No images? Click here March 2021 Froedtert InpatientBy Drs. David Del Toro and Olivia Park During the initial stages of the COVID-19 pandemic here in Wisconsin, Froedtert Menomonee Falls Hospital (FMFH) IPR beds were converted to acute care beds, resulting in the official closure of IPR at FMFH on April 9, 2020. Thus we saw consolidation of all acute IPR beds to Froedtert Hospital on 5NE nursing unit. We are actively working on plans for a 50-bed freestanding IPR unit on the Bluemound campus that is tentatively scheduled to open in July 2022. Many changes have started to take place to help facilitate a smooth transition to the Bluemound campus. Drs. Braza, Park and Del Toro along with Rachel Stauffer participate in frequent IPR facility planning meetings with architects, rehab administrative personnel and rehab nursing leadership to review and revise the new IPR space utilization and other related topics. In mid to late October, the 5NE IPR unit had a mini-outbreak of COVID-19, when several patients tested positive; this required to severely restrict patient access. Through the efforts of numerous hospital staff (rehab staff, nursing, therapists, faculty, resident physicians, among many others) and with the direction and expertise of the hospital IPAC (Infection Prevention and Control) team, including Dr. Mary Beth Graham and Allie Reeme, we were able to “weather the storm." The 5NE IPR unit is now operating at a “robust” capacity. It has been working at a much higher capacity, and we would like to thank all those involved for their hard work. PM&R is also involved in the new post-COVID multidisciplinary clinic, which went live in late January 2021. During 2020, the 5NE rehab staff with the assistance of rehab nursing, PPS coordinators and therapy leadership, transitioned away from the traditional QI measure, FIM (functional independence measure) scores to a new federally mandated measure called “Quality Indicators." An ongoing comprehensive education plan was put in place for all disciplines, including PT, OT, SLP/ ST and rehab nursing. Dr. Sayko and Dr. Del Toro along with Linda Foglia, RN (Director of Nursing for Neurosciences, Transplant and Rehab), have been working with the Liver Transplant team, including Dr. Johnny Hong, to provide rehab therapy guidelines and develop a clinical pathway to facilitate optimal rehabilitation for post-op liver transplants patients with the potential for acute IPR program, when clinically indicated. Additionally, Dr. Sayko, Dr. Del Toro and Linda Foglia, RN, are working with the Director of Internal Medicine hospital teams and Director of Case Management / SW to facilitate early PM&R consults with the goal of providing real-time decision-making and transfer patients efficiently to 5NE IPR unit if clinically warranted. Dr. Olivia Park has been extremely valuable and instrumental in reviewing and revising several of the compliance documents for IPR patients, including the team conference notes and thus streamlining the work of our super-busy IPR providers. Through the excellent work by Dr. Orr and the rest of the SCI team, the official “Inpatient Consult” order for “Spinal Cord Injury Medicine” became available in Epic. The goal of this inpatient consult order is to notify the SCI team of any SCI patient admitted to the hospital, providing access to our providers for clinical recommendations and other input as needed. See graph below. Working on the 5NE IPR ACT (accountable care team) with multiple rehab staff (nursing, therapy, CM/SW, etc.), Dr. Orr and Dr. Del Toro are happy to report that while continuing to see some fluctuation in 30-day readmissions from IPR patients, our 72-hour readmission rate for calendar year 2020 has been 2% or less and sometimes 0% (in 8/12 months). Kudos to all those staff and providers that provide care for 5NE IPR patients. Give yourself a pat on the back!
Bea and Carlos building a snow child Have news to share with your PM&R colleagues? We would love to hear from you for our next issue, so please email any recent publications, awards, presentations, shout-outs, pictures, etc. to Beatriz Envila at benvila@mcw.edu. Medical College of Wisconsin | 8701 Watertown Plank Road | Milwaukee, WI 53226 Connect to MCW on Social |