How the program works: Restoring function quickly
Patients get more therapy in less time
A typical day for patients at Columbia St. David’s Rehabilitation Center’s Progressive Orthopedic Program is similar to that of other orthopedic rehab patients, but the pace is faster and the work is more intensive. While most patients go to their meals in wheelchairs, POP patients walk to and from meals in a group with a therapist’s assistant. POP patients get full therapy services seven days a week instead of fewer hours of therapy on weekends like most rehab patients.
"It’s not that the program is radically different. It’s the way we administer the program," says Donna Young, PT, clinical supervisor of the physical medicine department.
According to data from the Uniform Data System for Medical Rehabilitation in Buffalo, NY, the national average length of stay in rehab is 10 days for knee replacement patients. Before the POP was created, the average stay at St. David’s was nine days. In the first three months of the POP, patients had an average stay of 5.3 days.
"Physicians are sold on the program, and their patients are incredibly pleased," says Laura Halliday, LMSW/ACP supervisor of the orthopedic program in rehab.
Both the POP and the regular orthopedic rehab program emphasize activities of daily living and include community outings, but the intensity and pace is different for POP patients. "It kind of comes down to hours. If someone can tolerate four or five hours of therapy a day, they may be a candidate for POP," Young says.
POP patients spend four days in acute care, including surgery day. They receive exercise, ambulation, and pool therapy in acute care, getting out of bed and exercising on their first day. They begin walking to exercise classes and pool therapy on the second day. By day four, when they transfer to the rehab unit, they are familiar with equipment such as reachers and dressing sticks, as well as their exercise regime. "When they come to rehab, we’re not starting from square one to teach them everything," Young says.
On the fourth day, the patients do their exercises and have pool therapy in the morning at the acute care hospital. At midday, they are transferred to the rehab unit, where they spend the rest of the day working on activities of daily living. Many of those emphasize home skills since many patients go home alone.
Patients start their days in rehab by dressing themselves and walking to breakfast. Then they walk to pool therapy, exercise on the mat, and practice ambulation.
"A POP patient typically would tell us he’d prefer to walk. It’s partly their mindset. They are doers. They were active before surgery, and they want to go back to an active lifestyle," Young says.
[Editor’s note: For more information, call Donna Young at (512) 867-5511 or Laura Halliday at (512) 867-5277.]
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