I've attached an article which was published in the April issue of JNPT which
reframes neurologic PT delivery into 4 different models: Traditional, Skilled
Maintenance, Consultative, and Wellness. The authors and others also did a
wonderful presentation at CSM using case studies to illustrate the benefits of
each model (I'm sorry I don't remember their names but it was one of my
favorite presentations at CSM 2022).
What I think is most helpful are the tables on pages 7-9 which described the
models and outlines the language to use in documentation. Having a discussion
with patients around these models and their care I think is extremely helpful
in getting everyone (patient, PT, family) on the same page.
Also if there is a need in your community perhaps they will support a wellness
center for your patient population. One was started about 2 years ago in my
community (New Orleans) by an extremely smart and driven individual who has a
quadriplegic level spinal cord injury: https://www.splitsecondfoundation.org/ ;
It's a non-profit foundation which has a gym for people with neurologic
impairments with trainers, PT tech, and a PT supervising. They have been very
aggressive with fundraising and offer their services at a very reasonable price
for their members ($50 per month). Everyone involved with this organization
have worked extremely hard to create an invaluable resource. They are a model
for others to follow. I've included the PT and founder on this e-mail for
people to reach out with questions.
Thanks,
Rachel
From: neuropt-bounce@xxxxxxxxxxxxx <neuropt-bounce@xxxxxxxxxxxxx> On Behalf Of
Angela Link
Sent: Tuesday, November 8, 2022 7:49 AM
To: neuropt@xxxxxxxxxxxxx
Subject: [neuropt] Re: Outpatient difficult discharges
*EXTERNAL EMAIL: EVALUATE*
Just putting an extra point out - for the correct patient, getting involved in
a research study can also be something they can be engaged and participate in.
Studies can be anywhere from a few days/weeks to a year long with follow ups
depending on preference and interest.
I direct patients to
clinicaltrials.gov<https://nam10.safelinks.protection.outlook.com/?url=http%3A%2F%2Fclinicaltrials.gov%2F&data=05%7C01%7Crtromm%40lsuhsc.edu%7C7ecd7624d38b45bb58f208dac1900a0a%7C3406368982d44e89a3281ab79cc58d9d%7C0%7C0%7C638035121700031182%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=yr1JJ03avozH80Sp5mF3UguXa9e2uQxBRdIWhMI2Z%2FE%3D&reserved=0>
since those are all IRB approved studies. We also talk about low vs. high
risk studies and what it could entail for htem. They can search by state,
diagnosis and go from there!
https://clinicaltrials.gov/<https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Fclinicaltrials.gov%2F&data=05%7C01%7Crtromm%40lsuhsc.edu%7C7ecd7624d38b45bb58f208dac1900a0a%7C3406368982d44e89a3281ab79cc58d9d%7C0%7C0%7C638035121700031182%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=LHWIxvQ%2FWRDlbEX75TpsocRBSl1%2FHJtVRKP37NL1mak%3D&reserved=0>
-Angela
Angela Link, PT, DPT, NCS
Board Certified Specialist in Neurology for Physical Therapy
Spaulding Rehabilitation Hospital - Charlestown, MA
Clinical Researcher at INSPIRE Lab - Cambridge, MA
Drexel University Class of 2014
Linked In Profile :
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On Sun, Nov 6, 2022 at 9:03 PM Kathleen Hines
<kathleen.buzzeo@xxxxxxxxx<mailto:kathleen.buzzeo@xxxxxxxxx>> wrote:
Hello All!
I am giving a presentation to my outpatient clinic on discharge planning
in the outpatient setting specifically with neurological clientele. I work in
Massachusetts for Spaulding and we have a large outpatient neuro caseload. As
outpatient is the "end of the line" in rehab often the discharges are emotional
for family and clinicians.
I am aware this is a very broad question but how do you all prepare these
patients for their last day in PT?
I usually will connect them with a social worker early on in their care,
introduce them to community resources and day rehab programs if applicable,
talk about discharge early so they are aware of the plan and encourage them to
return for a "tune up" as needed and guided by their neurologist. I am very
specific that this tune up is for one of 3 reasons: their neurologist wants
them to return, they had a fall or new weakness or pain (ect.) or their home
exercise is no longer challenging. We do not have a neuro-focused gym that I
am aware of on the south shore. Prior to the pandemic the YMCAs had assistants
who would assist clients get onto and off of equipment this program is no
longer running unfortunately. I do refer to our outpatient clinic at a gym so
they can be set up with a gym program if they are interested and family and or
friends can be trained to help Them In a gym setting.
What else do others do to prepare for this difficult phase in their journey?
Thank you in advance!
Sincerely,
Kathleen Buzzeo PT, DPT, CBIS
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