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R E H A B I L I T A T I O N VOL . 2, NO. 4, WINTER 2016 QUARTERLY BaylorHealth.edu/Rehab An Educational Journal of Baylor Institute for Rehabilitation INNOVATIVE CARE One-day joint program helps eligible patients get home sooner T raditionally, total knee and hip replacement surgeries have involved multiple-day hospital stays. Not anymore. Now, eligible patients can undergo a knee or hip replacement one day and be discharged the next. Baylor University Medical Center at Dallas began offering its one-day joint program in 2014. 3 Staff rallies to help friends and strangers after a recent natural disaster “The program was developed to fill a need that we recognized among our total joint replacement patients who had been fast tracked. These patients were able to go through surgery and rehabilitation quickly,” says Licia Harper, PT, supervisor of the rehabilitation-orthopedics team at Baylor University Medical Center at Dallas. To be qualified for the one-day joint program, patients must: • Be in overall good health 4 ew council identifies dual N diagnosis TBI/SCI patients to improve treatment 6 • Attend a joint class at Baylor University Medical Center at Dallas • Have a support person at home • Arrange transportation home from the hospital • Purchase bathroom equipment prior to the surgery date • Attend “prehabilitation” with an outpatient therapist prior to the surgery (one to three sessions) • Attend post-operative outpatient therapy (at least one session) Patients are also required to sign an agreement stating that they will adhere to the requirements of the program. The evidence-based research behind Baylor Rehab’s patient care The oneday joint program at Baylor Dallas puts eligible patients on the fast track to joint pain relief. (cover story continued ) Developing the Protocol The inpatient protocol allows patients to drink clear fluids up to two hours before surgery, which reduces the risk of dehydration. Pre-surgical medications are also administered to reduce anxiety and nausea. Patients are discharged home with no wound issues, no nausea and well-managed discomfort, as well as a plan for postoperative rehabilitation in place. “Our goal is to decrease the length of stay and total cost without increasing the risk of readmission,” Mabrey says. Upon discharge, patients’ post-operative rehabilitation is scheduled There have been with the same therapist who zero readmissions The Logistics performed their The program begins within 30 days prehabilitation. long before hospital of discharge for “Using the same admission with the therapist has prehabilitation proparticipants of improved patient cess. “Patients receive the program. satisfaction,” education and are says Melissa prepared for surgery Arana, MSN, before they come in,” RN, CMSRN, orthopedic outcomes Harper says. “Because they will only manager at Baylor University Medical be in the hospital for 24 to 36 hours, this prehabilitation is very important.” Center at Dallas. “Because a relationship was developed prior to surgery, Once patients are admitted to the hospital, everyone is aware of their sta- we are providing a continuity of care. Patients report that they are pleased tus as one-day joint participants; this to know where they’re going and who helps them move through the process they’re going to see post surgery.” efficiently. ZERO 2 | BaylorHealth.edu/Rehab In addition, Baylor Scott & White Health is developing an app (available for iPhones and iPads) for one-day joint program patients. Patients can use it to access information about their surgery, track their pre- and post-operative progress, and send messages to the care coordinator. The app contains contacts and checklists, and can help patients keep track of physical therapy exercises repeated daily. Measurements of Success The program has gone well overall, with 19 percent of knee and hip patients participating so far. Dr. Mabrey has been surprised by the age range of eligible participants. “I thought we would focus on patients in their 40s and 50s. However, we’ve had highly motivated patients in their early 70s participate in the program successfully,” he says. And while data is preliminary (117 patients through August 31, 2015), there have been no readmissions within 30 days of discharge for patients who participated in the program. In addition, it has increased the number of hip and knee patients going home the day after surgery from 4 percent to about 20 percent. “One year of this initiative has reduced hospital costs,” Arana says. Brandie Owen, MSPT, OPA-C, MBA, a center manager of outpatient PHOTOS BY THINKSTOCK While one-day joint programs have been initiated at smaller hospitals, instituting