Hoensbroek Rehabilitation Center. Albère Köke

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1 Hoensbroek Rehabilitation Center Albère Köke

2 Content Rehabilitation Foundation Limburg (SRL) Patient profiles Benefits medical rehabilitation Outcome measurement Summary / conclusions

3 Hoensbroek Maastricht Valkenburg (children) Heerlen

4 Rehabilition Foundation Limburg Rehab Center Sports Health Center Auditive system and speech Center Vocational Center Department Rehabilition Atrium Hospital Heerlen Adults Hoensbroek Rehabilitation Center Children Franciscusoord Valkenburg Department Rehabilitation Maastricht Hospital

5 SRL core bussiness Comprehensive rehabilitation programs for adults and children Diagnostic/advice/treatment hearing/speech problems Re-integration work Education (children / professionals) Research

6 Mission SRL wants to guide disabled people back to independent participation in society by combined high quality care Interdisciplinary ICF model Client centered care Evidence based In cooperation Transparant

7 Patientprofiles in HRC (adults) Cardiac (heart attack, post surgery) Spinal Cord Injury Amputation/trauma Chronic Pain Stroke Brain injury

8 Patients treated in HRC beds / 436 employees 731 clinical patients 2843 outpatients Individual / group Therapy hours: Clinic Outpatient department Payment by Health Insurance Average clinical days: 47

9 Patientgroups Clinical N Outpatients N Clinical days Cardiac Spinal cord Amputation/ trauma Chronic Pain Stroke Brain injury

10 Professionals HRC Rehabilitation physicians: 17 Physical therapist: 38 Occupational therapist: 29 Social workers: 7 Psychologist: 9 Sport-instructors: 5 Speech therapist: 7

11 Benifits Client: improvement in activities and participation; quality of life; self management; autonomy Funder: cost effective high quality care Community: re-integration into work and social life, less medical shopping/costs

12 Outcome measurement Not systematically defined or measured in most teams/units Stroke Team is developing a core set Team Chronic Pain implemented standard outcome measurement

13 Outcome measurement chronic pain Based on the Dutch Core Set Painrehablitation 2007 Consists anamnestic questions and standard meaurements Patiens description and treatment evaluation Initiative on Methods, Measurements, and Pain Assessments in Clinical Trials (IMMPACT) 2003, 2005 etc ICF core set low back pain 2004 ICF core set chronic widespread pain 2004

14 Outcome Domains Dutch Pain and fatigue Physical functioning Emotional functioning core set Participant ratings of global improvement and satisfaction with treatment Symptoms and adverse events Participant disposition (withdrawal and adherence to the treatment regimen) Participation (family life, social life, recreational activities, work) Patient individual goals Medical consumption

15 Measurements Pain and fatigue numeric score 0-11 Physical functioning SF36 physical functioning MPI- interference Emotional functioning SF36 mental health Participation Pain Disability Index Working ability Index Patient Individual Goals Patient Specific Functional Scale Canadian Occupational Performance Measure Medical consumption several questions Patients rating of improvement / satisfaction numeric score point Likert scales Patients disposition drop out rates Adverse events open questions

16 Extra measurement pain HRC Screening/diagnostic set Anxiety depression HADS/BDI Negative beliefs PCS/TSK (+ for evaluation) Personality disorders VKP Evaluation: Acceptance CPAQ Self efficcay CPSS Expectations VAS

17 Timing measurements T0 start pain rehabilitation program T1 end of treatment T2 3 months follow up T3 12 months follow up

18 Implementation I Report published and send to all rehabilitation centers and hospitals Article in the Dutch Pain Journal (NTPP) Presentations on symposia/conferences www. revalidatiebijpijn.nl

19 Implementation II WEBbased systems for data is developed 8 rehabilitation center + 4 hospitals will participate in a national implementation project To establish benchmarks and norm data

20 Summary /Conclusion Outcome measurements in HRC are not common in all teams In the stroke unit a set is under construction Outcome measurement in chronic pain contains only self reported questionnaires by patients Dicipline measures, activity monitoring, perfomnace measures under construction (in field of chronic pain) Goal SRL is to implement standardized outcome measurements in all teams

21 Kwaliteit van leven SF FF SF RPF RPE MG VI PYN AG azm pijn Cardio MS Depressie Kanker

22 Kwaliteit van leven SF FF SF RPF RPE MG VI PYN AG azm HRC Friesland Cardio MS Depressie Kanker

23 Kwaliteit van leven SF FF SF RPF RPE MG VI PYN AG azm HRC Friesland Cardio MS Depressie

24 Questionnaires should be used as resources! But use them properly!!

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