYour Orthotics service is changing
Your Orthotics service is changing Important for referrers on changes effective from January 2015 Why is the service changing? As demand for the orthotics service increases and budgets remain relatively
More informationYour Risk for Stroke and How to Be Prepared
Your Risk for Stroke and How to Be Prepared TABLE OF CONTENTS 01 / 02 / 03 / 04 / 06 / 07 / 08 / 09 / 14 / Stroke Education Stroke: The No. 5 Cause Of Death In The U.S. Is Stroke Preventable? Stroke Risk
More informationInitial analysis of newly added data items. Do they provide insights of value?
University of Wollongong Research Online Australian Health Services Research Institute Faculty of Business 2013 Initial analysis of newly added data items. Do they provide insights of value? Frances Simmonds
More informationWe will look at the definition of Neuro-Rehabilitation as opposed to Palliative Care, What impairments patients have at diagnosis How good we are at
We will look at the definition of Neuro-Rehabilitation as opposed to Palliative Care, What impairments patients have at diagnosis How good we are at picking these up; What we need to do to change the system
More informationBACKGROUND ON INPATIENT REHAB FACILITIES (IRF)
BACKGROUND ON INPATIENT REHAB FACILITIES (IRF) There are 1,140 IRFs in the US 1,000 rehab units within hospitals 217 freestanding rehabilitation hospitals 68% for-profit; 30% nonprofit. Most with designated
More informationKeeping up with the evidence in stroke rehabilitation: new (and newer) developments in the national clinical guideline
Keeping up with the evidence in stroke rehabilitation: new (and newer) developments in the national clinical guideline Audrey Bowen Stroke Association John Marshall Memorial Professor of Neuropsychological
More information13th. UK Stroke Forum Conference 2018 #UKSF18
13th UK Stroke Forum Conference 2018 #UKSF18 Life Time Achievement Award Professor Pippa Tyrrell Professor of Stroke Medicine and an Honorary Consultant Salford Royal Foundation Trust The Lifetime Achievement
More informationRehabilitation and Metastatic Spinal Cord Compression
Rehabilitation and Metastatic Spinal Cord Compression Pradeep Thumbikat MS, MSc, FRCS Consultant in Spinal Cord Injuries Sheffield Teaching Hospitals 1 Evidence for Rehabilitation Differences and similarities
More informationRehabilitation medicine programme: update report
Rehabilitation medicine programme: update report Item type Authors Citation Publisher Report Health Service Executive (HSE); Patient Safety First Health Service Executive, Patient Safety First. Rehabilitation
More informationComplex regional pain syndrome in adults: concise guidance
CONCISE GUIDANCE Clinical Medicine 2011, Vol 11, No 6: 596 600 Complex regional pain syndrome in adults: concise guidance Lynne Turner-Stokes and Andreas Goebel on behalf of the guideline development group
More informationSpecialty Rehabilitation Fact Sheet
TIRR Memorial Hermann is a nationally recognized rehabilitation hospital that returns lives interrupted by neurological illness, trauma or other debilitating conditions back to independence. Some of the
More informationOriginal Article. Client-centred assessment and the identification of meaningful treatment goals for individuals with a spinal cord injury
(2004) 42, 302 307 & 2004 International Society All rights reserved 1362-4393/04 $25.00 www.nature.com/sc Original Article Client-centred assessment and the identification of meaningful treatment goals
More informationSpinal Cord Injury Fact Sheet
TIRR Memorial Hermann is a nationally recognized rehabilitation hospital that returns lives interrupted by neurological illness, trauma or other debilitating conditions back to independence. Some of the
More informationAssessment and early identification
The Right Care: creating dementia friendly hospitals Assessment and early identification Good practice for better care 1 Assessment and early identification Section 1 Self assessment statements from National
More informationOUTCOMES AND DATA 2016
AND DATA 2016 SERVED BY REHAB IMPAIRMENT CATEGORY 20 patients 5.1% MAJOR MULTIPLE TRAUMA W/BRAIN OR SPINAL CORD INJURY 24 patients 6.2% TRAUMATIC 39 patients 10.0% AMPUTATION LOWER EXTREMITY 26 patients
More informationImplementing the Rehabilitation Prescription
Implementing the Rehabilitation Prescription This document sets out the conceptual development and some general principles for implementation of the standard rehabilitation prescription within the acute
More informationIndependent prescribing by physiotherapists in neurological rehabilitation: Management of spasticity with botulinum toxin
London North West Healthcare NHS Trust Independent prescribing by physiotherapists in neurological rehabilitation: Management of spasticity with botulinum toxin Dr Stephen Ashford Regional Hyper-acute
More informationIntegrated Care Approach for Frailty in the Older Person Conference, March 8 th 2017
Integrated Care Approach for Frailty in the Older Person Conference, March 8 th 2017 Mairéad Chawke Senior Physiotherapist & Joint ESD Co-Ordinator Galway University Hospitals ESD aims to accelerate discharge
More informationSpinal cord injury and quality of life: a systematic review of outcome measures
Systematic review Spinal cord injury and quality of life: a systematic review of outcome measures 37 37 44 Spinal cord injury and quality of life: a systematic review of outcome measures Authors Jefferson
More informationNATIONAL INSTITUTE FOR CLINICAL EXCELLENCE SCOPE
NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE 1 Guideline title SCOPE Chronic fatigue syndrome/myalgic encephalomyelitis: diagnosis and management of chronic fatigue syndrome/myalgic encephalomyelitis in
