Performance Improvement MONITOR ... - Reflectx Staffing

February 2011
Performance Improvement
M O N I T O R
Volume 2, Issue 4
TRAVELMAX AND REFLECTX UPDATE
JoiNT CoMMiSSioN
Join Commission Center for transforming
HealtHCare, taCkles misCommuniCation
among Caregivers
Top U.S. Hospitals Identify Causes, Develop Targeted
Solutions to Save Lives
OAKBROOK TERRACE, IL – October 21, 2010 – An estimated 80
percent of serious medical errors involve miscommunication between
caregivers when responsibility for patients is transferred or handedoff.
Recognizing this as a critical patient safety issue, a group of 10
leading U.S. hospitals and healthcare systems teamed up with the Joint
Commission Center for Transforming Healthcare to use new methods
to find the causes of and put a stop to these dangerous and potentially
deadly breakdowns in patient care.
Healthcare organizations have long struggled with the process of
passing necessary and critical information about a patient from one
caregiver to the next, or from one team of caregivers to another. A
hand-off process involves “senders,” the caregivers transmitting patient
information and releasing the care of the patient to the next clinician,
and “receivers,” the caregivers who accept the patient information and
care of the patient.
The Hand-off Communications Project began in August 2009.
During the measure phase of the project, the participating hospitals
found that, on average, more than 37 percent of the time hand-
Joint Commission continued on next page...
CLiNiCAL CoRNER
Deborah Kalinoski, MSS Vice President of
Clinical Services, oversees the overall
Division Clinical Operations.
Jennifer McConnell, RN, Regional Director of
Clinical Services (RDOCS) for the Travel Division.
If you ever have any clinical issues or
questions, contact your recruiter and he/she
will put you in touch with Jennifer McConnell.
We plan to bring you informative news that
will help keep you up-to-date with Travel
Division happenings centered around our
Performance Improvement activities. One
area in which we would like for all external
employees to become more involved and
interactive is with our Vice President of Clinical
Services, Deborah Kalinoski. We have
created an e-mail address where you can feel
free to ask questions and/or discuss issues any
time: askdeb@maxhealth.com.
Joint Commission update
Joint Commission 2011 National Patient Safety Goals:
There are no new National Patient Safety Goals for 2011. Minor
revisions have been made in updating the 2011 goals from the
2010 goals. Details regarding these revisions can be found here:
http://www.jointcommission.org/standards_information/
npsgs.aspx
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JoiNT CoMMiSSioN continued
offs were defective and didn’t allow the receiver to safely care for
the patient. Additionally, 21 percent of the time senders were
dissatisfied with the quality of the hand-off. Using solutions
targeted to the specific causes of an inadequate hand-off,
participating organizations that fully implemented the solutions
achieved an average 52 percent reduction in defective hand-offs.
The 10 hospitals and health systems that volunteered to address
hand-off communications as a critical patient safety problem are:
• Exempla Lutheran Medical Center, Wheat Ridge, Colorado
• Fairview Health Services, Minneapolis, Minnesota
• Intermountain Healthcare LDS Hospital, Salt Lake City, Utah
• The Johns Hopkins Hospital, Baltimore, Maryland
• Kaiser Permanente Sunnyside Medical Center, Clackamas, Oregon
• Mayo Clinic Saint Marys Hospital, Rochester, Minnesota
• New York-Presbyterian Hospital, New York
• North Shore-LIJ Health System Steven and Alexandra Cohen
Children’s Medical Center, New Hyde Park, New York
• Partners HealthCare, Massachusetts General Hospital, Boston
• Stanford Hospital & Clinics, Palo Alto, California
Although The Joint Commission requires accredited organizations
to use a standardized approach to hand-off communications,
breakdowns in communication have been a leading contributing
factor in sentinel events, which are unexpected occurrences
involving death or serious physical or psychological injury, or the
risk thereof. In addition to patient harm, defective hand-offs can
lead to delays in treatment, inappropriate treatment, and increased
length of stay in the hospital.
