Published 2013 2012 Annual Report The Regional Rehabilitation Center 2012 Annual Report 1
FROM THE CEO At Faxton St. Luke s Healthcare (FSLH) we care for thousands of individuals in our community, from every walk of life and every type of circumstance. Each patient has their own unique story. Rehabilitation Services at Faxton St. Luke s Healthcare Diane Jackson, OTR/L Director of Rehabilitation Services 315.624.5462 djackson@mvnhealth.com On the Cover: Kristine McIlwain, PT, DPT, physical therapist (left), and Coral Hunt, OTR/L, occupational therapist (right), with Gary Philipson. We are fortunate to be able to share the journey of one family that encompasses a number of different departments and care teams at FSLH. Gary and Lisa Philipson provide us with a glimpse of their journey, which began with Gary s stroke and takes us through his inspiring recovery. We can all appreciate and learn from our patients stories and see how important good communication is throughout the care experience. We witness the vital role that physicians, caregivers, family and friends play in a loved one s recovery. In this report we are reminded how random connections can sometimes help direct patients on the right care path. When one of our nurses had a chance conversation with a FSLH therapist she learned that we provide a program that would be helpful to her daughter. Alysa Keady is now on the road to recovery thanks to our Post-Concussion Program. Getting healthy and staying healthy is something we should all be focused on and our Wellness Center provides a number of opportunities to do just that. Our wide range of programs and services are open to our employees and to the community. My thanks to Nancy Mazurowski for her commitment to better health and for being an inspiration to others. I hope you enjoy our annual report. I think you will be touched by our stories and impressed by the tremendous talent and dedication our staff displays each and every day in caring for our community. Sincerely, Stephen Wade, MD Medical Director of Rehabilitation Services 315.798.8737 Scott H. Perra, FACHE President/CEO
The Journey from Patient to Person Follow Gary Philipson as he navigates life after a stroke with the help of our Rehabilitation Team It all started with a literal pain-in-the-neck. In December 2012, Gary Philipson had what he thought was a touch of the flu. For weeks, he d been experiencing the general lethargy that often accompanies any typical wintertime bug. The fit-and-trim Gary was in his mid- 50s, had stable blood pressure and the low cholesterol numbers befitting a man who has spent a lifetime enjoying the great outdoors. When the symptoms he was feeling dragged on, his doctor prescribed some medication for his head and neck pain. I thought I was just sick, said Gary. Everyone kept telling me there was a flu bug going around that caused this bad headache, so that s what I assumed was wrong. The New Year came and went and Gary, like the rest of the holidazed, returned to work. On January 8, 2013, a normal workday not unlike any other, he was sitting at his desk when, as he tells it, I felt like someone had drawn a line down the center of my body. Suddenly, he went limp, collapsing onto the floor of his office. He had just suffered a stroke that leveled a devastating blow to the right side of his body. In a dizzying haze of EMTs, whirling lights and sounds, he was rushed to FSLH, the area s only designated Primary Stroke Center, where he was immediately assessed by the Emergency Department staff. Once all stroke alert team members completed their evaluations, the team decided to treat Gary with tissue plasminogen activator (t-pa), the most effective treatment available to the nearly 800 stroke patients FSLH treats each year. To be effective, patients must receive t-pa within three hours of a stroke and FSLH s goal is to administer it within one hour from the time a patient arrives at the hospital. Gary had it in 31 minutes a hospital record. The quick action of the Emergency Department was a big first step toward recovery, but Gary still had a long way to go. He spent the next five days in the Critical Care Unit. After that, he was moved to AC-3, FSLH s Stroke Unit, where he spent the remainder of the weekend. Scott Brehaut, MD, medical director of the Stroke Program at FSLH, referred Gary to a neurosurgeon in Buffalo to make certain the other artery in his neck wasn t blocked and that a stent wasn t needed. It was this quick trip that gave the Philipsons an early glimpse of just how special their experience at FSLH would be. In Buffalo, I was amazed at the difference between a community hospital and a city hospital, recalls his wife, Lisa. He was just one of hundreds of patients there. Once we got back to Faxton St. Luke s on Wednesday, he took his first shower in a week and they put him in sweatpants and a shirt. Immediately, it was like he went from a patient to a person. In this flurry of activity, Lisa points to Dr. Brehaut as an initial calming influence, never letting the gravity of Gary s situation dampen the family s mood. Gary and Lisa Philipson at Herb Philipson s in the New Hartford Shopping Center. Because Gary was younger, the goal was to get him recovered as soon as possible so he could get back to his life and work. Lisa Philipson 4 2012 Annual Report 2012 Annual Report 5