a streamlined program at a large academic medical center presented potential challenges, according to Jay Mabrey, MD, MBA, CPE, chief of the department of orthopedic surgery at Baylor University Medical Center at Dallas. “Because there are multiple care silos, it is tough to get everyone on the same page,” he says. “In addition, the physical layout of the large hospital and number of people involved can cause delays in just having patients moved from one area to the next.” Reducing time in the recovery room, for example, is one challenge, as patients traditionally stay in recovery for as long as six hours in larger facilities. Working as a multidisciplinary team, prehabilitation and post-operative physical therapy rehabilitation programs were developed for the outpatient side, while a protocol from admission to discharge was developed for the inpatient phase. A diverse group of team members, including anesthesiologists, physical therapists, surgeons, nurses and pharmacists, were involved in the development of the program. “We all work together to provide focused care in a streamlined but cohesive fashion,” Harper says. services at Baylor Institute for Rehabilitation, is currently analyzing data from the program and performing a cost analysis. Based upon the initial data and information, she is reporting better outcomes, bettereducated patients and high patient satisfaction. Part of this is because of the prehabilitation requirement, which examines barriers to recovery in the home (e.g., pets) and the presence of a support person. “We make sure the support person is aware of the exercises the patient should be doing daily and can report back to the therapist. They are part of the continuum of communication,” Owen says. Another reason for the success of the program is the timing of postoperative rehabilitation. “If a patient has surgery on Monday and is discharged on Tuesday, we schedule him or her for outpatient therapy beginning on Wednesday or Thursday of that week,” Owen says. n Licia Harper, PT, is supervisor of the rehabilitationorthopedics team at Baylor University Medical Center at Dallas. She can be reached at 214.820.9089 or 3 Licia. [email protected]. Jay Mabrey, MD, MBA, CPE, is chief of the department of orthopedic surgery at Baylor University Medical Center at Dallas. He can be reached at 214.820.7010 or 3 Jay.Mabrey@ BSWHealth.org. Melissa Arana, MSN, RN, CMSRN, is orthopedic outcomes manager at Baylor University Medical Center at Dallas. She can be reached at 214.820.8044 or 3 Melissa. [email protected]. Brandie Owen, MSPT, OPA-C, MBA, is a center manager of outpatient services at Baylor Institute for Rehabilitation. She can be reached at 817.329.2524 or 3 BrOwen@BIR-rehab. com. A MESSAGE FROM The Medical Director Amy J. Wilson, MD Medical Director, Baylor Institute for Rehabilitation Chief, Department of Physical Medicine and Rehabilitation, Baylor University Medical Center Helping Our Own When It Matters Most A natural disaster can make one realize just how small the world really is. On the night after Christmas 2015, our community suffered the wrath of an unusual winter tornado. Now it seems that nearly everyone in the Dallas and Fort Worth areas has a connection to someone who was impacted, including many in our own Baylor Institute for Rehabilitation family. With the extent of the devastation evident by the light of the following day, we found out that some of our fellow coworkers had lost Although many of everything in the storm except for their precious lives. Although many us are accustomed of us are accustomed to seeing the to seeing the human human impact of some of the hardest misfortune life can dish out, the impact of some of the ruin caused by this powerful storm hardest misfortune is sobering. As the day after the storm wore life can dish out, the on, friends and strangers alike ralruin caused by this lied in support of those suffering in loss. I was comforted by the empapowerful storm is thy shown by my organization in its single-minded desire to help our sobering. brothers and sisters. Within a couple of days, employees had donated thousands of dollars in a grass roots effort to support our own. Albert Einstein is often quoted as saying, “Only a life lived for others is a life worthwhile.” While we have long built a reputation on our dedication to compassionate patient care, I am also proud of the humanitarian efforts that extend beyond the confines of our buildings. Dr. Wilson can be reached at: 3 [email protected] BaylorHealth.edu/Rehab | 3 TREATING SCI AND TBI Council identifies needs of dual diagnosis patients A recent study published in the Journal of Head Trauma Rehabilitation estimates that 40 to 58 percent of