Can we do a better job of weaning patients from prolonged mechanical ventilation?
October 2, 2012 By Sean Muldoon, MD
The publication of the June 2012 issue of the journal Respiratory Care followed a national symposium dedicated to the "chronically critically ill patient," the patient with ongoing costly medical interventions, risk for medical complications and death, and the need for extensive post-acute care services. One article and subsequent discussion was devoted to the topic of liberating patients on prolonged mechanical ventilation, or PMV patients, from their need for this ongoing treatment. PMV is defined, in this article, as mechanical ventilation needed for at least 21 days.
We know there are barriers to weaning patients from PMV, but it can be argued that we haven't formally studied them enough to know how to overcome them. The barriers may include age, identifying windows of opportunity for weaning, a concurrent condition known as critical illness neuromyopathy (CINM) and cardiac issues.
from → Cardiology, Hospitals, Long Term Care, Management, Pulmonology, Quality, Rehabilitation, Ventillator
How Do We Best Care For the Chronically Critically Ill?
September 24, 2012 By Sean Muldoon, MD
Sean R. Muldoon, M.D., M.P.H., F.C.C.P.
Senior Vice President and Chief Medical Officer
Kindred Healthcare Hospital Division
Many important questions were raised by information published in the June 2012 issue of the journal Respiratory Care. This issue followed a national symposium dedicated to the "chronically critically ill patient," the patient with ongoing costly medical interventions, risk for medical complications and death, and the need for extensive post-acute care services.
from → Accountable Care Organization, Cardiology, Critical Care, Hospice, Hospitals, Kidney Failure and Disease, Long Term Care, Management, Nursing Centers, Pulmonology, Rehospitalization, Ventillator
RehabCare Employees Care for Patients in Nearly Every State
September 18, 2012 By Sophia Kroon
National Rehab Awareness Week is Sept. 16-22, which makes this an ideal time to highlight the impact that Kindred's RehabCare Division has on our patients. The country's largest provider of rehab services, RehabCare offers physical therapy, occupational therapy, and speech-language therapy to more than 2,100 facilities in 46 states. "Many of our patients are critically ill and are on ventilators or have trachs [tracheostomies]," says Vienna Lafrenz, OTR/L, CLT, Director of Clinical Operations - West Region, RehabCare. "We also treat a lot of medically complex patients who have multiple diagnoses or conditions."
from → Assisted Living, Exercise, Occupational Therapy, Physical Therapy, Quality, Rehabilitation, Speech and Language Pathology
DaVita Recognizes Kindred as Hospital Services Partner of the Year
August 17, 2012 By Sophia Kroon
Anthony Disser, Kindred's Senior Vice President of Clinical Operations, Hospital Division accepted the 2012 Hospital Partnership Award. Also pictured: DaVita's Lynn Robinson (left) and Joanne Brady (right).
Once a year, DaVita Inc., a leading provider of kidney care who delivers dialysis services to patients with chronic kidney failure and end stage renal disease, recognizes one of its partners with its Hospital Partnership Award. Kindred Healthcare is the recipient for 2012; the award was given at DaVita's Hospital National Meeting on July 25.
from → Hospitals, Kidney Failure and Disease, Management, Nursing Centers, Quality, Rehabilitation, Uncategorized
A Kindred Success Story: Cody
July 20, 2012 By Sophia Kroon
Cody, a patient at Kindred Hospital San Gabriel Valley, had great dedication and never gave up on his health.
Cody, a patient at Kindred Hospital San Gabriel Valley, was visiting a cousin's home when he was found unresponsive and taken by ambulance to a short-term acute care hospital. He was admitted for acute respiratory failure, hypoxia, encephalopathy, acute renal failure, acute hepatitis and rhabdomyolysis.