Recognizing that there is no quick fix, the Center and the
participating hospitals set out to solve the problems through the
application of Robust Process Improvement tools. RPI is a factbased,
systematic, and data-driven problem-solving methodology
that allows project teams to discover specific risk points and
contributing factors, and then develop and implement solutions
targeted to those factors to increase overall patient safety and
healthcare quality. Barriers to effective hand-offs experienced by
receivers include incomplete information, lack of opportunity to
discuss the hand-off, and no hand-off occurred. "Senders" identified
too many delays, "receivers" not returning a call, or "receivers" being
too busy to take a report as reasons for hand-off failures.
“These 10 organizations are leading the way in finding specific
solutions to the complex problem of hand-off communication
failures,” says Mark R. Chassin, M.D., M.P.P., M.P.H., president,
The Joint Commission. “A comprehensive approach that focuses
on systems is the only way to ensure that the many caregivers
upon whom patients rely are successfully communicating vital
information during these transitions in care.”
The targeted hand-off solutions from the Center, which are
described using the acronym SHARE, address the specific causes
of unsuccessful hand-offs. SHARE refers to:
• Standardize critical content, which includes providing
details of the patient’s history to the "receiver", emphasizing
key information about the patient when speaking with the
"receiver", and synthesizing patient information from separate
sources before passing it on to the "receiver".
• Hardwire within your system, which includes developing
standardized forms, tools and methods, such as checklists,
identifying new and existing technologies to assist in making the
hand-off successful, and stating expectations about how to conduct
a successful hand-off.
• Allow opportunity to ask questions, which includes using
critical thinking skills when discussing a patient’s case as well
as sharing and receiving information as an interdisciplinary
team (e.g., a pit crew). "Receivers" should expect to receive
all key information about the patient from the "sender",
"receivers" should scrutinize and question the data, and the
"receivers" and "senders" should exchange contact information
in the event there are any additional questions.
• Reinforce quality and measurement, which includes
demonstrating leadership commitment to successful handoffs
such as holding staff accountable, monitoring compliance
with use of standardized forms, and using data to determine a
systematic approach for improvement.
• Educate and coach, which includes organizations teaching
staff what constitutes a successful hand-off, standardizing
training on how to conduct a hand-off, providing real-time
performance feedback to staff, and making successful hand-offs
an organizational priority.
In addition to hand-off communications, the Center is aiming to
reduce Surgical Site Infections (SSI) following colorectal surgery
through a new project launched in August 2010 in collaboration
with the American College of Surgeons. Participating
organizations include the Mayo Clinic, OSF Saint Francis Medical
Center, Cedars-Sinai Medical Center, North Shore-LIJ Health
System, Cleveland Clinic, Stanford Hospital & Clinics and
Northwestern Memorial Hospital. The solutions for this project are
expected to be published in the fall of 2011.
All Joint Commission-accredited healthcare organizations
have access to the solutions through the Targeted Solutions
Tool (TST), which provides a step-by-step process to measure
performance, identify barriers to excellent performance, and
implement the Center’s proven solutions that are customized to
address an organization’s specific barriers. The first set of targeted
solutions, created by eight of the country’s leading hospitals and
healthcare systems working in collaboration with the Center,
focuses on improving hand hygiene. Accredited organizations can
access the TST and hand hygiene solutions on their secure Joint
Commission Connect extranet. The targeted solutions for handoff
communications are currently being pilot tested to prove their
effectiveness in demographically diverse hospitals and will be added
to the TST in the second half of 2011. A project to reduce the risk
of wrong site surgery is also in process. Future projects are expected
to focus on preventable hospitalizations, medication errors, and
other aspects of infection control.
Joint Commission continued on next page...
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JoiNT CoMMiSSioN continued
statements from tHe Center’s partiCipating Hospitals
“The communication that is involved in patient transfers is a
critical concern that can have a severe impact on care. Therefore,
we are pleased to participate in The Joint Commission’s Hand-off
Communications Project to find ways of improving this process.