spinal cord injury (SCI) patients also have a traumatic brain injury (TBI), with car accidents and falls accounting for many of these dual injuries. Preliminary data from an internal chart review at Baylor University Medical Center at Dallas and Baylor Institute for Rehabilitation in Dallas suggests that potentially three out of four SCI patients may have some degree of brain injury, the effects of which can be over- 4 | BaylorHealth.edu/Rehab whelming, even more so if the injury is undiagnosed and untreated, says Dr. Angela Vrooman, co-chief resident in PM&R. The results of an undiagnosed TBI can result in potentially more complications and longer stays in rehab, Dr. Vrooman adds. The Challenge Baylor Institute for Rehabilitation is part of the North Texas Model System for TBI and has separate teams that manage TBI and SCI. While this focused expertise serves patients well in the treatment of a specific injury, there has been concern that unrecognized TBI dual diagnosis patients can have a significantly impacted recovery due to lack of diagnosis. For example, the presence of TBI may affect a SCI patient’s carryover of learned behaviors or adaptation of new skills. Thus, knowledge of this comorbidity is important so the treatment team may customize their plan to account for these difficulties and optimize each patient’s therapy based on what is known to be effective in both TBI and SCI populations. “We have found the diagnosis of TBI in SCI occurs at all levels of care, from in the field to the emergency room to the acute care setting. A few patients are getting all the way to rehabilitation without receiving a proper diagnosis,” says Dr. Vrooman. This is likely because there are no clear consensus recommendations for the screening and identification of dual diagnosis patients, she says. Patients who are treated solely for their SCI injuries aren’t receiving the model system of care they would have received had the TBI been identified earlier in the process. Finding a Solution To address this, Baylor Institute for Rehabilitation has formed the Dual Diagnosis TBI/SCI Council, which is being led by Seema Sikka, MD, physician in spinal cord injury medicine at Baylor Institute for Rehabilitation. The group includes therapists, neuropsychologists, case managers and physicians from both TBI and SCI fields. The council’s goals are to: • Identify dual diagnosis patients among patients with traumatic SCI • Ensure that all patient needs are met throughout the care continuum • Improve collaboration between the SCI and TBI teams • Foster research • Improve patient and staff education about dual TBI/SCI diagnosis “We are working to develop ways to obtain better information from as early as the scene of an accident through acute care at Baylor University Medical Center at Dallas, then into rehabilitation,” Dr. Sikka says. “We also are working to better categorize mild TBI, which are the majority of cases in SCI.” The hope is that by bringing the SCI and TBI teams together, increased communication will result in improved patient care and outcomes. n Angela Vrooman, DO, is co-chief resident in PM&R. She can be reached at 3 Angela.Vrooman@ BSWHealth.org. Seema Sikka, MD, is a physician who is board certified in spinal cord injury medicine, brain injury medicine and physical medicine and rehabilitation at Baylor Institute for Rehabilitation. She can be reached at 214.820.9395 or 3 Seema. [email protected]. SPINAL SURGERY PROTOCOL Scoliosis patients benefit from pre- and post-surgical therapy B aylor Institute for Rehabilitation is using an evidence-based continuum of care model to coordinate with Baylor Scoliosis Center at Plano to provide surgical patients with appropriate physical and occupational therapy from presurgery throughout hospitalization. Baylor Scoliosis Center opened in 2005 and the physicians on the medical staff have performed more than 2,000 scoliosis surgeries. In early 2014, Baylor Institute for Rehabilitation began the scoliosis continuum of care which included initial education and training with therapy staff regarding physician-specific protocols and collaboration between the acute care therapists and the rehab therapist to provide quality care throughout the patient’s rehabilitation course. Patients requiring scoliosis surgery are often very complex and can have multiple comorbidities which require monitoring during their acute care stay. These surgeries often last seven to eight hours, and the patients require intensive rehabilitation afterwards. Patients have to relearn how to complete their activities of daily living (ADLs) and mobility following surgical intervention as they have had to compensate for their curvature for years in some cases, which