Madonna Rehabilitation Hospital seeks to provide leading-edge facility and treatment experiences for those who come here after an unexpected accident or illness as well as those who have been wounded while bravely serving our country.
Our goal is to be able to offer patients and their families an environment that mirrors the community into which they will return. An equally important goal is to bring hope and promise to patients and their loved ones from their earliest moments at Madonna. The focus, as always, emphasizes what patients can accomplish in their rehabilitation program, and ultimately, their life outside of Madonna.
These combined goals have necessitated facility renovation and technology and equipment upgrades to truly create a rehabilitation experience. This experience will help patients to regain their highest possible level of independence by building opportunities for therapy and skills practice throughout the hospital in a simulated community-like atmosphere. This initiative is the largest undertaking in Madonna's history. It will require $8.5 million dollars in philanthropy to "drive rehabilitation forward" and make these goals a reality. Over the next two years, Madonna will evolve into a complete rehabilitation community to better serve our civilian and military patients
Facility Enhancement
Setting the Tone: In Feb. 2008, the renovation of the Outpatient Day Rehabilitation area on the northeast side of the hospital debuted, projecting an overall look for the project with tile floors, streetlights, wood cabinetry and an updated color scheme.
A New Feeling of Community: A community main street feel is emerging along the south corridor of the hospital with a variety of inviting storefront facades, a palette of fresh paint and high baskets of cascading plants. Renovations began in June 2008 and updates are nearly complete. A highlight of the main street is our Wall of Honor which shares patient success stories that inspire current patients and their families with comfort and hope.
The hospital cafeteria, a hub of activity for patients, families and staff -- has been renovated to reflect three distinct themes. One-third of the cafeteria is a time machine that takes guests back to a typical 50s diner complete with black and white tile, cherry red booths and 50s inspired artwork. Guests can also enjoy a garden bistro dining experience in the center of the cafeteria that spills out onto a sunny outdoor plaza. The final dining area takes guests to an Internet Cafe milieu with full wireless capability. Each area has different seating options and configurations, allowing patients to practice in a variety of settings.
A welcoming oasis is taking shape in the family living lounge just behind the hospital elevator lobby. The signature piece of this relaxing family area is a large salt water fish tank that encloses one wall of the lounge. Work is underway on the front lobby to the very first impression of the hospital a positive one. A calming water feature beckons visitors to a tiled concourse ending at a newly designed customer service center, the first stop for outpatients and other guests.
Just south of the lobby is the Madonna Wall of Inspiration, featuring a canvas of patient photos and famous quotes that blend together to create hope and promise for those we are privileged to serve. The wall is just another example of the colorful, healing environment we have worked to create for our patients, their families and our Madonna staff members.
Spaces to Live Life to the Fullest: Patients will enjoy new challenges in rebuilding their lives once therapy practice spaces are completed. Whether it is cooking a meal for the family, setting and clearing the table, making a bed or cleaning the bathroom, specially designed kitchen, dining room, bedroom and bathroom environments will give patients the real life experience of being back in their homes. Community practice areas such as a grocery store, a laundry and a garden center will boost patient confidence levels.
To nurture the all important spiritual side of rehabilitation, visitors to the chapel will enjoy a new gathering area just outside the main chapel. Summertime will bring the addition of an accessible playground for our smallest patients as well as visiting children.
Private Space Renovation:
While renovation is ongoing in the public areas of the hospital, Madonna began the slow process of patient room remodeling in the spring of 2008. A prototype room has been completed and is being tested with patients and caregivers to assess the various components. In order to create the least amount of disruption to patient care, this phase of the project will take approximately 20 months. A total of 106 rooms will be renovated.
Each room will receive a makeover that takes patients from a clinical, hospital environment to a personal space that is more homelike. Each room will include new flooring, wall and ceiling paint, window treatments, a cabinet headwall behind the bed, bed table, night stand, flat screen TV, and art work. Larger rooms will be equipped with a sofa that transforms into a bed for family members who wish to stay with their loved one. The current built-in cabinetry will be refaced. In these new spaces patients will be able to:
- access the Internet wirelessly,
- view video clips about their disability or a therapy exercise,
- communicate with friends and family outside the hospital and with staff, and
- have more entertainment options
Smart Hospital = Smart Rehabilitation
Smart Hospital Implementation: The implementation of Smart Hospital technology covers the upgrade of patient care systems including treatment team access, diagnosis, delivery, clinical documentation and programming. Madonna has chosen Eclypsis as the provider for this phase of the hospital renovation. Upgrades include electronic medical record installation and a new nurse call system. Implementation is slated to begin next year with completion in December of 2010.