I am proud of our employees and their efforts. It is rewarding to
know that their work combined with similar activities at the other
project participant sites will help improve patient-centered health
care across the country.” – Michael J. Dowling, President and CEO,
North Shore-LIJ Health System
“This work demonstrates a new and exciting way to deliver safer
care. By collaborating with leading institutions around the country,
we’re identifying proven strategies that improve communications
during critical points of transfer for our patients.” – Mark Eustis,
President and CEO, Fairview Health Services
"Patients' safety is greatly enhanced when we have smooth and
effective communication hand-offs as patients move across care
settings. So, patients everywhere will benefit from what we and the
other leading health care programs have learned in this collaborative
effort with The Joint Commission. This initiative greatly increases
the chances for good, safe continuity of care for everyone." – Susan
Mullaney, Administrator, Kaiser Permanente Sunnyside Medical Center
"Partners HealthCare frequently collaborates with other
institutions across the nation on patient quality and safety
initiatives – but has never worked with such a comprehensive
group at the same time. This collaboration has produced results
beyond the capability of any single participant and validates The
Joint Commission's proposition that critical issues in health care
can be addressed in a rigorous and thoughtful way. I know that our
patients, and patients across the country, will reap benefits from
this work." – Terrence O’Malley, M.D., Medical Director, Non-Acute
Care Services, Partners HealthCare, Massachusetts General Hospital
“We know that breakdowns in communication that can occur
when patients are handed-off from one caregiver to another are a
leading cause of patient harm and medical errors. Few areas within
the spectrum of patient care give us such an enormous opportunity
to improve patient outcomes and reduce mistakes as improving
these communications. The Joint Commission’s initiative in this
area is a welcome start.” – Ronald R. Peterson, President, The Johns
Hopkins Hospital and Health System, and Executive Vice President,
Johns Hopkins Medicine
“We believe that this has been an outstanding project and we are
thrilled to have been a participant. Hand-off communication is
critical to the patient care process. Being able to identify where
there are breakdowns in the hand-off process and focus on where
we can improve, as well as develop targeted solutions, will improve
the quality of care our patients receive.” – Kevin Tabb, M.D., CMO,
Stanford Hospital & Clinics
"Exempla Lutheran Medical Center is proud to participate in the
Joint Commission Center for Transforming Healthcare's critical
initiative to improve the quality of hand-off communications.
We know how important it is to communicate accurately and
effectively when we transfer patients from one caregiver to another.
But what is it that interferes with those communications? Working
with the Center and the other participating hospitals, and with
the use of Lean Six Sigma, we identified some of the critical
barriers to effective communication to establish processes that can
be replicated to consistently make patient transfers safer. We are
committed to working with the Center and the other participating
hospitals to help solve these complex patient safety issues and
share best practices." – Grant Wicklund, President and CEO, Exempla
Lutheran Medical Center
The Center is grateful for the generous leadership and support of
the American Hospital Association, BD, Ecolab, GE Healthcare,
GlaxoSmithKline (GSK), Johnson & Johnson and Medline
Industries, as well as the support of GOJO Industries, Inc. and The
Federation of American Hospitals.
For more information about the Joint Commission
Center for Transforming Healthcare visit
www.centerfortransforminghealthcare.org.
Established in 2009, the Joint Commission Center for Transforming Healthcare
aims to transform American health care into a high-reliability industry that
ensures patients receive the safest, highest quality care they expect and deserve.
The Center’s participants – the nation’s leading hospitals and health systems – use
a proven, systematic approach to analyze specific breakdowns in care and discover
their underlying causes to develop targeted solutions for health care’s most critical
safety and quality problems. The Center is a not-for-profit affiliate of The Joint
Commission, which shares the Center’s proven effective solutions with its more
than 18,000 accredited health care organizations. Learn more about the Center at
www.centerfortransforminghealthcare.org.
