When Outcomes are Everything

Transcription

1 700 Children s Drive Columbus, Ohio Nationwide Children s Hospital INPATIENT REHABILITATION PROGRAM 2013 Annual Report To learn more about our program and take a video tour of our unit, visit us on the web at NationwideChildrens.org/Rehab. To make a referral, call (614) When Outcomes are Everything Inpatient Rehabilitation Program 2013 Annual Report Accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) as a Pediatric Specialty Program 9161

2 Before his car accident, James didn t know where his life was headed. Now, he s working on a college degree and living independently. A car accident left 18-year-old James with a collapsed lung, a bruised heart, a fractured spine in the C-6 vertebrae and several other injuries. After initial treatment, he was transferred to Nationwide Children s Hospital for his rehabilitation. Despite his use of a ventilator and the complete loss of movement in his arms and legs, James was welcomed to the Inpatient Rehabilitation Unit, where he began preparing for an entirely new life. In addition to achieving physical goals such as independent breathing, eating and wheelchair use, James worked with rehab staff to accomplish his most immediate personal goal: graduating from high school with his senior class. After three months of intensive therapy and preparation for his return to his community, James left Nationwide Children s just in time for graduation. Then he surpassed his own goal: he started a college degree. Keep reading to learn about the resources and assistance James received to aid in his return to community, as well as other achievements by our team in Jayne Derr (School Teacher), Ellen S. Kaitz, MD, FAAPMR (Physician, Section of Physical Medicine and Rehabilitation; Director, Pediatric Rehabilitation Fellowship Program), David Vargo (Patient Care Assistant, Rehabilitation), James Rambo (former patient), Lynn Sagona, RN (Nurse, Rehabilitation), Rhine (Dr. Kaitz s dog) 1 Inpatient Rehabilitation Program 2013 Annual Report Inpatient Rehabilitation Program 2013 Annual Report 2

3 SUCCESS TABLE OF CONTENTS All About Community...pages 5-6 The Importance of Home...pages 7-8 Laying the Groundwork for Return to Community... page 10 Best Outcomes, No Matter the Starting Point... page 11 The Difference is Clear... page 14 The Importance of Accreditation... page 16 Inpatient Rehabilitation Program Leadership... page 17 TO LEARN MORE ABOUT OUR PROGRAM AND TAKE A SLIDE-SHOW TOUR OF OUR UNIT, VISIT NATIONWIDECHILDRENS.ORG/REHAB. TO MAKE A REFERRAL, CALL (614) In Nationwide Children s Rehabilitation Program, patient and program outcomes are a powerful measure of how successful we are in meeting the needs of our patients and families and preparing them for reintegration to home, community and school. We measure outcomes with each patient over the course of his or her rehab stay as well as post-discharge, which provides information about the quality of our program and any areas that we may need to improve. We are proud to report that 2013 was a highly successful year for the Rehabilitation Program, including an outstanding Commission on Accreditation of Rehabilitation Facilities (CARF) reaccreditation and Nationwide Children s JCAHO reaccreditation, both of which recognized the extraordinary work that we do in rehab. But even more significant recognitions of our efforts are the individual success stories of our patients, such as James. His amazing story represents what hard work can accomplish with the expertise and commitment of an outstanding interdisciplinary team. Join us as we celebrate both our patient successes in outcomes and our program successes in providing excellent rehabilitation care to all our patients and families. MICHELLE A. MILLER, MD, FAAPMR Medical Director and Section Chief, Physical Medicine and Rehabilitation, Nationwide Children s Hospital Clinical Assistant Professor, The Ohio State University College of Medicine OUR MISSION The mission of the Rehabilitation Program is to provide comprehensive, family-centered rehab services to meet the physical, developmental, social, psychological and educational needs of our patients and their families. CARF-ACCREDITED Nationwide Children s Hospital has been accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) since In 2013, we renewed our three-year accreditation as a Pediatric Specialty Program following an independent, external review of our operations and outcomes. CARF accreditation is the gold standard among leading rehabilitation programs. It demonstrates our commitment to providing quality services, focusing on the unique needs of each patient and family and continually evaluating the results of our services. 3 Inpatient Rehabilitation Program 2013 Annual Report Inpatient Rehabilitation Program 2013 Annual Report 4

