2011 Annual Report The Regional Rehabilitation Center Published December 2012
Dear Friends, Compassionate, patient-centered, quality care is always our goal at The Regional Rehabilitation Center at Faxton St. Luke’s Healthcare (FSLH). This report shares how our team’s vision to expand long-term care services in Oneida County has become a reality. In 2013, we will celebrate the opening of our new Acute Inpatient Rehabilitation Unit (IRU) at the Center for Rehabilitation and Continuing Care Services, also the site of St. Luke’s Home. The specially designed, state of the art unit supports our patients in their efforts to regain independence and return home. Patients are at the center of all we do, and our wide range of inpatient and outpatient services make The Regional Rehabilitation Center your “one stop” for all your physical rehabilitation needs. The quality care we provide our patients is the result of our staff’s dedication to lifelong learning and professional development. Our team is highly educated with specialized credentialing in their respective fields. We have much to look forward to in 2013 with the completion of the Center for Rehabilitation and Continuing Care Services complex, including the
On the Cover: Lisa Hrynuk, RN, BS, CRRN, IRU nurse manager, and Georgia Deveans-Smith, RN, BS, CRRN, IRU nurse clinician. Lisa Bauer, MS, OTR/L, works with a patient in the transitional living center. Physical Therapist Victoria Ponce, PT, with a patient in the new rehabilitation gym.
relocation of Senior Network Health, Visiting Nurse Association of Utica and Oneida County, Mohawk Valley Home Care and an expanded Adult Day Health Care Program. Having inpatient rehabilitation and Continuing Care Services at one location is a tremendous benefit to our patients, residents, their families, medical staff and employees. The Regional Dialysis Center at FSLH will also open a new eight station outpatient dialysis unit at the site. This is a convenience for the many patients at St. Luke’s Home and inpatient rehabilitation who require dialysis treatments. The expansion and renovations were made possible by an incredible $31.3 million grant provided through Phase 20 of the Health Care Efficiency and Affordability Law of New York State (HEALNY) and the Federal-State Reform Partnership (F-SHRP). Our vision is to be the premiere healthcare organization in the region. Through the commitment of our employees, medical staff, administration and board of directors, we are building a culture of excellence to make that vision a reality.
Stephen Wade, MD Meenakshi (Mini) Malhotra, MBA, MHA, OTR Medical Director, Rehabilitation Services Vice President, Strategic Integration
premiere healthcare organization in our region,” said Mini Malhotra, MBA, MHA, OTR, vice president of Strategic Integration at FSLH. “Having inpatient rehabilitation and Continuing Care Services at one location is a tremendous benefit to our patients, residents, their families, medical staff and employees.”
Acute Inpatient Rehabilitation to Move to New $2 Million Unit at the Center for Rehabilitation and Continuing Care Services
An Interdisciplinary Approach
In late 2011, FSLH broke ground on a multi-million dollar expansion to St. Luke’s Home, commencing work on what is to become the Center for Rehabilitation and Continuing Care Services. These renovations were made possible by a $31.3 million grant from New York State to improve long-term care services and consolidate community-based alternatives for Oneida County residents.
Our Acute Inpatient Rehabilitation Unit (IRU) will soon move to the new complex and joins the 40bed Subacute Rehabilitation Unit already located at St. Luke’s Home. In early 2013, FSLH’s Home Care Services, Adult Day Health Care and a new eight station outpatient dialysis unit will also relocate to the complex. “This is an incredible opportunity for our organization to provide much needed services at one location,” noted Scott H. Perra, FACHE, president/CEO of FSLH. “Our rehab patients are often supported by our Home Care Services team after discharge and having them in one complex allows patients to benefit from a collaborative plan of care. I commend the teams for having the vision to create such a comprehensive program to serve our community.”