has caused increased pain, difficulty ambulating, difficulty completing basic ADLs, and even difficulties with breathing. Before Surgery PHOTOS BY THINKSTOCK Prior to the procedure, all patients meet with a therapist. “This initial meeting helps patients get an idea of what to expect during the hospital stay as well as preparation for the changes in physical and mental status that often accompany spinal surgery,” says Donna Kaufhold, MBA, OT/L, director of acute care therapy services at Baylor Scott & White Medical Center – Plano. Patients also have the opportunity to discuss pain management strategies, and are encouraged to make the hospital more like home. For example, they might bring in a favorite blanket or some relaxing music when they are admitted, says Kara Pridgen, PT, DPT, of Baylor Scott & White Medical Center – Plano. After Surgery All patients are moved to the intensive care unit (ICU) because of the nature of the surgery and the pain management requirements. A physical therapist initiates the patient’s treatment beginning on post-op day 1. “Our goal on the first day is to get the patients to move from the bed to the chair, stay in the chair around an hour and return to the bed,” Pridgen says. Patients also meet with an occupational therapist post-surgery. “We provide education and training for self-care, including the use of adaptive equipment, to prepare patients for when they will eventually head home,” says Emily Fulmer, OTR, a registered occupational therapist at Baylor Scott & White Medical Center – Plano. While in the ICU, patients meet with the physical therapist twice daily and the occupational therapist daily (or more often, if needed). Patients continue working on their therapy goals after they move from the ICU to the orthopedics floor. Many patients are eventually moved to Baylor Institute for Rehabilitation at Frisco, where the average stay for a scoliosis patient is 12 days, says J. Michael DeLeon, PT, DPT, MBA, director of rehabilitation at Baylor Institute for Rehabilitation at Frisco. During their hospital stay, patients participate in a group-based, four-part, back education series, while also receiving daily physical and occupational therapy. The first half of the series focuses on home management, assistive devices and energy conservation. The second half of the series discusses moving beyond pain. It focuses on alternative coping strategies to pain management such as pacing for pain, breathing techniques and guided imagery. The group setting allows patients to speak with one another and ask questions in a supportive environment. “By working in a partnership along the continuum of care we provide patients with the necessary education in in-patient rehabilitation,” DeLeon says. n Donna Kaufhold, MBA, OT/L, is director of acute care therapy services at Baylor Scott & White Medical Center – Plano. She can be reached at 3 Donna.Fitch@ BSWHealth.org. Kara Pridgen, PT, DPT, is a physical therapist at Baylor Scott & White Medical Center – Plano. She can be reached at 3 Kara. [email protected]. Emily Fulmer, OTR, is a registered occupational therapist at Baylor Scott & White Medical Center – Plano. She can be reached at 3 Emily.Fulmer@ BSWHealth.org. J. Michael DeLeon, PT, DPT, MBA, is director of rehabilitation at Baylor Institute for Rehabilitation at Frisco. He can be reached at 3 JMDeLeon@ BIR-rehab.com. BaylorHealth.edu/Rehab | 5 MOVING MEDICINE FORWARD Innovative research and achievements in 2015 T his was another productive year for the research program at Baylor Institute for Rehabilitation, and included numerous interdisciplinary publications and presentations by our clinicians and researchers. In addition, Baylor Institute for Rehabilitation started several new and externally funded research grants and continues to work as part of the North Texas Traumatic Brain Injury Model System in conjunction with the University of Texas Southwestern Medical Center. Grants • Simon Driver, PhD, started a collaborative grant with the University of Texas School of Public Health titled, Project WOWii: Developing and testing a Webbased intervention to promote exercise among those with spinal cord injury. The field-initiated project is being funded for three years by the National Institute of Disability, Independent Living, and Rehabilitation Research (NIDILRR). • Driver also continued work with the University of Texas School of Public Health on the Centers for Disease Control and Prevention grant focused on “Translating the Group Lifestyle Balance™ program to promote healthy weight among people with mobility impairment.” The research team successfully enrolled more than 70 participants with mobility impairment and is currently delivering the