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FirstHealth of the Carolinas
One-on-one rehabilitation By Dick Broom
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One-on-one rehabilitation One-on-one
FirstHealth really emphasizes the importance of spending one-on-one time with our patients and not being in a hurry to get them in and out,” says Jill Botnick, director of Outpatient and Regional Rehabilitation Services. “We have an exceptional staff of caring people who look at each patient’s needs and then help them get better.”

Rehabilitation services—physical therapy (PT), occupational therapy (OT) and speech/language pathology—are provided to inpatients at all three FirstHealth hospitals and at six outpatient clinics. Therapists see patients with many different problems including back and joint pain, dizziness, brain injuries and stroke, as well as patients recovering from various types of surgery.

Rehab for stroke patients often includes a combination of therapies (PT to build strength and improve balance, OT to help manage daily tasks such as dressing and bathing, and speech therapy to help with talking and swallowing). The inpatient Center for Rehabilitation at Moore Regional consistently achieves high scores for getting patients back on their feet and back home.

“Our average length of stay is shorter than that of the region and the nation,” says Linda DeYoung, administrative director of FirstHealth Rehabilitation Services. “Our patients go home sooner, and when we follow up on them after discharge, we find that a high percentage have been able to maintain their gains and do really well.”

Most of the outpatient rehab clinics are based in the FirstHealth Centers for Health & Fitness, where patients have full access to the equipment and pools. Heather Buie, director of Rehabilitation Services at Richmond Memorial Hospital in Rockingham, says many patients with arthritis in their hips or knees benefit from aquatic therapy.

Richmond also has an “un-weighting” system that supports patients while they are using a treadmill. For example, it can help stroke patients who have difficulty using one side of their bodies. “It allows them to re-learn the motions of walking without having to bear all of their body weight,” Buie says.

At Montgomery Memorial Hospital in Troy, “We see patients with all types of needs,” says Mike Shutt, director of Rehabilitation Services. “We specialize in being generalists.”

CARF accreditation

The Center for Inpatient Rehabilitation at FirstHealth Moore Regional Hospital in Pinehurst has been accredited by CARF International as an adult inpatient rehabilitation program and a stroke specialty program.

Founded in 1966 as the Commission on Accreditation of Rehabilitation Facilities, CARF establishes consumer-focused standards to help organizations measure and improve the quality of their programs and services. A CARF-accredited organization has put itself through a rigorous peer review process and demonstrated to a team of surveyors during an on-site visit that its programs and services are of the highest quality and are measurable and accountable.

Moore Regional received its fifth consecutive three-year accreditation in 2008.

Montgomery Memorial has a unit for patients who need to be in the hospital for rehabilitation following a stroke, joint replacement, heart surgery or other major procedure.

“Patients can stay there while we help them get their strength and conditioning back,” Shutt says. “The unit is staffed by the same therapists who see outpatients. That’s a big asset, because it means we can provide greater continuity of care.”

In light of the current economic slump, FirstHealth’s rehab staffs are making a special effort to lower patients’ costs.

“For example, we are trying to reduce the number of outpatient therapy sessions some patients need,” DeYoung says. “We have them come in for fewer but longer sessions and give them more to work on at home, and that helps keep their expenses down.”

Adding inovation to the traditional

Along with traditional therapies, the rehabilitation services offered at FirstHealth Moore Regional Hospital include several new, innovative options.

With “Wii-habilitation,” patients use the Nintendo Wii interactive video game system to improve their balance, endurance and range of motion. Wii players use a cordless device that detects motion to control the on-screen movements of people competing in various sports.

For patients who have difficulty walking because of a condition called “foot drop,” the Bioness system includes a leg cuff that delivers mild electrical stimulation to the calf muscles. This helps lift the foot, allowing the patient to walk without assistance.

WiiSome patients with stiffness, muscle spasms and certain types of pain respond well to Anodyne therapy, which uses near-infrared light energy to create heat that dilates the blood vessels and increases circulation. One of the most popular rehabilitation therapies offered at Moore Regional doesn’t seem like therapy at all. It involves petting and playing with dogs. (See related story.)

“It’s amazing how much animal-assisted therapy can help patients progress,” says Linda DeYoung, administrative director of FirstHealth Rehabilitation Services. “For example, we had a patient who would hardly walk. But when the dog came in, he would walk across the room to pet it and toss a ball for it. We are looking at expanding animalassisted therapy to our outpatient program, because we have had such great results with inpatients.”

The “Wii-habilitaton” and Animal-Assisted Therapy programs were funded by disbursements from the Moore Regional Hospital Foundation.