The New IRU Previously located at the Faxton Campus, the new 19,000 square foot unit has 10 private rooms and seven semi-private rooms, all of which have large, handicap-accessible bathrooms. Staff selected Adirondack-themed colors and fabrics that are soothing and natural to give the unit a home-like feel. 4
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“We’ve always had an exceptional team of caregivers,” said Lisa Hrynuk, RN, BS, CRRN, IRU nurse manager. “Now we have the opportunity to provide this care in a specially-designed, state of the art environment.” The new unit features a transitional living center equipped with new appliances that simulate typical household activities, like cooking and laundry. Here patients practice every day skills that many may take for granted, such as how to get food from the stove to the table while using an assistive walking device. Patients also have exclusive use of a new dining room and rehabilitation gym, which creates greater opportunities for socialization — an important aspect of recovery. “The transitional living center and witnessing the progress of their peers give those patients who are unsure if they are ready to return home the confidence to believe in their recovery,” said Georgia Deveans-Smith, RN, BS, CRRN, IRU nurse clinician. In all, the renovations to the IRU cost more than $2 million, not including an investment of $400,000 in new equipment for the unit. “The Center for Rehabilitation and Continuing Care Services supports our vision of becoming the
Regional Rehabilitation Center
Occupational Therapist Coral Hunt, OTR/L, working with a patient in the new rehabilitation gym.
The Center for Rehabilitation and Continuing Care Services was carefully designed to optimize relationships between related services for the convenience of patients, families and caregivers. “Communication will be strengthened between all areas because everyone will be working side by side,” said Diane Jackson, OTR/L, Occupational and Physical Therapy manager. “This proved challenging at the Faxton Campus because the unit and rehabilitation gym were on different levels. Not only did we have to transport patients between floors, but our staff tended to communicate largely by phone.” “This move allows us to become even more interdisciplinary,” said Deveans-Smith. “Each service has been separate up to this point and will benefit from enhanced teamwork made possible by proximity. Transitioning between services within the same building is also a comfort for our patients because the staff they are already familiar with are always nearby.” “Our new program design provides for all patient needs, from the inpatient setting to their return home,” remarks Malhotra. “And as always, we continue to provide high-quality outpatient rehabilitation and wellness programs at The Regional Rehabilitation Center at the Faxton Campus.” n
“We’ve always had an exceptional team of caregivers. Now we have the opportunity to provide care in a specially-designed, state of the art environment.” — Lisa Hrynuk, RN, BS, CRRN, IRU nurse manager
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Excellence in Action: Clinical Quality Drives the Care We Provide At FSLH, quality is a measure of success, a goal to work toward and above all a state of mind. Quality is not defined by a single action, but is the sum of all actions that impact the patient’s experience. Ensuring that each of the 450 patients admitted to the IRU receives high quality, individualized care is of primary importance to the Inpatient Rehabilitation team.
As a measure of the quality services and programs available to our patients, the Acute Inpatient Rehabilitation Program voluntarily participates in a rigorous peer review process to demonstrate our commitment to the high standards and practices expected of industry leaders. In 2011, FSLH was re-accredited for a three year period by the Commission on Accreditation for Rehabilitation Facilities (CARF), an independent, nonprofit organization focused on advancing the quality of services and outcomes available to rehabilitation patients. “CARF’s strict standards focus on quality patient care and outcomes, which helps us to create a culture of clinical excellence and find ways to improve the care we provide,” said Mini Malhotra, MBA, MHA, OTR, vice president of Strategic Integration. “This achievement speaks to the dedication and commitment of our physicians, nurses, therapists and support staff in providing an exceptional patient experience.” “We are proud to be the only CARF accredited inpatient rehabilitation program in the Mohawk Valley,” said Georgia Deveans-Smith, RN, BS, CRRN, IRU nurse clinician. “Through CARF, we have the ability to benchmark against units across the nation providing similar care which guarantees that we’re doing the best for our patients that we possibly can.” With a philosophy that emphasizes a team approach to individualized treatment and care, the goal of the IRU team is to help patients regain independence and transition back home. Patients are cared for by a team of medical professionals that includes physical and occupational therapists, speech-language pathologists, a psychologist, a case manager/social
Lisa Bauer, MS, OTR/L, shows a patient how to use adaptive equipment to help put her shoes on.