Source: http://www.centerfortransforminghealthcare.org/news/display.
aspx?newsid=23
Joint Commission continued on next page...
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oPPoRTUNiTiES FoR iMPRoVEMENT
performanCe measurement
and improvement update
PERFORMANCE IMPROVEMENT
Several areas of performance improvement are still above our threshold. Key focus
areas that will be addressed include medication errors and “do not returns” for clinical
procedure and unprofessional behavior.
medication errors
Medication errors continue to be a huge concern due to the high incidence of
medication errors noted throughout the United States. Medication errors can result
in harmful effects or death, increase hospital length of stay, and add tremendous cost
to healthcare. Medication errors continue to be a cause of concern for maxim Staffing
Solutions as evidenced by our performance improvement data. There are many ways
you can take steps to minimize this risk:
make certain to follow the 6 rights of medication administration:
4Right Medication. Check the physician order and check it against the
medication label.
4Right Dose. Check the physician order and the medication label. Look up the
medication if you are unfamiliar with it.
4Right Time. Check the order and check the medication label. Check the time.
Give the medication at the time prescribed.
4Right Route. Check the MD order and check the medication label to determine
that the medication will be given by the right route.
4Right Patient. Check the MD order and check the medication label. Check the
patient and check the patient’s allergies prior to medication administration.
4Right Documentation of Medication. Properly document the medication given,
dose, time, route, and patient response to medication.
take steps to stay current on medications:
Many new medications come into the market each year. Take steps to become familiar
with medication so you have a full understanding of medication administration, dosage,
side effects, and proper storage. Consider taking continuing education courses to better
understand medication administration and prevent medication errors. MedCom is a
CEU vendor that Maxim uses that offers a course on medication administration. Please
contact your Maxim representative for more information.
do not returns
A “Do Not Return” (or DNR) occurs when a facility notifies Maxim that they do
not wish for a particular staff member to return. Facilities have the right to do this,
and Maxim must honor their request. DNRs usually occur due to two reasons:
unprofessional behavior and for clinical reasons.
do not return for Clinical procedure
Prior to performing any procedure, make certain to follow the facility policy and
procedure manual. If, at any time, you are unsure about any type of treatment,
medication, or procedure, STOP and ASK FOR HELP! This will ensure that the
patient gets the proper treatment.
do not return for unprofessional Behavior
Did you know that Maxim has to report all cases of unprofessional behavior that result
in a DNR to The Joint Commission? Unprofessional behavior is disrespectful and
disruptive to staff and patients. In some cases, facilities have reported these types of
behaviors to the state licensing boards. Please take a moment to consider your behavior
when working in facilities. Make certain to maintain professionalism at all times.
JoiNT CoMMiSSioN continued
new! tHe Joint Commission
Center for transforming
HealtHCare
Established in 2009, The Joint Commission
Center for Transforming Healthcare aims
to solve healthcare’s most critical safety and
quality problems. The Center’s participants –
the nation’s leading hospitals and health
systems – use a systematic approach to
analyze specific breakdowns in care and
discover their underlying causes to develop
targeted solutions that solve these complex
problems. In keeping with its objective to
transform healthcare into a high reliability
industry, The Joint Commission will share
these proven effective solutions with the
more than 18,000 health care organizations
it accredits and certifies. Hospitals have made
significant advances in quality – even better
results are now achievable. Hospitals and The
Joint Commission are working together to
improve systems and processes of care.
More information can be found here: http://
www.centerfortransforminghealthcare.org/
Source: http://www.centerfortransforminghealthcare.org/
about/about.aspx
w w w . t r a v m a x . c o m 4

pi Corner
Ask Deb
tHis edition’s question to our readers:
As healthcare providers, we are experiencing a continual issue of medication errors. This quarter, we would like to hear opinions from
our readers related to this issue. Your opinions are very important to us. This information will be used to work with our clients and
hopefully alleviate, or at least lessen, the occurrence of medication errors. Our goal is to assist the client, employee, and patient in
hopes of ensuring safe healthcare.