intervention. Baylor Institute for Rehabilitation is also modifying the Group Lifestyle Balance program for adults with TBI, with funding from the Ginger Murchison Foundation; the team is currently enrolling participants. Both projects are being completed collaboratively with the University of Pittsburgh, where the original program was developed. • Katherine Meredith, PhD, Valerie Bobb, PT, and Lorien Hathaway, PT, were awarded a Multiple Sclerosis Society Impact Grant to help meet the needs of providers working to improve quality of life for patients. The grant is 6 | BaylorHealth.edu/Rehab being used to assist in the purchase of a biofeedback machine and to train the clinical team on using the equipment for treatment of bowel and bladder dysfunction. • Shahid Shafi, MD, and colleagues continue work on the NIDILRR TBI Model Systems Center grant. The project includes comparative effectiveness research and modular/ collaborative research projects including sleep patterns, Internet use and aging with TBI. Select Publications • Driver, S., Rachal, L., Swank, C., Dubiel, R. (2015). Objective assessment of activity in inpatients with traumatic brain injury: Initial findings. Brain Impairment. http://dx.doi.org/10.1017/ BrImp.2015.20 • Salisbury, D., Driver, S., and Parsons, T.D. (2015). Brain-computer interface targeting non-motor functions after spinal cord injury: A case report. Spinal Cord 53 Suppl 1:S25-6. • Hamm, J., Driver, S. (2015). Strategies to increase physical activity participation of young adults with Asperger Syndrome in the community. Strategies 28(3):3-8. • Trost, Z., Agtarap, S., Scott, W., Driver, S., Guck, A., Roden-Foreman, K., Reynolds, M., Foreman, M. L., Warren, A. M. (2015). Perceived injustice after traumatic injury: Associations with pain, psychological distress, and functional outcomes. Rehabilitation Psychology 60(3):213-221. • Fromm, N., Salisbury, D., Driver, S., Dahdah, M., Monden, K., Driver, S. (2015). Functional recovery from neuroinvasive west nile virus: A tale of two courses. Rehabilitation Psychology [Epub ahead of print]. • Cleveland, S., Driver, S., Swank, C., & Macklin, S. (2015). Classifying physical activity research following stroke using the behavioral epidemiologic framework. Topics in Stroke Rehabilitation 22(4):289-298. • Warren, A.M., Boals, A., Trost, Z., Holtz, P., Elliott, T., Reynolds, M. (2015). Mild traumatic brain injury increases risk for the development of posttraumatic stress disorder. The Journal of Trauma and Critical Care Medicine [Epub ahead of print]. • Dodd, Z., Driver, S., Warren, A.M., Riggs, S., & Clarke, M. (2015). Effects of adult romantic attachment and social support on resilience and depression in individuals with spinal cord injuries. Topics in Spinal Cord Injury Rehabilitation 21(2):156-65. • Driver, S.J, Warren, A.M., Agatrap, S., Reynolds, M., Trost, Z, Monden, K., Hamilton, R. (2015). Identifying predictors of resilience at inpatient and three months post spinal cord injury. The Journal of Spinal Cord Medicine DOI: 10.1179/2045772314Y.0000000 270. • Stiers, W., Barisa, M., Stucky, K., Pawlowski, C., Van Tubbergen, M., Turner, A.P., Hibbard, M., Caplan, B. (2015). Guidelines for competency development and measurement in rehabilitation psychology postdoctoral training. Rehabilitation Psychology 60(2):111-22. Select Presentations • Hull, B., Thut, C., Cheng, S., and Fitch, D. (2015). Acute care therapists can survive and thrive in uncertain times. American Physical Therapy Association Annual Combined Sections Meeting, Indianapolis. • Rachal, L., Swank, C., and Driver, S. (2015). Reliability of dual-task measures in the acute rehabilitation setting following traumatic brain injury. Brain Injury Summit, Vail, Colorado. • Cleveland, S., Driver, S., Swank, C., and Shearin, S. (2015). Classifying physical activity research following stroke using the behavioral epidemiologic framework. Association of Academic Physiatrists, San Antonio, Texas. • Zaman, A. (2015). Delayed treatment for herpes zoster resulting in disabling plexopathy in the immunosuppressed patient. Association of Academic Physiatrists, San Antonio, Texas. • Cheng, S., Hull, B. (2015). How to accelerate the implementation of best practice guidelines by using change management strategies to create the right workplace culture. National Summit on Safety and Quality, Arlington, Virginia. • Carroll, S. (2015). Introducing the early-parenting perception and performance scale: EPPS. Evaluating the way we measure parent performance. National Association of Neonatal Therapists, Phoenix. • Driver, S., Rachal, L., Swank, C., Dubiel, R. (2015). Piloting the use of accelerometers to assess the amount and intensity of activity completed by