Regional Rehabilitation Center
worker, a certified therapeutic recreational specialist, a dietitian and a physiatrist — a physician who is specially trained in physical medicine and rehabilitation. Rehabilitation nurses support the rehabilitation plan of care and address concerns involving medication and pain management. Twelve IRU nurses are certified rehabilitation registered nurses (CRRNs), a designation earned by passing a national exam demonstrating rehabilitation expertise. Studies have shown that even a small increase in the number of CRRNs on a unit supports a patient’s specialized care and can decrease the average length of stay for patients by as much as one day. CRRNs support the treatment plans established by physical therapists, occupational therapists and speech-language pathologists. These individuals have achieved doctorate and graduate level designations in their respective fields, which they supplement with continuing education to learn about current developments and new therapies available to rehabilitation patients. “Rehab nurses think differently about what patients and their families need,” said Lisa Hrynuk, RN, BS, CRRN, IRU nurse manager. “One of the most difficult things for rehab nurses to learn is the fine line between doing for the patient and making the patient do for themselves. We can’t be there when a patient goes home, so they need to feel confident about themselves and their recovery.” As a result of the advanced training of IRU nurses and therapists, patients experience actual rehabilitation 24 hours a day, not just during their treatment sessions. n
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Q&A with Dr. Stephen Wade Stephen Wade, MD, is the medical director of the IRU. He is a physiatrist and also works as an interventional pain management specialist at Spinal and Skeletal Pain Medicine in Utica, New York. He is board certified by the American Academy of Physical Medicine and Rehabilitation and the American Board of Pain Medicine. Q. What do you enjoy most about being the IRU medical director? A. I enjoy our team environment and how we all work together cohesively. We meet and discuss patients and formulate plans in order to better serve our patients. Q. What is a physiatrist? A. Physiatrists are nerve, muscle and bone experts that treat injuries or illnesses that affect how you move. We deal with different patients with a variety of ailments including pain, stroke, traumatic injuries and sports injuries. Q. How important is a physiatrist’s role in the IRU? A. Our role is very important because we oversee and manage the rehabilitation unit while working closely with the team. Q. Why should patients choose FSLH? A. Our staff and their dedication set FSLH apart. Their attitude and commitment to their jobs is outstanding. We strongly support our patients and cater specifically to their rehab needs. Q. How would you describe the IRU team at FSLH? A. The team is well trained, professional and works well together. They are confident in their abilities and are constantly evolving professionally. As the direct care providers, the team is there with the patients helping them progress and achieve their goals. I’m proud of their dedication. The team is truly an integral part of the whole patient experience.
Physical Therapists, Victoria Ponce, PT, and Kristine McIlwain, PT, DPT, with a patient in the new rehabilitation gym.
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2011 Program Performance Patient Report Card
Stroke Patient Admissions 33%
Total Patient Admissions
98.2 percent
of the patients discharged from The Regional Rehabilitation Center report that they maintained their own care and independence 90 days after discharge.
92.8 percent
Most Experienced in the Region for Treating Stroke Related Disabilities
of patients are living independently at home 90 days after discharge from The Regional Rehabilitation Center. Most of our patients go home and stay home.
As the area’s only designated Primary Stroke Center, the percentage of stroke patients out of the total number of admissions was 33.3 percent compared to the region at 23.4 percent and the nation at 25.1 percent. We have more experience treating the disabilities associated with stroke than other facilities in the area.
4 Length of Stay
Highest FIM Gain Score in the Nation Our average Functional Improvement Measure (FIM) gain score for a patient’s ability to carry out functional skills, such as eating, bathing, dressing, etc. was much higher than that of other rehabilitation programs in the nation. Patients at The Regional Rehabilitation Center are more independent at discharge with a FIM gain score of 95.6 as compared to the national average of 88.4. This means our patients showed more improvement.
3.63 out of 4.0 Patient Satisfaction Score
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3.3 out of 4.0
Quality of Life Score The Regional Rehabilitation Center scored a 3.3 out of a perfect 4.0 with 93.4 percent of patients reporting that our rehabilitation program improved their quality of life.
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National Average Regional Rehabilitation Center
Highest LOSE Score in the Nation The 2011 Length of Stay Efficiency (LOSE) score of 2.86 was above the national average of 2.27. LOSE is a correlation of the length of stay and Functional Improvement Measurement (FIM) gain. LOSE indicates the gain in functional status of the patient during his or her rehabilitation stay. This means our patients showed greater improvement over less time.
National FIM Score
95.6
Regional Rehabilitation Center’s Score
2
Functional Improvement
88.4
Regional Rehabilitation Center
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Outpatient Rehabilitation Services at The Regional Rehabilitation Center Physical, occupational and speech therapy, as well as lymphedema, audiology and hearing instrumentation services, continue to be offered at the Faxton Campus on an outpatient-basis. Call (315) 624-5400 for information.
Center for Rehabilitation and Continuing Care Services 1650 Champlin Avenue, New Hartford, New York 13413
Make a difference in the life of a rehabilitation patient. Donate today by visiting www.faxtonstlukes.com/rehabgiving