• Ms. Opdyke leaves Kindred Hospital with a smile and new appreciation for her extended lease on life.

    Aubrey Opdyke, a 27-year-old wife and mother came to Kindred Hospital – The Palm Beaches after a two-month battle for her life at a local sub acute hospital against Public Enemy No. 1; swine flu. Ms. Opdyke had spent five weeks in a coma, suffered six collapsed lungs, a near-fatal seizure and worst of all, lost the child she was carrying. The young mother had been six months pregnant with her second child when she contracted H1N1 that July. In spite of every possible effort, her baby girl could not be saved. Once her condition had stabilized, Ms. Opdyke was transferred to Kindred Hospital having lost two months of her life and the life of her child during the medically induced coma that had saved her life.

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  • The publication of the June 2012 issue of the journal Respiratory Care followed a national symposium dedicated to the “chronically critically ill patient,” the patient with ongoing costly medical interventions, risk for medical complications and death, and the need for extensive post-acute care services.  One article and subsequent discussion was devoted to the topic of liberating patients on prolonged mechanical ventilation, or PMV patients, from their need for this ongoing treatment. PMV is defined, in this article, as mechanical ventilation needed for at least 21 days.

    We know there are barriers to weaning patients from PMV, but it can be argued that we haven’t formally studied them enough to know how to overcome them. The barriers may include age, identifying windows of opportunity for weaning, a concurrent condition known as critical illness neuromyopathy (CINM) and cardiac issues.

    Can we do a better job of weaning patients from prolonged mechanical ventilation?

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  • National Rehab Awareness Week is Sept. 16-22, which makes this an ideal time to highlight the impact that Kindred’s RehabCare Division has on our patients. The country’s largest provider of rehab services, RehabCare offers physical therapy, occupational therapy, and speech-language therapy to more than 2,100 facilities in 46 states. “Many of our patients are critically ill and are on ventilators or have trachs [tracheostomies],” says Vienna Lafrenz, OTR/L, CLT, Director of Clinical Operations - West Region, RehabCare. “We also treat a lot of medically complex patients who have multiple diagnoses or conditions.”RehabCare Logo

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  •  Anthony Disser, Kindred's Senior Vice President of Clinical Operations, Hospital Division accepted the 2012 Hospital Partnership Award. Also pictured: DaVita's Lynn Robinson (left) and Joanne Brady (right). Anthony Disser, Kindred's Senior Vice President of Clinical Operations, Hospital Division accepted the 2012 Hospital Partnership Award. Also pictured: DaVita's Lynn Robinson (left) and Joanne Brady (right).

    Once a year, DaVita Inc., a leading provider of kidney care who delivers dialysis services to patients with chronic kidney failure and end stage renal disease, recognizes one of its partners with its Hospital Partnership Award. Kindred Healthcare is the recipient for 2012; the award was given at DaVita’s Hospital National Meeting on July 25.

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  • Many of you are probably already aware that May is Better Hearing and Speech Month. Since one of the goals of Better Hearing and Speech Month is to raise awareness about communication impairments and the professionals who treat them, this seems like a good time to share some information about Kindred’s speech and language pathologists (SLPs), and what they do for our patients.

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  • Editor's Note: Due to the late onset of winter, flu continues to show up in communities across the United States.

    In December of 2009, 24-year-old Sarah Flack was admitted to Kindred Hospital-San Francisco Bay Area following a five-week stay at another hospital where she had been battling H1N1. “I moved to Kindred because my parents were told it was a good place for physical therapy and for weaning people off of ventilators,” Flack says. “The staff there was phenomenal.”

    One of the things that Flack liked about Kindred Hospital was the staff’s flexibility. “I was one of the youngest patients there, so I always had family in my room during visiting hours and sometimes even after,” she says. “When I was first admitted to Kindred, I was in a room with another patient, and it was just too crowded. So I asked for another room, and within a few hours, they moved me into a room that had plenty of space.”

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  • The 2011 Clinical Impact Symposium Cardio-Pulmonary Rehabilitation Across the Continuum, held December 6-8 in Louisville, Ky., offered some great information on providing patients the highest level of care.

    Cardio-Pulmonary Clinical Impact Symposium “The clinical guidelines for long-term care and rehabilitation have evolved gradually and changed considerably over the last several years,” he says. “Skilled nursing facilities have sometimes lagged behind. Dr. Pandya provided some easy-to-follow instructions and tools that will help those facilities to better manage their patients with diabetes.”

    Sean Muldoon, M.D., Chief Medical Officer and Senior Vice President, Hospital Division, Kindred Healthcare, says that the “hazards of immobility that lead to polymyoneuropathy” theme was a common one during several of the sessions. “This validates the Kindred model of integrated restorative services, which will lead staff to update these findings with renewed determination into hospital care models,” he says.

     

    Daniel Forman, MD, FACC, FAHADaniel Forman, MD, FACC, FAHA

     

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  • Weakness: Polyneuromyopathy - the Role of Mobility

    By Ryan Squire
    Peter Morris, MDPeter Morris, MD

    The issue of chronic critical illness or Post Intensive Care Unit Syndrome (PICS) is of great importance in the management of patients in the ICU.   There are many additional synonyms for the problem, and the number of names for syndrome demonstrates lack of critical understanding of the syndrome.

    Why is this an important concern? Acute respiratory failure results in 1.1 million ICU admissions needing mechanical ventilation annually.   There are 400,000 ICU deaths/yr with resp failure; hospital mortality: 37%.  The cost of this care is substantial and rising; total health care costs total 17.6% of GDP in the US.

    The key questions to be answered about early rehab care in the ICU are:

    Morris points out fiscal considerations of ICU rehabilitation are a potential barrier and historically, the fear of early movement of ICU patients may also fuel reluctance to intervene.

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  • Lawrence Cahalin, PhD, PTLawrence Cahalin, PhD, PT

    Activities of physical therapy and rehabilitation are critical in improving outcomes for the patient with heart disease.  The areas to be focused on include aerobic exercise training, resistance/strength training, and inspiration muscle training. These may have important impacts on measures such as hospitalization, quality of life (QOL), and even survival. One of the first steps is understanding your risk for heart attack. Cahalin urged the audience to visit the American Heart Association's website for heart attack risk factor assessment and asked that we have our patients do the same and take the assessment.

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  • Daniel Forman, MD, FACC, FAHADaniel Forman, MD, FACC, FAHA

    Daniel Forman, MD, is Medical Director of the Cardiac Rehabilitation and Exercise Testing Laboratory at Brigham and Women's Hospital. Dr. Forman suggests that while most of focus of heart care is placed on diseases of the heart, there is an enormous opportunity to modify biology and lifestyle years before cardiopulmonary disease ever shows up. Lifestyle factors such as eating habits, exercise habits, tobacco use and sleep add up over time and lead to disease. Add biological factors like age, family history, and genetic predispositions and there are many factors that lead to disease.

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