inpatients following TBI. North American Brain Injury Society’s 12th Annual Conference on Brain Injury, San Antonio, Texas. • Salisbury, D., Dahdah, M., Driver, S., Parsons, T. (2015). Integration of technology in neurorehabilitation. North American Brain Injury Society’s 12th Annual Conference on Brain Injury, San Antonio, Texas. • Woolsey, A., Warren, A.M., Driver, S., Reynolds, M. (2015). Caregiver psychological outcomes of ICU patients with traumatic brain injury: Understanding of ICU experience. North American Brain Injury Society’s 12th Annual Conference on Brain Injury, San Antonio, Texas. • Klakeel, M., Monden, K.R., Trost, Z., Garner, A., Wike, A., & Hamilton, R.G. (2015). Pain and depression are associated with perceived disability and expectations for injury-related limitations among individuals with spinal cord injury. ISCoS and ASIA Joint Scientific Meeting, Montreal, Canada. • Rothbauer, J. (2015). Incidence of lymphedema in females with Turner Syndrome. National Turner Syndrome Conference, Cincinnati. • Vrooman, A. (2015). Special implications of May-Thurner Syndrome in the spinal cord injured population: A case report. Academy of Spinal Cord Injury Professionals Educational Conference and Expo, New Orleans. • Sikka, S., Borsh, S. (2015). Implementing a neurogenic bowel program in acute care: Patient knowledge. Academy of Spinal Cord Injury Professionals Educational Conference and Expo, New Orleans. • Carroll, S., Sturdivant, C. (2015). A safe pressure relief hydrogel device for neonates: Part of a Plagiocephaly prevention program. Vermont Oxford Network 26th Annual Quality Congress, Chicago. • Jones, T., Schaer, A., Torres, H., Maxwell, M., Lichtenstein, J. (2015). “Bundle Up” for patient safety: Reducing falls for the inpatient rehabilitation patient with a specific neurological diagnosis. Association of Rehabilitation Nurses, New Orleans. • Hudson, B. (2015). Delirium: What’s all the confusion? Association of Rehabilitation Nurses, New Orleans. • Leal, R., Whitney-Bujold, J., Cook, L. (2015). The use of a transitional living room to prepare patients with SCI and their caregivers for discharge home. Association of Rehabilitation Nurses, New Orleans. • Hirshour, M. (2015). Improving patient satisfaction using a team approach to improve the patient experience. Association of Rehabilitation Nurses, New Orleans. • Concannon, L. (2015). Seatbelts for safety. Association of Rehabilitation Nurses, New Orleans. • Dubiel, R., Zaman, A., Callender, L., Driver, S. (2015). Over-utilization of seizure prophylaxis following traumatic brain injury. American Academy of Physical Medicine and Rehabilitation Annual Assembly, Boston. • Christiansen, J., Driver, S., Bennett, M., Hamilton, R., Reynolds, M., Warren, A.M. (2015). Differences in outcomes among patients three months after acute traumatic injury who were and were not admitted to an inpatient physical rehabilitation facility. American Academy of Physical Medicine and Rehabilitation Annual Assembly, Boston. • Hamilton, R., Reynolds, M., Driver, S., Sikka, S., Bennett, M., Warren, A.M., Petrey, L. (2015). Analysis of registry healthcare utilization data for spinal cord injury patients over 10 years. American Academy of Physical Medicine and Rehabilitation Annual Assembly, Boston. • Warren, A.M., Driver, S., Reynolds, M., Bennett, M., Sikka, S., Hamilton, R. (2015). Posttraumatic stress symptoms among patients with spinal cord injury during acute inpatient hospitalization. American Congress of Rehabilitation Medicine, Dallas. • Driver, S. & Reynolds, M. (2015). Modifying an evidence-based lifestyle program of individuals with traumatic brain injury. American Congress of Rehabilitation Medicine, Dallas. • Smith, H., Driver, S., Reynolds, M., Bennett, M., Warren, A.M. (2015). Preliminary analysis of effect of body mass index and health outcomes across the continuum of care posttraumatic injury. American Congress of Rehabilitation Medicine, Dallas. • Salisbury, D., Driver, S., Reynolds, M., Bennett, M., Warren, A.M., Petrey, L. (2015). Healthcare utilization after traumatic brain injury: Utilizing a regional hospital database. American Congress of Rehabilitation Medicine, Dallas. • Woolsey, A., Driver, S., Callender, L. (2015). Assessing health literacy awareness among staff at an inpatient rehabilitation hospital system. American Congress of Rehabilitation Medicine, Dallas. • Foster, T., Hamilton, R., Callender, L., Christiansen, B. (2015). Does time/ day of admission predict unplanned transfers from inpatient rehabilitation? American Congress of Rehabilitation Medicine, Dallas. • Fromm, N., Driver, S., Salisbury, D., Meredith, K., Callender, L., Bennett, M. (2015). Understanding outcomes and recovery in the