Patient Care

During the fiscal year July 1, 2010 through June 30, 2011, Madonna Rehabilitation Hospital served 220 individuals with spinal cord injury.

Several standard measurements are used to assess the outcomes of persons served.

Inpatient outcomes on AR are compared with national acute rehabilitation benchmarks compiled by the American Medical Rehabilitation Providers Association (AMRPA) database called erehabdata. There are no national benchmarks for outpatient SCI rehabilitation programs.

The outcomes described below are for all patients with traumatic and non-traumatic spinal cord injuries discharged from Madonna during FY 2011

Madonna served twice as many patients with traumatic spinal cord injury, versus patients with non-traumatic spinal cord injury such as spinal laminectomy with nerve impingement than the region and nation. This explains the higher case mix index (indicating more medically complex), longer number of onset days (days in acute care, indicating medical stability) and longer length of stay at Madonna Rehabilitation Hospital. Despite this, Madonna's patients were at the same functional level at discharge and made similar amount of change as described by the discharge FIM scores.

Discharge to Community Overall, Madonna discharged 72.2% of SCI patients served on acute rehabilitation to a community setting which is greater than the nation and region. Discharge to community rates for specific populations of SCI include:

Traumatic SCI: Madonna 71.1%, Region 67.5%
Nontraumatic SCI: Madonna 70%%, Region 55.6%

On LTACH, 32% of patients with SCI discharged directly home and an additional 26% transferred to acute rehab.

Average Length of Stay On AR, patients with SCI stayed an average of 48 days. On LTACH, the average length of stay was 29 days.

Functional Gains (FIM) SCI patients served on acute rehabilitation made excellent functional gains as measured by 21.3 FIM gain, which is comparable to the nation and region. MRH patients were at a higher functional level overall at discharge than the region as measured by FIM at discharge. MRH 75.4, Region 73.3.

Predicted Outcomes On average, MRH patients with SCI accomplished 84% of the goals that were established upon admission.

Inpatient Satisfaction 77% of inpatients rated their overall experience as "Excellent" and 97% as "Excellent" or "Good".

Maintenance of Gains 92% of patients who responded to a telephone survey completed 3 months after discharge said they had maintained the gains they made during their stay at Madonna.

* FIM is a 7-point tool used by rehabilitation hospitals throughout the nation to assess a patient's function in 18 areas, including self-care, bowel and bladder function, transfers, locomotion, communication and cognition. Maximum score on FIM is 126.

RDP Functional Gains: Patients with SCI served in the Rehabiltation Day Program made an average FAM** gain of 16 points, discharging at a "modified independent" level.

Traditional Outpatient Functional Gains: Patients with SCI served in traditional outpatient services had an average total score of 45/56 on an abbreviated FIM+FAM scale, also "modified independent".

Outpatient Length of Stay On average, outpatients with SCI were seen for 10.6 days. More specifically, they received the following number of visits by discipline:

Physical Therapy: 10.4
Occupational Therapy: 9.9

Outpatient Satisfaction: 100% of RDP and traditional outpatients with spinal cord injury rated their overall experience as "Excellent". 83% "strongly agreed" and 100% either "strongly agreed" or "agreed" they would recommend the program to family or friends.

** FAM is a 7-point tool used by many comprehensive outpatient providers throughout the nation to assess a patient's function. It includes the 18 areas identified in the FIM, including self-care, bowel and bladder function, transfers, locomotion, communication and cognition, plus an additional 12 areas including such things as Employability, Community Re-Entry, and Car Transfers. Maximum score on FAM is 210.