Ask Deb wants to know: What do you think is the most appropriate way to properly handle a personality conflict with your supervisor?
Please send your responses to askdeb@maximstaffing.com.
previous question:
Why do you think that medication errors are taking place when
nurses go into a facility and work shifts?
Winning Response:
I have been an agency nurse for 4 years. Though I have not had any
medical errors, I have had a few near misses. In my experience, the
top two reasons that set up agency nurses for potential medication
errors are:
1. Inadequate training
• This last year, one of the six hospitals I worked at gave me a
full patient load and expected me to complete an orientation
checklist within the same shift. Additionally, the person
tasked with orienting me was also given a full patient work
load. Another hospital did not provide any training at all. I
had to hit the floor running.
• Alternatively, one facility, not only provided me a 2 hour
orientation separate from my work shift, but they also gave
me a handout so I would not forget the information. That
reference material was well used!
2. Poorly communicated shift expectations. The expectations
are not only different between health care facilities, but they are
different between work areas. For example: At one hospital it
is the night RN's responsibility to provide sliding scale insulin
coverage for high blood glucose levels, yet in the same hospital
on a different unit the coverage is expected to be provided by
the day shift RN. I suppose reason number two could also be
attributed to inconsistent expectations throughout facilities.
What helps me prevent errors:
1. I take notes when given information. If the facility allows,
I save a file for each unit in a password protected personal
computer document folder. That way, I can cue up the
expectations specific to each unit (prevents me from needing to
ask the same questions each time). I recently took advantage of
this approach to fill in on a unit I had not worked on in a year. It
made for a successful and safe shift.
2. I write down all the important phone numbers that I will need
to do my job properly (inpatient pharmacy, transportation/escort,
discharge pharmacy, etc) and place that list in my ID badge
holder. Prevents me from needing to run to the nurse's station to
reference the phone list. Saves time!
3. I make checklists for each patient to remind me when
medications are due.
Congratulations to last week's
winner, Dana Schanrfenberg!
Enjoy your $100 gift card!
About Dana Schanrfenberg...
I earned a BSN and a BA in Biology
with a minor in chemistry at Seattle
Pacific University in 2001. For the
majority of my career as a nurse, I
have worked primarily in oncology
and medical-surgical settings. In 2009, I completed a master
of nursing degree at the University of Washington with a focus
on education. For the past five years, I have worked part time
as a medical-surgical instructor in the clinical setting and as an
agency nurse for almost the same amount of time. Currently, I
am employed with Maxim Staffing Solutions and teach at North
Seattle Community College in Seattle, Washington.
It is my joy to work with nursing students and care for patients in
vulnerable life transitions. Exposure to so many different settings
has strengthened my skills as a nurse and helped me to more fully
appreciate the "art" in the "art and science" of nursing. Working
as an agency RN has allowed me to balance my efforts to serve
the community I live in, continue to teach, and be there for my
husband and two children when needed.
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REhAb ThERAPy NEwS
apta: Cms releases 2011 mediCare pHysiCian
fee sCHedule final rule
The Centers for Medicare and Medicaid Services (CMS) released
the 2011 Medicare Physician Fee Schedule Final Rule, which,
is disappointing to report, contains significant cuts to outpatient
therapy services that will negatively impact physical therapists and
millions of patients. Under a new multiple procedure payment
reduction (MPPR) policy, physical therapists will see a 7%-9%
reduction in payment for these services starting January 1, 2011.
The association is deeply concerned about this policy. APTA has
worked diligently these past few months educating CMS, White
House officials, the Medicare Payment Advisory Commission
(MedPAC) and other policymakers about the detrimental effect
the MPPR policy will have on physical therapists and the patients
we serve. The initial MPPR proposal called for an 11%-13%
cut in payments and, while our actions did have an impact, we
are nonetheless seriously troubled by this final rule. This lesser
reduction of 7%-9% will still mean disturbing repercussions for
outpatient therapy providers and their patients. As such, APTA
is now aggressively exploring all legal, regulatory, and legislative
options to negate the MPPR policy.