Coral was excellent, really excellent. I felt like she and all of the other therapists put forth 110 percent every time they worked with me. Gary Philipson New Unit, Same Great Care The new Acute Inpatient Rehabilitation Unit at the Center for Rehabilitation and Continuing Care Services has 10 private rooms and seven semiprivate rooms, all of which have large, handicapaccessible bathrooms. opportunity to provide this care in a speciallydesigned, state of the art environment. Patients also have exclusive use of a new private dining room and rehabilitation gym, which creates greater opportunities for socialization an important aspect of recovery. I d never met Dr. Brehaut before, but what a wonderful guy. So caring. Every time I d get scared, he d come in and calm me down. He was so encouraging, said Gary. The physical trauma of the stroke would propel Gary on an eight-week journey, testing his resolve in ways he had never thought possible. He entered the Acute Inpatient Rehabilitation Program unable to lift his right leg, move his fingers or raise his right arm. He couldn t walk nor could he even swallow. The simplest tasks snapping a finger or giving a thumbs up were now virtually impossible to perform. At 55, this man who enjoyed kayaking and tossing around the ball with his sons was starting all over again. Early on, Gary was unable to get himself out of bed, in need of 24-hour care. The Rehab staff would help him get dressed in the morning and then it was off to work at his new job. He had a session of occupational therapy (OT) focusing on his arm, and then he d have an hour of physical therapy (PT) for his leg. A short rest period would follow, then speech therapy, then more rest. He d then have sessions of OT and PT in the afternoon. This was his day, every day, for two months. (From left to right) Kristine McIlwain, PT, DPT, physical therapist; Gary Philipson; Coral Hunt, OTR/L, occupational therapist; and Olivia DeCola, MS, CCC-SLP, licensed speech-language pathologist. I remember going in there and going to the gym and I m in a wheelchair, Gary said. I had to get up out of the chair and walk around a cone. It was basically a distance of eight feet or so, but it took me almost twoand-a-half minutes. And this is with them holding me or I would have fallen. Despite this nearly epic walk, that to most of us is equal to a few quick steps to the fridge, the Inpatient Rehabilitation Unit (IRU) staff never lost sight of his ultimate goal. They told me he d walk out of here without a cane, said Lisa. And I was like, Are you kidding me? Within a week, he progressed from laying in bed all day to sitting in a wheelchair, touring the Rehab Unit and hanging out in the Visitors Lounge. In sessions, he was walking with the assistance of a walker, climbing stairs and moving his right leg with more and more confidence. His right arm was coming along a bit slower. Meanwhile, visits from family and friends assisted with his speech progress, forcing him to talk to the many who dropped by to see him. A good friend told us to find a rehab facility close to home so family can go and see him, said Lisa. Even more vital, his friends can see him and provide encouragement. From 4pm to 7pm almost every night, there were people that came by to visit him. This constant level of encouragement, coupled with FSLH s dedicated staff, kept Gary mentally focused on the big picture: returning to his life. His daughter also spent a lot of time on the unit, coming by after school to help him with his speech homework. Within three weeks, Gary was finally able to manage his ADLs (activities of daily living) by himself with little assistance from Lisa. Physically, he began walking without a walker, even climbing 10 stairs. This rapid improvement underscores the commitment and quality of Gary s care. Occupational Therapist Coral Hunt was particularly influential. She, and the rest of the Rehab staff, spent hundreds of hours kneading muscles, forcing thousands of repetitions and coaxing every last ounce of effort out of Gary s recovering body. Coral was excellent, really excellent, said Gary, recalling his time spent under her care. She had a great demeanor. I felt like she and all of the other therapists put forth 110 percent every time they worked with me. After five weeks, Gary was making remarkable progress. It