More informationDelivering rehabilitation in the community
Delivering rehabilitation in the community Rebecca Fisher, Satu Baylan, Terry Quinn, Katrina Brennan, Neil Muir, Marion Walker, Sarah Florida-James, Peter Langhorne Overview Implementation of Community
More informationSEMINAR PROGRAMME Join us on Twitter #brainpower
SEMINAR PROGRAMME Join us on Twitter #brainpower Seminar Programme 09:30 Registration and refreshments 10:00 Introduction and welcome Barbara O Connell Chief Executive Session 1: Current trends in evidence
More informationGuidelines for Recognition of Private Hospital-Based Rehabilitation Services March 2016
Guidelines for Recognition of Private Hospital-Based Rehabilitation Services March 2016 Developed by the Consultative Committee on Private Rehabilitation Guidelines for Recognition of Private Hospital-Based
More informationEmerson Hospital Outpatient Services
Emerson Hospital Outpatient Services A Growing Demand initiative to expand sports rehabilitation and specialty services 310 baker avenue, concord, massachusetts Our pediatric occupational therapy specialists
More information78,000 hip fractures per year. 700,000 older people attend A&E due to a fall each year. Falls in the UK Overview and health care strategy
Falls in the UK Overview and health care strategy Sue Jackson Chartered Physiotherapist Orthopaedic / A&E extended scope practitioner Some statistics for the UK 30% aged >65 will fall per year 45% aged
More informationSouth East Coast Operational Delivery Network. Critical Care Rehabilitation
South East Coast Operational Delivery Networks Hosted by Medway Foundation Trust South East Coast Operational Delivery Network Background Critical Care Rehabilitation The optimisation of recovery from
More informationMy hip fracture care: 12 questions to ask A guide for patients, their families and carers
My hip fracture care: 12 questions to ask A guide for patients, their families and carers About this guide This guide is aimed at patients who have a hip fracture, and their families and carers. It explains
More informationReport from Workshop 8 th June 2017
National Clinical Audit of Specialist Rehabilitation following major Injury (NCASRI) Report from Workshop 8 th June 2017 Prepared by the NCASRI Team: Professor Lynne Turner- Stokes Dr Karen Hoffman Dr
More informationAROC Outcome Targets Report Inpatient Pathway 3
AROC Outcome Targets Report Inpatient Pathway 3 Anywhere Hospital January 2013 December 2013 Australasian Faculty of Rehabilitation Medicine AROC impairment specific benchmarking process...3 Introducing
More informationFunctional Level During the First Year After Moderate and Severe Traumatic Brain Injury: Course and Predictors of Outcome
Original Article Elmer ress Functional Level During the First Year After Moderate and Severe Traumatic Brain Injury: Course and Predictors of Outcome Maria Sandhaug a, b, e, Nada Andelic c, Svein A Berntsen
More informationVaccination gets you wealthier.
Vaccination gets you wealthier. A: What makes you healthier? B: What makes you wealthier? A: Google 58,000,000 hits B: Google 500,000,000 hits Wealth to health ratio is 10:1 Prof. David M Salisbury CB
More informationPALLIATIVE MEDICINE Nigel Sykes St Christopher s Hospice London UK
Guttmann Conference June 2013 PALLIATIVE MEDICINE Nigel Sykes St Christopher s Hospice London UK Palliative Medicine What is Palliative Medicine and where did it come from? The extent and organisation
More informationMeeting the Future Challenge of Stroke
Meeting the Future Challenge of Stroke Stroke Medicine Consultant Workforce Requirements 2011 201 Dr Christopher Price BASP Training and Education Committee Stroke Medicine Specialist Advisory Committee
More informationNeurodegenerative diseases Includes multiple sclerosis, Parkinson s disease, postpolio syndrome, rheumatoid arthritis, lupus
TIRR Memorial Hermann is a nationally recognized rehabilitation hospital that returns lives interrupted by neurological illness, trauma or other debilitating conditions back to independence. Some of the
More informationLars Jacobsson 1,2,3* and Jan Lexell 1,3,4
Jacobsson and Lexell Health and Quality of Life Outcomes (2016) 14:10 DOI 10.1186/s12955-016-0405-y SHORT REPORT Open Access Life satisfaction after traumatic brain injury: comparison of ratings with the
More informationSpecialised Spinal Cord Injury CODING HANDBOOK
National Spinal Cord Injury Strategy Board Commissioning Classifications Sub-Group Specialised Spinal Cord Injury CODING HANDBOOK Second Edition Containing Definitions of Commissioning Classifications
More informationNeurodegenerative Diseases, Debilitating Conditions and Multiple Trauma Program (Neuromuscular Rehab)
Neurodegenerative Diseases, Debilitating Conditions and Multiple Trauma Program (Neuromuscular Rehab) TIRR Memorial Hermann is a nationally recognized rehabilitation hospital that returns lives interrupted
More informationPrediction of functional outcome after spinal cord injury: a task for the rehabilitation team and the patient
() 8, 8 ± ã International Medical Society of Paraplegia All rights reserved ± / $. www.nature.com/sc Prediction of functional outcome after spinal cord injury: a task for the rehabilitation team and the
More informationEarly Intervention Teams services for early psychosis
Early Intervention Teams services for early psychosis Early intervention services work with people who are usually between 14 and 35, and are either at risk of or are currently experiencing a first episode
More informationRecognition of Skills and Training Q. Does the Greens support direct referrals to selected medical specialist services?