APTA believes this policy is unjustified, as it is based on flawed
analysis conducted by CMS in the agency's effort to avoid duplication
of payment when multiple services are furnished during a session
or day. As we know, the practice expense values for the codes
reported by physical therapists had already been reduced to avoid
duplication during the Relative Value Update Committee (RUC)
review process, thus making the MPPR an unfair and unnecessary
policy. In addition, CMS only examined the median number of units
in private practice therapists' offices and physician offices, which
account for approximately 35% of expenditures. Data from skilled
nursing facilities, hospitals, rehabilitation agencies, and comprehensive
outpatient rehabilitation facilities, which account for the remaining
65% of expenditures, were not taken into account. And, CMS
excluded all dates of service during which one unit of service is billed,
further skewing the data on which this policy is based.
Lastly, the final fee schedule rule includes several other provisions
important to physical therapists, including the implementation
of the $1,870 therapy cap without an exceptions process, the
projected cut in the sustainable growth rate/conversion factor of
approximately 30%, and the expiration of the geographical practice
cost index (GPCI) floor. Also in the rule, CMS discusses options
for therapy payment alternatives, quality reporting under the
physician quality reporting initiative (PQRI), and application of a
MPPR policy for therapy services under Medicare Part B.
APTA will work to ensure that CMS establishes payment policies
that guarantee appropriate payment for the high quality services we
provide our patients. The Association is committed to being a leader
in policy change and in developing payment models that accurately
reflect the care and treatment provided by physical therapists.
Source: American Physical Therapy Association, http://www.apta.org/AM/
Template.cfm?TEMPLATE=/CM/ContentDisplay.cfm&Section=Media&CONT
ENTID=77196
internet-Based reHaB is a viaBle treatment
option following knee surgery
Knee replacement patients undergoing telerehabilitation - a unique
Internet-based postoperative rehabilitation program that can be
conducted from the patient's home - experience the same results
as patients who undergo traditional postoperative rehabilitation,
according to a new study published in the Journal of Bone and Joint
Surgery ( JBJS). Telerehabilitation is becoming a popular alternative
for patients who live in remote areas and who have no access to
traditional rehabilitation centers.
"The concept for telerehabilitation is a decade old; however, wellconducted
research studies demonstrating its benefits and potential
are rare," said study author Trevor Russell, PhD, School of Health
and Rehabilitation Science, University of Queensland, Brisbane,
Australia. "This study offers measurable evidence that such
technology can be used to provide effective rehabilitation services
for knee replacement patients."
Rehabilitation following knee replacement surgery is essential to
ensure patients regain flexibility, strength and mobility," Dr. Russell
said. "Patients who do not have regular access to rehab services
after surgery are unlikely to achieve maximum results following
knee replacement. Telerehabilitation ensures patients can have
access to rehabilitation programs."
Study Details:
• The researchers enrolled 65 patients who underwent TKA
and randomized them to receive six weeks of either traditional
outpatient rehab services or Internet-based outpatient rehab.
• For the purposes of this study, patients in the telerehab group
performed their therapy in a hospital room designed and
furnished to replicate a typical home environment.
• Patients in the telerehabilitation group received rehab through realtime
(live video and audio) interaction with a physical therapist
via an Internet-based system. Therapy sessions were limited
to 45 minutes and consisted of self-applied techniques under
the guidance of the remote therapist, along with exercises and
education in the postoperative management of the affected knee.
