Clinical Outcomes: The Numbers That Count.

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1 Patient Outcomes and Satisfaction A Leader in Rebuilding Lives Clinical Outcomes: The Numbers That Count. Whatever shape healthcare reform finally takes, the need for healthcare organizations to provide high quality and cost efficiency will be at the core. So will the ability to demonstrate patient-centered care that focuses on outcomes and satisfaction. After more than forty years of regional and national leadership in brain injury, spinal cord injury and stroke, the Rehabilitation Center at SCVMC is well positioned to generate and help interpret this data. We are also pleased to share it with patients and families, healthcare professionals, researchers, regulatory agencies and payers as a basis for making informed and insightful choices regarding acute rehabilitation services. The outcomes data that follow, separated into diagnosis-related categories, help demonstrate the Rehabilitation Center s long-standing record of exceeding national averages for individuals receiving care and treatment. This report also provides a look at some current and future activities at the SCVMC Rehabilitation Center. While this information provides a useful tool for making medical care decisions, it also reflects the accomplishments of the people we serve in their journey toward the highest possible levels of productivity, independence and quality of life. For many of them that includes getting back to the people and activities they enjoy most. We have included some of these individuals, part of a series of stories highlighting life after rehab entitled Return. Relearn. Relive to show the human face of our clinical outcomes.

2 Spinal Cord Injuries Phil Long: A graphic designer by vocation and a wine maker by passion, Phil sustained an incomplete cervical spinal cord injury when a wine barrel (empty but still quite heavy) rolled down from a stack and struck him on the face and forehead. Following inpatient rehab and ongoing outpatient rehab, Phil is back to his wife and his wine, appropriately labeled Longevity. To watch Phil s story, (click here?) PATIENT SATISFACTION (SPINAL CORD INJURY) 88.8% of our patients would recommend our Rehabilitation Program to a family member or friend. (PRC Data 2011)

3 Traumatic Brain Injury Christian Bauerle: During a pre-season high school football game Christian received a serious head injury that resulted in emergency neurosurgery to repair blood clots along his brain stem. His prognosis was uncertain but eventually he was able to begin rehabilitation at SCVMC and, ultimately, returned back to high school where his family, friends, faculty and personal determination helped him resume academic and recreational activities and move on to college. To watch Christian s story, (click here?) PATIENT SATISFACTION (TRAUMATIC BRAIN INJURY) 88.8% of our patients would recommend our Rehabilitation Program to a family member or friend. (PRC Data 2011)

4 Stroke Teresa Renaldi: At the age of 91 Teresa had a stroke at her home and was found by a neighbor. Following emergency care at the Joint Commission-designated Primary Stroke Center at SCVMC she recovered and received physical, occupational and speech therapy at the Rehabilitation Center. After relearning basic skills as an inpatient, and with ongoing outpatient care, Teresa gained enough independence to return to her home. PATIENT SATISFACTION (STROKE) 88.8% of our patients would recommend our Rehabilitation Program to a family member or friend. (PRC Data 2011)

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6 Current Research and Clinical Trials Asubio Clinical Trial. SCVMC is participating in the Phase 2 clinical trial of a medication developed by Asubio to improve neurological function in patients with newly diagnosed (12 hours post injury) acute spinal cord injury. This trial will determine whether subjects receiving the investigational medication are more likely to improve by two or more motor levels from baseline on either their right or left side as determined using the International Standards for Neurological Classification of Spinal Cord Injury Scale. Preclinical evidence has shown that medication to support corticospinal neuron survival and axonal regrowth. James Crew, MD, Chief, Spinal Cord and Orthopedic Rehabilitation is the Principle Investigator. San Bio Clinical Trial. This Phase A study of modified stomal cells in patients with stable ischemic stroke is another SCVMC and Stanford University Medical Center collaboration. The early stage trial includes the intracranial injection of adult marrow-derived stomal cells at Stanford while screening and referrals take place at SCVMC. In cell culture and animal models, these cells have been shown to restore function to damaged neurons related to stroke and neurological conditions. Stephanie Kolakowsky-Hayner, PhD, Director of Rehabilitation Research at SCVMC is the Principal Investigator for the referring sub-site. SCIRP Grant. This three-year project, funded through the Department of Defense Spinal Cord Injury Program (SCIRP), is a research partnership between SCVMC and the VA Palo Alto Health Care System, the University of California San Francisco and San Francisco General Hospital. The SCVMC Co-Investigator is Stephen McKenna, MD, Director, Rehabilitation Trauma Center. The purpose of the project is to develop best practices for military service members, veterans and other individuals with SCI and concommitant TBI, and includes leveraging a bedside-to-bench, bench-to-bedside collaboration between clinicians and basic scientists. For the full range of research projects being carried out by SCVMC s Rehabilitation Research Center please go to tbi-sci.org.