22 September 2014 Colleen Hartland, MLC 75 Victoria Street SEDDON VIC 3011 Dear Ms Hartland, The Australian Physiotherapy Association represents more than 4,100 Victorian physiotherapists and over 16,500
More informationSpecialised Services Commissioning Policy: CP141 Specialised Spinal Cord Injury Rehabilitation
Specialised Services Commissioning Policy: CP141 Specialised Spinal Cord Injury Rehabilitation February 2018 Version 1.0 Document information Document purpose Document name Author Policy Specialised Spinal
More informationSession 1 - Innovation in Diagnosis and Intervention for Autism and Related Disorders
European Academy of Childhood Disability 16th Annual Meeting - EACD 2004 Satellite Meetings: 6th October 2004 Main Conference: 7th-9th October 2004 Assembly Rooms, George Street, Edinburgh, Scotland Satellite
More informationAROC Intensity of Therapy Project. AFRM Conference 18 September 2013
AROC Intensity of Therapy Project AFRM Conference 18 September 2013 What is AROC? AROC began as a joint initiative of the whole Australian rehabilitation sector (providers, payers, regulators and consumers)
More informationRehabilitation in Hospital Authority- Challenges and the Way Ahead
Rehabilitation in Hospital Authority- Challenges and the Way Ahead Leonard S.W. Li Head, Division of Rehabilitation Medicine Department of Medicine Tung Wah Hospital Rehabilitation Services within Hospital
More informationPOSITION DESCRIPTION Grade 4 Physiotherapist Physiotherapy Department
POSITION DESCRIPTION Grade 4 Physiotherapist Physiotherapy Department Date revised: June 2015 POSITION: AWARD/AGREEMENT: Grade 4 Physiotherapists Health Professionals (Public Sector Victoria) CLASSIFICATION
More informationThe Role of Physiatry in the Care of Adults and Children with Hydrocephalus
The Role of Physiatry in the Care of Adults and Children with Hydrocephalus Scott E. Brown, MD Chairman Department of Physical Medicine and Rehabilitation Sinai Hospital of Baltimore Who Are We? PHYSICAL
More informationComprehensive Management Of Spinal Cord Injury (Clinical Symposia) Volume 34, Number 2 By FRACS Sir George Bedbrook, MD William H Donovan;OBE
Comprehensive Management Of Spinal Cord Injury (Clinical Symposia) Volume 34, Number 2 By FRACS Sir George Bedbrook, MD William H Donovan;OBE READ ONLINE Spinal Cord Stimulator Implant. Spinal cord stimulation
More informationLondon Strategic Clinical Networks. Quality Standard. Version 1.0 (2015)
London Strategic Clinical Networks Quality Standard Version 1.0 (2015) Supporting the delivery of equitable, high quality AKI care through collaboration www.londonaki.net @LondonAKI Overview The management
More informationSpecialist Neurological Rehabilitation at Christchurch Group
Specialist Neurological Rehabilitation at Christchurch Group christchurchgroup.co.uk 1 welcome A warm Christchurch Group is based on the principles of integrity, transparency, compassion and positivity.
More informationFalls and Fragility Fracture Audit Programme
Falls and Fragility Fracture Audit Programme Update for Healthcare Conference 5 th November 2014 Dr Helen Wilson Member of FFFAP Executive Board Content The Falls and Fragility Fracture Audit Programme
More informationRehabilitation/Geriatrics ADMISSION CRITERIA. Coordinated Entry System
Rehabilitation/Geriatrics ADMISSION CRITERIA Coordinated Entry System Table of Contents Rehabilitation and Geriatric Service Sites 3 Overview of Coordinated Entry System...4 Geriatric Rehabilitation Service
More informationT here is strong evidence that organised stroke care reduces
ORIGINAL ARTICLE Stroke units: research and reality. Results from the National Sentinel Audit of Stroke A G Rudd, A Hoffman, P Irwin, M Pearson, D Lowe, on behalf of the Intercollegiate Working Party for
More informationDevelopment and initial validation of the Northwick Park Therapy Dependency Assessment
Clinical Rehabilitation 2009; 23: 922 937 Development and initial validation of the Northwick Park Therapy Dependency Assessment Lynne Turner-Stokes King s College London, School of Medicine, Department
More information