s funny, there are some things I learned how to do again, said Gary. Little things, like tying my shoes and putting on my watch. That s the kind of improvement I was focused on. I d do something I couldn t do before and say, There s another thing I can do. It kept me wanting to continue. I wanted to be pushed. It was during the latter part of his stay that he received another boost to his already rapid rehabilitation. The new unit features a transitional living center equipped with appliances that simulate typical household activities, like cooking and For more information on the program or to laundry. Here patients practice everyday skills refer a patient, call 315.624.8620. that many may take for granted, such as how We ve always had an exceptional team of to get food from the stove to the table, while 6 2012 caregivers, Annual said Georgia Report Deveans-Smith, RN, BS, using an assistive walking device. 2012 Annual Report 7 CRRN, IRU nurse manager. Now we have the
He was moved from the existing IRU, located at the Faxton Campus, into a brand new unit at the Center for Rehabilitation and Continuing Care Services. The Center, which had been under construction when Gary had begun his rehab, was just what the doctor ordered. The new 19,000 square foot facility, which serves an estimated 450 patients annually, gave Gary an added push, working to energize his already hastened recovery. I got to pick out a new room, he said. It s a very, very nice facility. Not that the rehab was easier, but it did help during those final weeks. While Gary s physical transformation was dramatic, he was still having some issues swallowing. Every few weeks, Gary would go through a swallow evaluation to see what he could (and could not) eat. And each time, he would pass part of the test, and fail others. Finally, two days before he s supposed to be discharged, he finally passes the swallow evaluation, said Lisa. The speech therapist where the evaluation was conducted alerted his therapist back on the IRU. By the time we get back there, she s crying. She s so happy for him that he finally passed the test. Leaving the facility proved bittersweet for Gary. The last week or so, I felt a little funny about going home. Not that I didn t want to go. But I felt like it s good here, they know what to do and I had a routine. I was a little nervous about how I would manage at home. But the Rehab Program prepared me very well. Eight weeks after enduring a lifealtering stroke that robbed him of his ability to walk, talk and even eat, Gary walked down the red carpet to the applause of his therapists, graduating from the Inpatient Rehabilitation Program. He came in unable to get himself out of bed and left by walking by himself right out the front door. Despite what, for some, might have been an emotionally draining experience, Gary relied on the commitment of his family, friends and the Rehab staff to work through the daily challenges. I m surprised that I never did feel depressed. I did have some mood swings. When you go through recovery, you make progress and then you hit a plateau. It s a cycle. But overall, I continued to make gains and that kept me positive. The journey continued for Gary. Over the summer, he spent weekends in Old Forge and, to the delight of his family and friends, drove a boat, did a little jet-skiing and even played miniature golf, activities that would have been unthinkable just a few months earlier. His Inpatient Rehab experience had been so positive, Gary chose to return to FSLH s Regional Rehabilitation Center to continue in the Outpatient Rehabilitation Program going from three days, down to two and eventually, one day a week. But a bond had been formed between Gary, his family and the staff. In the months following his departure, the family returned a few times to the facility to visit those who were so instrumental in his recovery. When you go through recovery, you make progress and then you hit a plateau. It s a cycle. But overall, I continued to (Left) Kristine McIlwain, PT, DPT, instructs Gary Philipson on correct walking techniques and balance strategies to return home safely. (Top) Coral Hunt, OTR/L, assists Gary Philipson with exercises to restore his fine motor skills following a stroke. They were so excited to see him, said Lisa. There was not one person that we dealt with that was not compassionate. Every single person there was so involved in Gary s care and so invested in his recovery. Everyone. At the end of this remarkable journey, Gary and Lisa lean on words they heard early on from Dr. Brehaut. Words that Lisa recalls hearing from the Rehab staff, as well. Because Gary was younger, the goal was to get him recovered as soon as possible so he could get back to his life and work. As Dr. Brehaut kept saying to us, Live your life. Go and live your life. Thanks to the loving support of his wife, family, friends and the dedicated work of the Rehab Team at FSLH, each new day for Gary now begins with a single, independent step. Gary Philipson is president of Herb Philipson s. With eight locations throughout Central New York, the outdoor apparel and equipment retailer employs more than 250 people. Gary and his wife, Lisa, live in New Hartford, New York, and have three children. make gains and that kept me positive. 8 2012 Annual Report 2012 Annual Report 9 Gary Philipson