4 ALL ABOUT COMMUNITY The rehab unit offers state-of-the-art equipment and facilities, all designed to assist patients and families with the most important outcome of all: returning to the community. The focus on supportive connections and activity-focused rehabilitation offers patients a nurturing environment where they learn how to perform tasks they will face when they return to their homes and schools. Twelve patient rooms now make up the inpatient unit on the ninth floor, which also includes our therapy gym, rehab classroom and Determination Way a custom-designed simulated community that allows patients to practice activities of daily living in a realistic environment. TAKE THE TOUR Our facility provides comprehensive accommodations for rehabilitative therapy and teaching activities. Determination Way includes: A fully equipped kitchen with adaptive drawers and cupboards, which allows patients to practice everyday activities A full-sized Honda Civic to teach patients how to transfer in and out of a vehicle A simulated cafeteria and store, complete with a school lunch line counter and restaurant-style booth to help patients prepare for life after rehab A SMART Board interactive, electronic whiteboard to facilitate real-time teaching activities in the rehab school room 5 Take a tour of our2013 comprehensive Inpatient Rehabilitation Program Annual Report unit at NationwideChildrens.org/Rehab. A sensory activity space for the practice of movement and balance skills A LiteGait system to support patients during gait therapy and enable partial weight-bearing practice A rehab gym equipped with a climbing wall, basketball court and many other advanced recreational and rehab equipment options Patient rooms with ceiling-mounted patient lift systems for transport throughout the room and into the shower and bathroom Inpatient Rehabilitation Program 2013 Annual Report 6

5 I will never forget the grace and positive attitude that James displayed every single day while facing one of the biggest challenges of his life. Jayne Derr, Schoolteacher THE IMPORTANCE OF HOME While the health care team focuses on metrics for efficiency and comparisons, patients care about home when they can go home, how they will readjust to life in the community and what changes they will need to be as comfortable as possible. That s why our staff customizes treatment plans to help each patient achieve maximum independence upon their return to home, school and community. We know that each patient has a unique home environment and individual needs. Our team performs a comprehensive evaluation of the skills patients will need in their daily lives, including possible obstacles. Then we work with patients and their families to build a strategic, home-focused treatment plan. By using real-world situations and tools, we help patients prepare for day-to-day activities they will need to perform based on their individual abilities. No matter the complexity of the case, our team approach to return to community adapts to help every patient succeed. 100% 80% 99% 85% 88% 60% 40% 20% Discharge to Community A greater percentage of our patients are discharged back into the community despite the fact that we take on even the toughest cases. 0 Nationwide Children's Similar Facilities National Average All chart information based on 2013 data 7 Inpatient Rehabilitation Program 2013 Annual Report Preparing James for his return to the community combined actual schoolwork with the practice of functional skills for maneuvering in a classroom. Now he puts those skills to work at Wright State University. Inpatient Rehabilitation Program 2013 Annual Report 8

6 80% 70% 60% LAYING THE GROUNDWORK FOR RETURN TO COMMUNITY 50% 40% 30% 20% 10% 0% Regular Regular with Accomondation Talented/ Gifted Special Home Instruction N/A Acute Care 3% Extended Care 1% Home 96% Prior to Admission At Discharge Educational Reintegration Our patients return to their education with appropriate adjustments in accommodations or delivery mode. Disposition from Rehab For 96 percent of our patients, home is the first stop after discharge from rehab. Assessing Future Environments: Upon discharge, patients returning to home and school may require accommodations. We assess future environments for steps, ramps, handrails, doorway width, bed and bathroom locations and emergency exits. If any changes are needed, we help develop a plan. Designing a Treatment Plan: We develop a treatment plan to prepare patients for their return to home and school. Instead of organizing treatment based on patient limitations, we emphasize the mastery of individualized essential skills that patients will need upon return to the community. Adjusting Skills: Rehab helps patients master functional tasks they will need to succeed in the community, such as walking up porch stairs, getting in and out of the bathtub, getting dressed and using a kitchen. Basing Goals on Planned Outcomes: Instead of designing goals separately for each therapy discipline, the whole rehab team customizes goals to make sure the patient can succeed in the community they will rejoin. Involving Family from Day One: Teaching the family how to manage care from the beginning helps families understand their role in maintaining and directing the care plan after discharge. This makes the transition from hospital to home smoother and less stressful. Focusing on Home-Oriented Outcomes: Practicing community activities and home routines in a real-world setting helps build skills with direct transfers to the outpatient setting. By getting patients accustomed to their home activities while still in rehab, we help them master their skills for the easiest return to community. All chart information based on 2013 data 9 Inpatient Rehabilitation Program 2013 Annual Report Inpatient Rehabilitation Program 2013 Annual Report 10

7 Other: Neurological, 17% Spinal Cord Injury, 12% Traumatic Brain Injury, 29% Average Median 20 Other, 10% Cerebral Vascular Accident, 3% Non-Traumatic Brain Injury, 36% Impairment Groups Two-thirds of our patients must overcome brain injuries to achieve their own best outcomes. DAYS Length of Stay in Days Our median length of stay is less than three weeks. All chart information based on 2013 data Best Outcomes, No Matter the Starting Point Complex cases. Ventilators. Traumatic brain injuries. No matter the 35% 30% initial diagnosis or prognosis, our team works toward one goal: the 25% best possible outcome for each patient. We track our performance to turn the best outcomes of today into even better outcomes tomorrow. 20% 15% 10% 5% 0% <2 years 2-5 years 6-9 years years years >15 years Ages We accept patients of all ages and backgrounds. 11 Inpatient Rehabilitation Program 2013 Annual Report Inpatient Rehabilitation Program 2013 Annual Report 12