This initiative includes:
Documenting Care in "Real-Time" - patients in rehabilitation are not confined to a room, which can make communication among the multiple clinicians on a patient's team challenging. An enhanced documentation system will capture elements of care while patient treatment is in progress from anywhere within the hospital. This documentation allows:
- Up-to-the-minute updates on patient status
- Enhanced communication and coordination between care givers and therapists
- Reduced cost of transcription services
- A large patient care database for care referrals
Patient Communication System Enhancements - Patient rooms will be updated with a sophisticated nurse call system which links the patient directly to the nurse, rather than the nurse's station. Nurses wear a voice activated communication device that allows direct contact with patients as well as with other treatment team members throughout the hospital.
Enhanced Physician Access to Information - To facilitate communication between Madonna and the more than 100 hospitals from which we receive patient referrals, a Picture Archival and Communication System (PACS) provides high-resolution digital x-ray images. PACS can be readily accessed from other hospitals and physician offices and homes.
Clinical Innovation for Patient Care:
In order to take rehabilitation to the next level, Madonna must continue to be innovative in bringing new clinical applications to the research lab, the bedside and the therapy gym. New clinical innovations support Madonna's Centers of Excellence, as well as program expertise in traumatic brain injury and spinal cord injury.
Driving Program - Madonna has already purchased the assessment driving simulation tool with campaign funds on hand. This driving simulator checks for acuity, color, depth perception and reaction time. The new equipment more effectively helps those with disabilities use adapted vehicles and measures patient driving readiness. This equipment has been especially beneficial to returning soldiers who are being screened and treated at Madonna.
Vision Program - Following brain injury, the brain may not be able to interpret what the patient is seeing in certain areas of the field of vision. Today, using technology currently available in the region only at Madonna, therapists can retrain the brain to see the full visual field, allowing the independence sight affords as well as improving balance and other related physical functions. Equipment upgrades will increase the ability of our therapists to customize treatment for visual field losses and double vision, improving outcomes for a wider range of diagnoses. As funds are available, Madonna will order this cutting edge equipment.
Lokomat - Studies show that locomotion therapy supported by a robotic assisted device on a treadmill is an effective intervention for improving over-ground walking function caused by neurological diseases and injuries. The customized support and limb guidance provided by the Lokomat will enable us to use it with clients with a wide variety of walking impairments both in the inpatient and outpatient setting. We intend to use it to improve mobility in individuals following stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, cerebral palsy and other neurological diseases and injuries. We already have several gifts that are designated toward the purchase of the Lokomat.
Bioness - Patients who are recovering from a traumatic brain injury can benefit from electrical stimulation of the nerves in the arms and legs. The Bioness equipment is worn on the arm/hand or leg and can assist patients in returning function to their extremities so they can participate in skills of daily living and beyond. Madonna needs additional units to get this critical technology to our patients on waiting lists.
Additional Needs
In addition to these initial priorities, Madonna has identified several other areas of need:
Virtual Reality - virtual reality equipment, gloves and goggles patients wear that allow them to navigate through a virtual, computerized environment, holds great potential for helping patients regain physical function in a safe, virtual environment.
Assistive Technology - Madonna's Center for Excellence in Communication is a leader in assistive technology research and clinical therapy. Research initiatives on the horizon include:
- A study with the potential to expand Madonna's aphasia, or speech loss due to a brain injury, program, allowing staff to better match technology for patients based on research outcomes.
- A study that could lead to the development of new memory aid strategies for individuals with severe memory impairments, such as Alzheimers (early stages), traumatic brain injury, advanced Parkinson's, advanced multiple sclerosis, and the like
- A study that will design a "smart room" for persons with severe physical impairments, allowing them greater control over their environment and a higher level of independence and evaluate patient outcomes in this environment.
- A study that will evaluate the effectiveness of providing service through Telehealth (videophone) technology to persons in remote or rural areas. This program has the potential not only to reach patients without immediate care options, but also to safe money and time by reducing travel while maintaining access to information.
- A study that could lead to the development of new memory aid strategies for individuals with severe memory impairments, such as Alzheimers (early stages), traumatic brain injury, advanced Parkinson's, advanced multiple sclerosis, and the like
Four-plex housing unit - This facility allows patient families to stay conveniently close during treatment.