7 Special Rehabilitation Resources Journey to Recovery: Journey to Recovery is a specialized program designed to help patients with severe brain injuries reach their fullest potential for independence. This highly individualized program features a careful evaluation to determine what specific therapies will be the most effective based on each patient s particular needs. Journey to Recovery also focuses on a safe and caring environment with minimal use of tubes and sedating medications. Rehabilitation Trauma Center (RTC): This licensed and specialized medical/surgical unit is primarily for individuals with acute spinal cord injuries or brain injuries accompanied by respiratory concerns. Because patients to the RTC can be admitted very early post-injury and receive aggressive respiratory therapy, they are more likely to be successfully weaned from ventilators and are at a reduced risk for pulmonary and skin complications. Technology Assistance Program (TAP): This program gives rehab patients with brain injury, spinal cord injury and stroke the skills and access needed to connect with people, information and resources. TAP delivers needed technology in the form of web-based patient education, video conferencing, virtual visits, adaptive equipment, computer loans and individualized training to patients as quickly as possible so that it becomes a natural part of their rehabilitation as well as their lifestyle when they return home. New Developments at SCVMC Ekso Wearable Exoskeleton. After participating in an investigational study of the Ekso Bionics exoskeleton prototype, we are now using a commercial version of this therapeutic and prosthetic unit that enables some individuals with lower extremity paralysis and weakness to stand and walk with a reciprocal gait. We will continue to develop clinical practice guidelines for the Ekso system and participate in studies that focus on the relationship between mobility and the post-injury health issues associated with SCI. New Rehabilitation Facility Progress. With a projected opening date in June of 2014, the new Rehabilitation Center continues to take shape on the SCVMC campus. The design and construction focus on creating an optimal experience for patients, families and staff and include a number of patient room innovations and amenities resulting in a safe and more homelike setting, as well

8 as a range of enhanced areas, both indoor and outdoor, for social interaction. In addition, the new center will feature state-of-the-art therapy gyms and one of the largest and most advanced aquatic therapy pools in the nation. Recent Awards and Recognition Rehab Nurses Win Unity and Diversity Award: The Rehab 1 Nursing Team (spinal cord injury and orthopedic rehab) received the Santa Clara County Unity and Diversity Award for its contributions to promoting diversity in the workplace and for its commitment to cultural sensitivity and cultural competence in patient care. The Rehab 1 Team placed in the hundredth percentile in the category of staff respect towards specific beliefs and customs. Stephen McKenna, MD named Health Care Hero Finalist: Dr. Stephen McKenna was named a finalist in the annual Silicon Valley/San Jose Business Journal s Health Care Heroes competition in the Research category. Dr. McKenna was cited for his pioneering work in the world s first clinical trial designed to explore the potential of embryonic stem cells in treating spinal cord injuries. Although the trial has closed, Dr. McKenna is currently playing a major role in efforts to continue the research across multiple public and private organizations. Referrals and Information To make an adult or pediatric admission to the Rehabilitation Center please call or fax For outpatient referrals, please call or fax For either inpatient or outpatient referrals, and to schedule a tour of the Rehabilitation Center, please call * The FIM or Functional Independence Measure is a standardized instrument adopted by most rehabilitation facilities nationwide that assesses a patient s functional performance across a spectrum of predefined activities reflective of daily living. Rehabilitation Center at Santa Clara Valley Medical Center 751 South Bascom Avenue, San Jose, CA scvmed.org/rehab 2012 Santa Clara Valley Medical Center. Santa Clara Valley Medical Center is owned and operated by the County of Santa Clara.