1 I N F I R M A R Y TOURO REHABILITATION CENTER Expansion & Renovation
2 The services I received here were the best. I thank God for everyone that worked with me. My stay here was the best even though I was missing home. Touro, keep up the good work; you re No. 1. I miss you guys on M6 brain injury unit. I was extremely pleased with my stay at Touro Rehabilitation Center. By the time I was discharged, I felt as if I had made many personal friends, especially with the therapy staff. Cover Photo: Devin Gregoire works on an occupational therapy writing exercise as part of his rehabilitation at the Touro Rehabilitation Center. The 23-year-old, who was set to graduate from a trade school, suffered a spinal cord injury as a result of a motor vehicle accident on May 31, He was ejected 30 feet from the vehicle, landing in a tree. Devin arrived at Touro in June from Our Lady of the Lake in Baton Rouge and was discharged in August.
3 A treat-you-like-family warmth. A reputation of uniqueness. The characteristics so often used to describe New Orleans are also fitting for the Touro Rehabilitation Center (TRC). But Touro s Rehab Center is ready for a new level of distinction, just like its Crescent City home, brightening the future for patients who are facing what is most likely the most difficult period in their lives. The overall need is for expansion, including the construction of an updated unit that allows space for 14 private rooms, as well as the ancillary space and equipment needed for a nationally recognized rehabilitation program to continue to treat patients at the highest level possible. New Unit with 14 Private Rooms A can-do spirit. There are currently 11 private rooms among the TRC s units. (Some four-bed wards are still being utilized as well.) The TRC struggles with its average daily census of 45 patients due to the lack of private rooms, making patient placement a juggling act and creating a constant waiting list that averages 20-plus patients. Private rooms are a necessity: There is a substantial amount of ancillary equipment that patients need during rehabilitation (wheelchairs, bedside commodes, stints, etc.) and with two patients, this presents too much clutter in one room. A philosophy of the TRC is to simulate a home environment for patients, so they are asked to bring street clothes to wear as well as other items from home that they would use in daily living. With two patients in one room, there is a lack of space for these items. The nature of the catastrophic conditions treated at the TRC creates the need for more privacy for patients and their families, especially when adaptive approaches are needed for personal hygiene issues.
4 It is important for families to be a part of the rehabilitation process, and private rooms facilitate more involvement. Due to the complexity of the TRC s cases, patients have often been hospitalized for long periods of time before admission. This increases the likelihood of patients having infections that require them to be in private rooms. Male and female patients cannot be placed in the same room. Private rooms would improve patient and family satisfaction. They have become an expectation of patients. Large and Small Gyms The safety of the patients is handled very well. Touro s operation is a good example of teamwork. I appreciated being a patient, and I know I received excellent care from all the staff. Inpatients at the TRC receive an average of 3 hours of therapy per day, 5 days a week, and working in the gym is an important facet of their therapy. Gyms a large gym, as well one or two small gyms are critical. The smaller low stim gyms are needed for patients who cannot handle the extra stimulation in the typical group setting of a gym. Kitchen and Dining Areas A specially designed and modified kitchen and dining area are important in the rehabilitation process both for therapy and socialization. This includes tables that raise and lower to different heights for wheelchair accessibility and appliances adapted for wheelchair accessibility. Kitchen accessories and small appliances simulate the home environment. Many brain injury patients hope to resume housekeeping duties when they return home, so the TRC evaluates them for safety awareness in the kitchen their ability to process
5 multiple tasks at one time, such as those involved in cooking and sequencing, the ability to scan and process visual data by looking for an ingredient in the cabinet. For the patients with spinal cord injuries, the cognitive side is usually intact, but they may need training on how to perform an old task in a new way, such as washing dishes or emptying a dishwasher from a wheelchair. Oftentimes it is a matter of showing them that life is different, but not over. They can still be a wife and a mom, etc., even if they have to do it from a wheelchair. At home, a patient wouldn t typically eat in bed by himself, so the TRC attempts to have patients eat together in a more social atmosphere. A dining area is key to facilitate this environment. Effective training bathrooms The TRC s occupational therapists work with patients on bathing and toileting, a key facet of their independence. The ideal set-up for training bathrooms simulates a variety of bathroom environments (separate shower and tub versus combined shower/tub). undergo this training toward the end of their family member s stay. Updating of Current Units In addition to the construction of the new unit, there is a need to update the current rehab units. The facility, built in the early 1980s, has suffered tremendous wear and tear, due in part to a difficult patient population. On the brain injury units, many patients are physically agitated, cognitively impaired and/or disoriented, and can become combative. This creates real wear and tear on the facility. On the spinal cord injury