Ambulatory Care Quarterly
Hospitals offer rehab within wellness centers
Hospital systems increasingly are opening medical-model wellness centers, creating opportunities to expand outpatient rehabilitation programs. Two new wellness centers offer a variety of rehab services for patients with chronic illnesses. Between them, the centers provide services to patients with musculoskeletal problems, diabetes, cardiac disease, and pulmonary disease.
At the same time, wellness centers provide the community with a fully equipped fitness facility staffed by health care and fitness professionals. The centers are an important addition to a hospital’s continuum of care, transitioning some sick patients to the community and providing the community with disease-prevention opportunities.
Regional Rehabilitation Center of Pitt County Memorial Hospital, part of the University Health Systems of Eastern Carolina in Greenville, NC, planned its 52,000-square-foot wellness center, named ViQuest, for several years before its summer 2000 opening. "We look at this center as a part of the continuum of health care," says Wanda Bennett, MS, OTR/L, administrator of outpatient rehabilitation services for the hospital. "We’ve been able to set up a program to transition patients to a wellness environment," she says.
Wellness centers can be tailor-made to suit a particular hospital’s and community’s needs. "There really was a huge need for a wellness center," Bennett says. "We have fitness clubs in the area, but many times those clubs aren’t meeting the needs of our patients, who are less than fit."
While musculoskeletal problems were a big concern for Pitt County Memorial Hospital, other hospitals have different priorities. For example, Cape Fear Valley Health System in Fayetteville, NC, has opened a wellness center, HealthPlex, which features special programs on diabetes management, cardiac rehab, and pulmonary rehab.
Hospital officials wanted to move those types of services to a wellness center to give patients a sense they are away from the clinical, sterile hospital environment, says Marcie Justice, MS, executive director. The 65,000-square-foot facility also devotes clinical space to physical therapy, sports medicine, and occupational therapy. Staff include physical therapists, occupational therapists, a vascular health exercise physiologist, a risk-reduction exercise physiologist, a psychologist, a diabetes nurse, a cardiac nurse and physiologist, and a pulmonary nurse and physiologist. There also are two contract dietitians and a fitness staff of 35.
Here are a few of the wellness centers’ features:
• Orthopedic therapy: ViQuest treats patients with musculoskeletal injuries, including hand and back injuries, whether they resulted from work, sports, car accidents, or other causes. "[Patients] include athletes who are injured and need to compete," Bennett says. "Or it could be a weekend warrior who overdid it a little bit and may need some therapy services."
• Cardiac rehab: Cape Fear’s HealthPlex has designed a rehab program for people with heart disease, including those who have had a heart attack, bypass surgery, or angioplasty. Physicians refer patients to the program for three months of treatment using a multidisciplinary approach. The cardiac team includes a nurse, psychologist, exercise physiologist, and dietitian.
• Return-to-work: The Pitt County rehab center’s WorkReady program includes training on how to prevent injuries, as well as job-safety visits to local companies. Since part of the hospital’s outpatient rehab facility has moved to ViQuest, the wellness center has become part of the continuum of care for WorkReady clients.
• Diabetes: Cape Fear’s diabetes program has moved to the wellness center, where clients are taught how to manage their disease in two or three sessions, lasting about four hours in all. The program, recently affected by Medicare cuts, originally offered eight hours of education in two half-day sessions, Justice says.
• Pulmonary rehab: The HealthPlex program is similar to its cardiac therapy program. "Basically, it’s set up like cardiac but is designed for people who have pulmonary disease, whether it’s chronic lung disease or emphysema," Justice explains. "Patients are referred by a physician; they come to the hospital for a couple of weeks and then they come out to the HealthPlex to be integrated into the wellness-center environment."
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