Although specially-designed equipment was used during the study,
Dr. Russell said in the future, telerehabilitation should be available
to patients with a home computer and other readily available
components. "The telerehabilitation system used in this study was
custom-made and consisted of a computer, an echo-cancelling
microphone, a web camera, custom software and an Internet
connection," Dr. Russell said. "The components are packaged in
a robust case for transportation. It is feasible that in the future
patients could use their own home computer with downloaded
software, provided they had a webcam and microphone of suitable
quality and a broadband Internet connection."
continued on next page...
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CoNTiNUiNG EDUCATioN
The Travel Division is proud to offer continuing education
through CE Direct. Please contact your NRM if you are
interested in taking any of the Continuing Education courses
that CE Direct has to offer.
Ce direCt Course offerings:
Advanced Practice Nursing
Ambulatory Care
Bio/Radiological Terrorism
Bioethics
Cardiology
Career Fitness®
Case Management
CMS Hospital-Acquired
Conditions
Complementary Healthcare
Correctional Health Nursing
Critical Care Nursing
Cultural Competency
Diabetes
Emergency Nursing
Endocrinology
ENT
FL State Required Courses
Forensic Nursing
Gastroenterology
Gerontologic Nursing
Home Health Nursing
Immunology
Infectious Disease/Control
Joint Commission Related
KY State Required Courses
Legal & Regulatory
Magnet Related
Management
Medical/Surgical Nursing
Men’s Health
MI State Required Courses
Neonatal Nursing
Neurology
NV State Required Courses
NY State Required Courses
Occupational Therapists
OH State Required Courses
Oncology
Ophthalmology
OR State Required Courses
Pediatric Nursing
Perinatal Nursing
Perioperative Nursing
Pharmacists
Physical Therapists
Professional Development
Psychiatric Nursing
Puerto Rico Required Courses
Re-Entry
Stroke
Women’s Health
WV State Required Courses
Call for Testimonials! Have you taken any of these CE Direct
in-service courses? We would love to hear about your experience.
Please e-mail askdeb@maximstaffing.com to share your feedback
on these courses.
REhAb ThERAPy NEwS continued
Important Findings:
• Following the six-week program, researchers discovered
participants in the Internet-rehab group achieved outcomes
comparable to those of the conventional rehabilitation group,
and fared better in some results, including a reduction in joint
stiffness.
• Patients in the telerehabilitation group also showed significant
improvement in specific functional areas, designed to mimic
their actual daily activities.
Dr. Russell said the success of this Internet-based program
could be due to several factors, including a higher reliance on
education about the proper way to perform exercises, resulting
in better overall outcomes. Higher levels of patient satisfaction
among the patients in the telerehabilitation group, perhaps due
to a heightened level of independence, also may have contributed
to their success, Dr. Russell noted.
"Patients in the telerehabilitation group reported a higher level
of contentment with their program than those in the traditional
rehab program, and indicated that they would have this rehab
method again and even recommend it to friends," he noted.
Patients in the telerehabilitation group were also more
compliant, completing an average of 2.2 exercise sessions per day
compared with 1.7 exercise sessions per day in the group that
received traditional rehabilitation.
Although in this study any patient who underwent TKA at
the hospital where the study was conducted had the option
of participating in telerehabilitation, Dr. Russell noted future
research might focus on determining whether specific types
of patients might respond better to telerehabilitation than
traditional therapy. Additional research should also focus on how
the program works in a real home situation, he added.
"Managing the rehabilitation needs of a growing number of
total knee replacement patients presents a major challenge
to physicians, physical therapists and health-policy decisionmakers,"
Dr. Russell noted. "Alternate service-delivery models
need to be considered to address these demands, improve access
to services and control medical costs. Our results indicate
telerehabilitation can be used successfully to achieve results
comparable to traditional rehabilitation, while eliminating the
obstacles faced by many patients in rural or remote areas."
Source: American Academy of Orthopaedic Surgeons
http://www.medicalnewstoday.com/articles/214270.php
TRAVELMAX and REFLECTX SERVICES and TRAVELMAX and
REFLECTX SERVICES logos are registered service marks of Maxim Healthcare
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of their respective owners.
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