unit, patients are learning to use wheelchairs this learning process results in bang-ups to the facility and equipment, especially in areas that are more difficult to navigate. The training bathrooms on the brain injury units are not adequate. One is the same bathroom in which nurses have to bathe the more severely impaired patients on a stretcher. This presents a timing/coordination issue. The other training bathroom is not effective, as the tub is too high, making it more difficult to teach patients to maneuver through the shower and tub environment. Transitional living space When preparing a patient for discharge, family involvement is an important part of the process. The family is just beginning to take over the patient s care, and monitoring and instruction by nurses and intervention by therapists will still be needed. A transitional living space a dual-use patient room with a suite attached for caregivers would allow families to
6 The Touro Rehabilitation Center (TRC) is a regional referral center and home to nationally recognized programs for brain and spinal cord injury, chronic pain and comprehensive inpatient rehabilitation. In 1929, Touro was one of the first hospitals in the United States to have a physical therapy department; today, the TRC remains proud of its history of excellence in rehabilitation. The only hospital accredited in several subspecialty areas by the Commission on Accreditation of Rehabilitation Facilities, the TRC provides interdisciplinary rehabilitation to physically challenged individuals to prevent or minimize impairment and disability, helping them to enjoy life with the highest degree of independence. TRC is a first class operation at Touro Infirmary. All staff members involved made my stay very pleasant. The TRC a 63-bed facility located within Touro Infirmary is led by Gary Glynn, M.D., Director, who has a national reputation for extraordinary compassion and extensive knowledge in the field of rehabilitation dating back more than 25 years. Under Glynn s guidance, the welcoming, supportive staff works as a team, treating each patient as they would their own family member. An emphasis on family education and patient dignity is a hallmark of the TRC s reputation of excellence.
7 A Snapshot of the TRC in 2007: The center treated 520 inpatients 77% of these 520 patients suffered brain or spinal cord injuries Approximately 72% of patients were discharged to a home setting Patients experienced an average of 64% functional improvement upon discharge, compared to the regional and national average of 41% The average length of stay was 25 days, compared to 16 days regionally/nationally, due to the more acute patients the TRC treats *FIM (Functional Independence Measure) is the most widely accepted functional assessment measure used in the rehab community. FIM gains are indicators of functional improvement, in both motor skills such as walking and eating and cognitive skills such as memory and expression. With the current closure of Charity Hospital s Louisiana Rehabilitation Institute after Hurricane Katrina, there has been an even greater need for the TRC s services in the community, as well as regionally. The TRC s patients are more acute, but gain more independence than patients both regionally and nationally. TRC s location within Touro Infirmary allows it to take and treat more medically complex patients that other facilities cannot or will not treat.
8 The Youngs Story Really, it s a miracle that he s even alive. All I wanted was for him to have the best opportuinty and all the help he could possibly have. Diane Young A chance meeting with a pastor in a hospital elevator divine intervention? For the Young family from West Monroe, La., you could call it that. Richard is the baby of 13 children, said Diane Young, speaking of her husband, 57, who sustained a brain injury after a 10-foot fall from a ladder, so we had some trouble convincing his family that we needed to travel to New Orleans and Touro. But in a hospital in their hometown Richard s second stop after stabilizing at LSU Shreveport Diane and her children crossed paths with a man on the elevator, a pastor who had just returned from visiting a patient at the Touro Rehabilitation Center (TRC). He told us what a wonderful place it was, Diane said. Nurses and even strangers the Youngs met echoed the pastor s praise for Touro. The nurses I talked to had seen patients before and after being treated at Touro, Diane said. They had gone from having no use of their bodies and no ability to carry on a conversation to being much more mobile and cognitively aware. The lack of a local rehabilitation center that could help Richard became clear almost immediately, and Diane knew that staying close to home would have meant her husband moving to a nursing home, confined to a bed. Richard couldn t sit up, feed himself or use the toilet, and he didn t make any sense when he talked, Diane said. All I wanted was for him to have the best opportunity and all the help he could possibly have. The Youngs arrived at the TRC s renowned brain injury unit on March 17. They left April 22. What happened in those five weeks is something Diane Young will never forget. Richard is now functioning. He can take care of himself, eat