More Than Just a Headache Concussions can have long-term effects that require special attention Imagine waking up each day to the dull throb of a constant headache and going through the day with waves of dizziness washing over you. For Alysa Keady, a junior at New Hartford High School, this has been her daily reality for more than a year. Alysa s symptoms began in August 2012, leaving her parents mystified as to what caused them. We weren t aware of any recent injuries, so we let it go for awhile because we thought it was just a headache, recalls her mother, Theresa Keady. But then it escalated to dizziness and she began to experience heart palpitations from the emotional stress of her symptoms. The Keadys set out to find help and embarked on a journey that took them to neurologists, chiropractors and acupuncturists, but throughout Alysa s symptoms persisted. A chance meeting in June 2013 between Theresa, a staff nurse at FSLH, and Carol LaTeer, an outpatient occupational therapist at FSLH s Regional Rehabilitation Center, would give Alysa the relief she had been looking for. I was caring for Carol as a patient and she had information on craniosacral therapy laid out in her room, said Theresa. Finding Carol was a Godsend because up until that point we felt like we were on our own. 10 2012 Annual Report Carol believed Alysa s symptoms were the lingering effects of concussions she had sustained years before. When someone sustains a brain injury like a concussion, the fragile brain makes direct contact with the hard skull and is left bruised. This contact is the result of the protective cerebral spinal fluid (CSF) being displaced by a sudden movement, such as a fall, car crash or impact to the head. Even without a recent concussion, all it would take is an unremarkable tumble to trigger an influx of CSF from the base of the spine to the brain to aggravate Alysa s previous brain injuries. Craniosacral therapy was the key to improving Alysa s symptoms because it focuses on the tissue and fluid that surround the brain and spinal cord the main structures in our central nervous system. This powerful system controls the workings of the entire body. When tissues tighten and the flow of CSF is restricted, the central nervous system can t function effectively, often resulting in tension, pain and other discomfort throughout the body. Alysa began feeling relief after just a few sessions with Carol. It really helped me a lot, she said. I was at pain level seven [of 10] when I started. I wasn t able to do the things I loved. Now I have a baseline of two and am able to do so much more. Carol describes Alysa s recovery as a carefully choreographed dance between symptom management, rehabilitative exercises and daily life accommodations. It s this comprehensive approach that makes FSLH s care of post-concussion patients unique. Symptom relief is often accomplished through craniosacral therapy, but the healing process is ultimately driven by the gains made in vestibular, cognitive and visual rehabilitation. These therapies use exercises and adaptations, such as avoiding certain types of light, to promote the brain s recovery. Strategies learned in rehabilitation give patients the skills they need to overcome any limitations at home, work or school caused by their symptoms. Family education is also a key component of therapy. Because a patient may look normal, it s often difficult for loved ones to understand the severity of what the patient is experiencing. Carol LaTeer, MS, OTR/L, CASAC, administers craniosacral therapy to help alleviate Alysa Keady s post-concussion symptoms. Because a patient may look normal, it s often difficult for loved ones to understand the severity of what the patient is experiencing. Carol LaTeer, MS, OTR/L, CASAC Post-Concussion Syndrome It is estimated that as many as 3.8 million people are treated annually for concussions. Although most people s symptoms of headache, blurred vision, irritability and fatigue go away after a few days, some experience lingering effects of dizziness, vertigo and sleep disturbances for months or even years. Persistent headaches can be accompanied by sensory issues, such as loss of smell, sensitivity to light or balance problems, as well as cognitive issues that affect work or school performance. Post-concussion syndrome occurs when a patient experiences any one or a combination of symptoms that don t resolve within three months. Anyone can sustain a concussion regardless if they lose consciousness and the likelihood of developing post-concussion syndrome doesn t appear to be related to the seriousness of their initial injury. Patients experiencing post-concussion symptoms are encouraged to ask their physician for an occupational therapy referral to FSLH or to call 315.624.5400 for more information. 11