Brain Mapping - This new field of research involves using a computer to map surface activity of the brain. Tracking this activity opens the possibility for training the brain, using biofeedback, to activate certain brain areas - allowing for greater recall, organization and mental efficiency. Software upgrades will allow mapping of deeper brain structures, important for the organization of working memory and the focusing of attention.
Movement Sciences Center - The Center for Excellence in Movement Sciences has several opportunities for research and its clinical application:
- Balance/Gait Equipment- this new equipment will allow staff to better diagnose balance and gait challenges in patients, and will offer opportunities for research in fall and fracture prevention.
- Metabolic Measurement- this equipment will allow staff to determine a patient's metabolic rate, or energy expenditure, providing information helpful to treatment and an important indicator in research.
- Research Chair Endowment- this area seeks funds to fully endow a research position within the center.
- Orthopedic Researcher- a researcher in this area will broaden the range of possibilities for research at Madonna to include the field of orthopedics, allowing access to a greater range of federal research funds and ultimately benefiting care for Madonna patients.
- Post-Doctoral Researcher- this position will help advance research at Madonna as well as link the hospital to other institutions.
Horticulture Therapy - the use of horticulture therapy can improve the functional skills in the physical, social, emotional, cognitive, and psychological domains of an individual. Through this program, Madonna patients Alzheimer's and long-term patients will be guided in gardening activities chosen for their therapeutic value. Currently, Madonna incorporates some horticulture therapy and seeks to expand this positive experience to as many patients as possible.
Swallowing Signals Lab - Madonna has long been a national leader in the research and treatment of swallowing disorders. By adding the swallowing signals lab to our existing equipment, we can improve our ability to assist patients with swallowing disorders by providing them with objective feedback during treatment sessions.
Adaptive Sports and Recreation - This program provides community adaptive sports and recreation workshops, open recreation times, and tournaments in a variety of sports and leisure activities to children and adults with disabilities. The programming allows individuals the opportunity to participate and compete in as varied activities as the rest of the community; to try new sports and recreation opportunities; and to explore new ways of doing previous activities. An active lifestyle prevents isolation as well as secondary complications of disabilities. Nearly 500 people participate each year.
Nebraska Concussion Study - This study has assessed, followed and managed 81 concussions sustained by high school athletes. In addition, the athletic trainers, coaches and physicians in the region have referred about 50 athletes to Madonna for further assessment and return to play guidelines. The goal of the expanded study is to be able to reduce the incidence of sports-related concussion through education and baseline testing, and to prevent the occurrence of second impact syndrome, a rare but potentially deadly outcome of repeat concussions.
Informatics - This research area will develop a revolutionary tool to support optimal therapy treatment planning by capturing, integrating and presenting all treatment-relevant information. Treatment records and information will be carefully selected, entered, and digitally organized to allow treatment teams to access and query the system about patient treatments not only in the immediacy of the moment, but the immediacy of the setting using hospital-specific information based on outcomes for patients in Madonna's specific treatment environment.
Education. - With the explosion of new technology and innovations in rehabilitative treatment, Madonna is looking to the future educational needs of our staff:
- Built into every piece of treatment equipment are funds to train staff on its optimal use. We are keenly aware of the nationwide nursing shortage and are responding by providing opportunities for nurses to continue their education while working.
- It is our belief that investing in our nurses by providing flexible options for nurses to progress from Licensed Practicing Nurse (LPN) to Registered Nurse (RN) to a Bachelor's program and rehabilitation nurse certification will encourage nurses to stay at Madonna, and attract new nurses to our facility. Along that continuum, nurses will also have access to a wide variety of certification options in treatment areas, allowing them to specialize according to their interests and needs.
- To continue to build the expertise in rehabilitation nursing we feel is critical to maintaining and improving the standard of care at Madonna and the rehabilitation community nationwide, we are creating the Institute for Rehabilitation Nursing. Through the institute, we will create a curriculum specific to the needs of rehabilitation hospitals and patients, creating a national model for the potential of rehabilitation nursing.
- Madonna's commitment to education reaches beyond the nursing staff. We believe that all employees benefit from a stimulating and engaged work environment. We will continue to encourage our staff to set and follow educational goals by providing on-site educational opportunities as well as tuition support for continuing education.