9 by himself and stay at home by himself, she said. He is able to do all of this only because of the treatment he received at Touro. Furthermore, because of the treatment he received at Touro, Diane said he might be able to work again someday. Richard s brain has the ability to heal for at least a year-and-a-half, so for that period of time he should continue to improve. He does have short-term memory loss, but really, it s a miracle that he s even alive, she said. If I have to tell him where to put his towel every day, then I ll just do that. The TRC s goal is for patients to return to the community functioning as independently as possible. Relearning everyday activities, such as cooking or shopping, are important in the rehabilitation process. At the Young household, Richard holds the title of morning coffee maker, a task he was able to learn as a result of his rehabilitation at Touro. He has also learned to go shopping. On a recent outing to the grocery store, our son-in-law was looking for a particular item, Diane said. Richard turned to him and said, You just read the sign at the end of the aisle. Without hesitation, Diane can recount the most memorable moment of her family s time at Touro. When Richard called my name for the first time, that was the happiest moment for me, she said. Before that, he didn t recognize me or my children. During Richard s stay at Touro, Diane said the doctors and nurses never shrugged off their questions. One day his eye was moving around, so we inquired about it, and the next day they had him at the doctor to see what the problem was, she said. So it wasn t just the rehab programs; Touro had everything, and I really admire that. Diane also appreciated Touro s availability of enclosure beds, which offer an alternative means of restraining brain injured patients. That was a big relief, she said. I really didn t want to see him tied down. Touro s Gumbel Building, which is located a block behind the main facility, offers accommodations for a TRC patient s family, a godsend for the Youngs. There was no way we could have afforded to make the drive and then pay for a hotel every week, Diane said. This room allowed us to have someone there with Richard every day of the week, and that made us all feel better. This is just part of the whole package of TRC it s just a great place. Richard recently told his wife that he doesn t think he s right. To me, that s improvement he s remembering that he s not remembering, Diane said. He has come so far, especially when I picture him lying in a bed unable to move, talking gibberish. When recalling their arrival at the TRC, Diane admits she was disappointed in the outdated look of the facility. But within five minutes of being here, that changed. The doctors and nurses immediately made us feel like they could really help us, and that put us at ease, she said. If Richard is able to drive in the future, the Youngs will make the trip back to New Orleans to complete the necessary driver testing. But other than that, don t expect to see them around. We probably won t be back, Diane said. Not because we don t want to, but because we don t need to.
10 One of the Gulf South s leading medical centers, Touro Infirmary is New Orleans only private, not-for-profit, faith-based, full service hospital. Founded in 1852 by philanthropist Judah Touro, Touro represents not only quality healthcare, but stability, history and tradition. Touro has served the community continuously for 156 years, closing its doors only twice during the Civil War and immediately following Hurricane Katrina. In 2007, Touro was, and continues to be, the busiest hospital in Orleans Parish: I feel that the care we received from the nursing staff and all the therapists was fantastic. We spent 3.5 months at Touro, and I would not go anywhere else. We thoroughly enjoyed our stay at the hospital, and I can t thank you enough. Patient admissions totaled 14,203 (up 10% from 2006) Outpatient visits (excluding ER visits) totaled 172,490 patients Our average daily patient census was 216 patients 25,552 people came through our emergency room, up from 22,973 pre-katrina We delivered 2,281 babies, up from 1,594 in 2006 Touro s history of excellence is seen in its clinical specialties, including: Heart and Vascular Center Gulf South Joint Replacement Center Family Birthing Center and Women s Health Touro Rehabilitation Center Cancer Treatment Touro Ambulatory Surgery Center The Touro Infirmary Foundation supports Touro s mission of providing the highest quality and most compassionate healthcare. Through the efforts of the Foundation and with generous support of our donors, Judah Touro s commitment to community service is still evident today. The generosity of our donors ensures that his vision will remain strong for years to come.
11 Touro Rehabilitation Center Expansion - Naming Opportunities Description Unit total Total Named Rehab Unit $1,000,000 $1,000,000 Named Wings (3) $ 500,000 $1,500,000 Named Large Gym $ 250,000 $ 250,000 Upgrading of Current Units (3) $ 250,000 $ 750,000 Transitional living space $ 250,000 $ 250,000 Kitchen $ 150,000 $ 150,000 Dining Room $ 125,000 $ 125,000 Equipped Patient Rooms (14) $ 100,000 $1,400,000 Named Small Gyms (2) $ 100,000 $ 200,000 Staff/Nurses Station (2) $ 50,000 $ 100,000 Large Gym Equipment $ 50,000 $ 50,000 Visitor Lounge $ 50,000 $ 50,000 Small Gym Equipment (2) $ 25,000 $ 50,000 Training bathrooms (2) $ 25,000 $ 50,000 Artwork $ 15,000 $ 15,000 Computer stations with programming (2) $ 5,000 $ 10,000 Total $5,950,000
12 One gesture of kindness. One gift from the heart. Thousands more families with hope. Most of the patients at the Touro Rehabilitation Center were living normal, healthy lives when tragedy and a catastrophic injury changed their lives instantly. We are committed to sustaining the center as one of the best in the country, so that we can continue to offer hope to families facing this traumatic time. Ways to Support the Touro Rehabilitation Center: Cash gifts made by check or money order Pledges made for a single year or over a period of time Gifts charged to a major credit card Gifts of stock Planned gifts, including bequests, charitable trusts or gift annuities Matching gifts made by your company or employer To learn more, call the Foundation at or visit I N F I R M A R Y 1401 Foucher Street New Orleans, LA
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