8 The Difference is Clear PATIENTS PER YEAR 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Inpatient Outpatient Other Hospital Referral Sources Nearly one-fourth of our patients come to us from other hospitals. INNOVATIVE FACILITIES, REAL-WORLD SETTING Our inpatient unit, located in the new hospital that opened in 2012, is outfitted with the leading equipment, allowing our patients to work toward recovery in a safe, fun environment. Our custom-designed simulated community provides a unique real-world environment where patients learn how to manage activities of daily living. COORDINATED CARE CONTINUUM Because we are located within a leading pediatric medical institution, we offer a complete continuum of care under one roof. Patients have direct access to a range of medical specialties, such as critical care, surgery, neurology, neurosurgery, orthopedics, radiology and pulmonary medicine. Access to round-the-clock emergency services means our patients aren t transferred to another facility when a critical need arises. Our program also accepts patients on ventilators, something many free-standing centers cannot do. TRAUMA EXPERTS Nationwide Children s is one of only three freestanding Level I Pediatric Trauma Centers in Ohio, and the only one that is also classified as a Burn Center by the American Burn Association. This allows trauma patients to receive an exceptional level of care with a seamless transition to a leading inpatient rehabilitation program. FOCUSED ON CHILDREN AND YOUNG ADULTS Nationwide Children s is specialized for the unique needs of children and teens. All of the physicians on our Physical Medicine and Rehabilitation team are pediatric specialists. Our outcome-oriented rehabilitation plans are designed with children s physical, cognitive and social development in mind an approach that prepares our patients to return to home, school and community. CARF-ACCREDITED FOR PEDIATRICS Our program is recognized by the Commission on Accreditation of Rehabilitation Facilities (CARF) as a Pediatric Specialty Program, an accreditation that recognizes our commitment to providing results-driven, quality services that focus on the unique needs of each patient and family. Nationwide Children s Similar Facilities National Admit WeeFIM score % Discharge WeeFIM score % WeeFIM Total Gain Average Length of Stay (days) All chart information based on 2013 data WeeFIM Efficiency Outcomes: National Summary WeeFIM scores measure children s fuctional abilities. Our patients are more independent by discharge than those exiting rehab at other hospitals around the country. 60% 40% 20% 0% Customer Satisfaction We pride ourselves on maintaining outstanding customer satisfaction rates. 13 Inpatient Rehabilitation Program 2013 Annual Report Inpatient Rehabilitation Program 2013 Annual Report 14

9 The Importance of Accreditation The Nationwide Children s Inpatient Rehabilitation Program continues to maintain accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF) as a Pediatric Specialty Program. The key benefits of CARF accreditation include: An independent, external review to identify strengths and areas for improvement based on objective expectations and guidelines common to all CARF-accredited programs Commitment to continuous quality improvement by applying CARF standards and collecting outcomes data to improve programs and services Assurance to families seeking services that we conform to internationally accepted standards Person-focused standards, which emphasize an integrated and individualized approach to services and outcomes Management techniques that are efficient, cost-effective and based on outcomes and consumer satisfaction 2013 Accreditation Highlights Nationwide Children s has received CARF s highest award of a three-year accreditation renewal for the eighth cycle in a row. Selected quotes from the 2013 accreditation report include: The atmosphere on the rehabilitation unit is positive, promotes hard work and progress and is supportive of the achievement of outcomes. The organization is commended for its extensive and creative educational opportunities for teaching children served, parents and even siblings about specific health care procedures and techniques. The organization has designed its space in a way that promotes having the child and family make it their home away from home. From the design and layout of the unit to the content of the rehabilitation gym, aptly named Determination Way, the needs of the persons served were considered and incorporated into the physical spaces. 15 Inpatient Rehabilitation Program 2013 Annual Report A team approach to real-life skill building helps patients like James prepare to take charge of their own care after they return home. Inpatient Rehabilitation Program 2013 Annual Report 16

10 INPATIENT REHABILITATION PROGRAM Learn more about our program and take a tour at NationwideChildrens.org/Rehab. To make a referral, call (614) Michelle A. Miller, MD, FAAPMR Medical Director Rosalind Batley, MD, FAAP, FAAPMR Carl Gelfius, MD, FAAPMR, FAANEM Ellen Kaitz, MD, FAAPMR Karl Klamar, MD, FAAPMR Michelle Potts, MD, FAAPMR Charline Catt, RN, MS Vice President, Patient Care Services: Rehab/Medical Services Karen Principe, RN, MS, NE-BC Program Manager Cindy Iske, MS, OTR/L Rehabilitation Coordinator Heather King, RN, CRRN Clinical Leader Julie Apthorpe, RN, BSN, CRRN Clinical Leader 17 Inpatient Rehabilitation Program 2013 Annual Report Inpatient Rehabilitation Program 2013 Annual Report 18