Get Well. Stay Well. Live Well. It s easy to do with the help of the Faxton St. Luke s Wellness Center If I didn t keep coming, I wouldn t have the stamina to do my job or be able to walk as well as I do. In a given month, the average person spends $80 on their morning cups of caffeine and more than $70 on cell phone plans. For Nancy Mazurowski, a mammographer at FSLH s Imaging Center, she spends $30 each month to maintain her mobility and fitness some might call that a bargain, but really, it s priceless. Nancy attributes her monthly membership at the Faxton St. Luke s Wellness Center with giving her the endurance to stand on her feet all day after a total knee replacement nearly three years ago. Everyone s here for a reason, said Nancy. If I didn t keep coming, I wouldn t have the stamina to do my job or be able to walk as well as I do. Bethany Kleist, Wellness Center coordinator, works with members in the aqua therapy pool. With unlimited access to strength and cardiovascular training equipment, as well as the heated aqua therapy pool, the Wellness Center at FSLH provides Nancy with a friendly, judgment-free atmosphere and the guidance she needs to maintain a healthy lifestyle. For many, the greatest benefit of the Wellness Center is that it s located in a clinical setting with staff who are trained to support the gains made in rehabilitation and promote continued success after therapy ends. Once I started doing outpatient therapy at Faxton St. Luke s for my knee, I realized how much better it felt to keep going, said Nancy. For her, this was the motivation she needed to supplement her three visits to the pool each week with at least two gym sessions. Whether you re looking to build your endurance like Nancy or align your energy through T ai Chi, the Wellness Center offers a variety of classes and fitness assessments to meet your individual needs. Visit www.faxtonstlukes.com/wellness-center or call 315.624.5484 to join today! 12 2012 Annual Report 2012 Annual Report 13 Nancy Mazurowski
2012 Program Performance Patient Report Card 96.7% of the patients discharged from The Regional Rehabilitation Center at FSLH report that they maintained their own care and independence 90 days after discharge. Total Patient Admissions 34% Stroke Patient Admissions Most Experienced in the Region for Treating Stroke-Related Disabilities As the area s only designated Primary Stroke Center, the percentage of stroke patients out of the total number of admissions was 34.6 percent compared to the region at 24.0 percent and the nation at 25.4 percent. We have more experience treating the disabilities associated with stroke than other facilities in the area. 94.8% 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. PEM Score Ranks in Top Percentile The Program Evaluation Model (PEM) is used for evaluating and comparing overall performance between facilities. It utilizes indicators that reflect national goals set by the Institute of Medicine for improving healthcare quality, including the delivery of care that is effective, efficient, timely, safe, equitable and patient-centered. The Regional Rehabilitation Center s PEM score for 2012 was 81.5, up 5.6 points from 2011, placing the program in the 88th percentile among nearly 800 facilities in the nation. 88.5 National FIM Score 98.5 Regional Rehabilitation Center s Score Length of Stay 4 3 2 1 0 Functional Improvement 3.26 out of 4.0 Patient Satisfaction Score 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 94.4 percent of patients reporting that our rehabilitation program improved their quality of life. FIM Gain Score Higher Than National Average 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 98.5 as compared to the national average of 88.5. This means our patients showed more improvement. National Average Regional Rehabilitation Center LOSE Score Higher Than National Average The 2012 Length of Stay Efficiency (LOSE) score of 3.37 was above that nation average of 2.33. LOSE is a correlation of the length of stay and 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. 14 2012 Annual Report 2012 Annual Report 15
Commission on Accreditation of Rehabilitation Facilities Make a difference in the life of a rehabilitation patient. Donate today by visiting www.faxtonstlukes.com/rehab-giving The Regional Rehabilitation Center 1676 Sunset Avenue, Utica, New York 13502 315.624.5400