subacute stages of West Nile Virus. American Congress of Rehabilitation Medicine, Dallas. • Swank, C., Shearin, S., Cleveland, S., Driver, S. (2015). Auditing the physical activity and Parkinson’s disease literature using the behavioral epidemiologic framework. American Congress of Rehabilitation Medicine, Dallas. • Parsons, T., Carlew, A., Salisbury, D. (2015). Brain-computer interface targeting cognitive functions after spinal cord injury. National Academy of Neuropsychology, Austin. • Longnecker, D. (2015). Brain tumors: Types, treatment options, and rehabilitation. American Speech Language Hearing Association, Denver. • Nickel, C., Reynolds, J. (2015). The case for comfort: Implementation of a comfort feeding plan in palliative and end-of-life care. American Speech Language Hearing Association, Denver. Baylor Institute for Rehabilitation has been named by U.S.News & World Report as the "Best Rehabilitation Hospital” in North and Central Texas. Baylor Institute for Rehabilitation hospitals in Dallas and Frisco are certified for stroke rehabilitation by The Joint Commission. BaylorHealth.edu/Rehab | 7 Baylor Scott & White Health Marketing Department 2001 Bryan Street, Suite 750 Dallas, TX 75201 NON-PROFIT ORG US POSTAGE PA I D AURORA, IL PERMIT NO. 500 Day Neuro now offers services in three locations The Day Neuro Rehabilitation Program (Day Neuro) offered by Baylor Institute for Rehabilitation now sees patients at two locations in addition to Dallas. The Las Colinas center in Irving opened in February 2015, and the Frisco location began seeing patients in December 2015. Day Neuro is a comprehensive outpatient rehabilitation program for patients who have acquired brain injury, including traumatic brain injury, stroke and brain tumor. “Our primary focus is on cognitive rehabilitation,” says Sarabeth Clopton, PT, DPT, Center Manager and Physical Therapist. There are numerous articles that support implementation of high intensity, high frequency rehabilitation following inpatient therapy, Clopton explains. Day Neuro bridges the gap between inpatient rehabilitation and a patient’s ability to function at home with minimal or no support. After being referred to Day Neuro, patients attend therapy for 6 hours per day, including physical, occupational and speech therapy, and group activity. They are typically seen from 3 weeks to 6 months post-injury. “Therapy is individualized and based on what each patient needs,” says Clopton. With three locations—Dallas, Irving and Frisco—Day Neuro now serves a wider population in the Metroplex. For more information, contact Sarabeth Clopton at [email protected]. Baylor Rehab neuropsychologist participates in concussion experts meeting Mark Barisa, PhD, ABPP, director of neuropsychology services at Baylor Institute for Rehabilitation, was among 30 independent concussion experts who met in October 2015 to develop standard guidelines for treating concussions, including best practices, protocols and active therapies. Hosted by the University of Pittsburgh Medical Center, the meeting was attended by representatives from the Centers for Disease Control and Prevention, the National Institutes of Health, the U.S. Department of Defense, and sports groups, including the NFL, NFL Players Association and the NCAA. The meeting was the first to focus exclusively on treatments, active therapies and best clinical practices for concussions. “It was a great opportunity for nationally known experts to come together and document that concussion is in fact a treatable condition, and to begin to reduce some of the myths that have dominated the discussion around concussions in recent years,” Dr. Barisa says. The consensus information from the meeting will be published as a white paper in a medical journal in 2016. The material in Rehabilitation Quarterly is not intended for diagnosing or prescribing. Consult your physician before undertaking any form of medical treatment. Physicians are members of the medical staff of Baylor Institute for Rehabilitation and are neither employees nor agents of Baylor Institute for Rehabilitation, Baylor Scott & White Health, Select Medical or any of their subsidiaries or affiliates. Baylor Institute for Rehabilitation is part of a comprehensive inpatient and outpatient rehabilitation network formed through a partnership between Baylor Institute for Rehabilitation and a wholly owned subsidiary of Select Medical. If you are receiving multiple copies, need to change your mailing address or do not wish to receive this publication, please send your mailing label(s) and the updated information to Robin Vogel, Baylor Scott & White Health, 2001 Bryan St., Suite 750, Dallas, TX 75201, or email the information to [email protected].