At the short-term acute care hospital, Cody's condition was stabilized but he still required high-intensity care. He transferred to Kindred Hospital San Gabriel Valley for continued care including ventilator weaning, respiratory therapy and rehabilitation.
from → Critical Care, Hospitals, Nutrition, Occupational Therapy, Physical Therapy, Quality
The Important Role of a Speech and Language Pathologist
May 21, 2012 By Ryan Squire
Many of you are probably already aware that May is Better Hearing and Speech Month. Since one of the goals of Better Hearing and Speech Month is to raise awareness about communication impairments and the professionals who treat them, this seems like a good time to share some information about Kindred's speech and language pathologists (SLPs), and what they do for our patients.
from → Exercise, Hospitals, Management, Nursing Centers, Rehabilitation, Speech and Language Pathology
A Young Patient Shares Her Story of Post-flu Recovery at Kindred
April 30, 2012 By Ryan Squire
Editor's Note: Due to the late onset of winter, flu continues to show up in communities across the United States.
In December of 2009, 24-year-old Sarah Flack was admitted to Kindred Hospital-San Francisco Bay Area following a five-week stay at another hospital where she had been battling H1N1. "I moved to Kindred because my parents were told it was a good place for physical therapy and for weaning people off of ventilators," Flack says. "The staff there was phenomenal."
One of the things that Flack liked about Kindred Hospital was the staff's flexibility. "I was one of the youngest patients there, so I always had family in my room during visiting hours and sometimes even after," she says. "When I was first admitted to Kindred, I was in a room with another patient, and it was just too crowded. So I asked for another room, and within a few hours, they moved me into a room that had plenty of space."
from → Critical Care, Hospitals, Occupational Therapy, Physical Therapy, Pulmonology, Rehabilitation
Cardio-Pulmonary Clinical Impact Symposium Provided Information and Inspiration
January 30, 2012 By Ryan Squire
The 2011 Clinical Impact Symposium Cardio-Pulmonary Rehabilitation Across the Continuum, held December 6-8 in Louisville, Ky., offered some great information on providing patients the highest level of care.
"The clinical guidelines for long-term care and rehabilitation have evolved gradually and changed considerably over the last several years," he says. "Skilled nursing facilities have sometimes lagged behind. Dr. Pandya provided some easy-to-follow instructions and tools that will help those facilities to better manage their patients with diabetes."
Sean Muldoon, M.D., Chief Medical Officer and Senior Vice President, Hospital Division, Kindred Healthcare, says that the "hazards of immobility that lead to polymyoneuropathy" theme was a common one during several of the sessions. "This validates the Kindred model of integrated restorative services, which will lead staff to update these findings with renewed determination into hospital care models," he says.
from → Cardiology, Critical Care, Diabetes, Endocrinology, Exercise, Hospitals, Management, Nursing Centers, Nutrition, Pulmonology, Quality, Rehabilitation, Rehospitalization
Bessie: A Seamless Recovery Across the Continuum of Care
Kindred's presence across the post-acute spectrum of care means that our patients can recover as fully as possible in the proper care setting. Bessie's story is a good example. She was living comfortable at home in Jeffersonville, Indiana, and using a Bi-PAP machine when she developed respiratory distress.
On January 3, she was admitted to a short-term acute care hospital. There she was placed on a ventilator and underwent a tracheostomy. She also developed pneumonia, renal dysfunction and hypertension. Because she was unable to wean from the ventilator, Bessie's physician chose to transfer her to Kindred Hospital Louisville for continued care.
At Kindred Hospital Louisville, Bessie was successfully weaned from the ventilator. She recovered from her pneumonia and her renal function improved significantly. By this point Bessie had gained strength with the help of physical, speech and occupational therapy, but her recovery was not complete.
from → Hospitals, Nursing Centers, Pulmonology, Ventillator
Preventing Rehospitalization of the CHF Patient: A Team Approach
Ehtel Frese, PT, DPT, MHS, CCS
Congestive heart failure is a very common reason for hospitalization, with over 1 million congestive heart failure (CHF) admissions per year; readmission rates are 30% at 30-60 days. Identifying methods to reduce the frequency of hospitalization and the associated costs are critically important.
Early exercise training may be useful in reducing morbidity and mortality in CHF. Aerobic and strength training are both key as muscle strength is a key predictor of long term survival, better than peak VO2.
The 6 min walk test is commonly used to measure functional capacity. A result under 300 meters is associated with increased mortality. The test is sensitive to changes in cardiac function, and a difference of 99 feet is considered the minimal improvement of clinical importance according to Ethel Frese.
from → Cardiology, Hospitals, Management, Rehospitalization