InstituteNews Advanced Rehabilitation February 2024 Caring for a Loved One After a Stroke The Invisible Scars of Brain Injuries Orlando Health Advanced Rehabilitation Institute new location NOW OPEN! Don’t Let a Spinal Cord Injury Stop You Steady on Your Feet: How To Prevent Falls as You Age Team Member and Patient Spotlights
2 This past fall, the Orlando Health Advanced Rehabilitation Institute relocated from the Orlando Health Orlando Regional Medical Center to its own free-standing rehabilitation hospital. This move was a first step in our vision of creating a worldclass rehabilitation program. We were also recognized this year by a leading news organization as a best physical rehabilitation center in America and moved up into the top quartile for U.S. News & World Report Best Rehabilitation Hospitals. Message from the President Focused on Growth in 2024 What drives us? Recently, a young teenager came back to say hello to our team. He had experienced a traumatic brain injury when hit by a car while skateboarding. His journey was a difficult one, but to see him laughing with and hugging team members reminds me of the important role we play in changing lives for the better. I enjoy looking out onto our terrace to see the camaraderie within a support group meeting or patients and their families spending quality time together. We are more than a hospital – we have an opportunity to be a part of someone’s journey. The coming year is going to be a year of growth. We will be going through our reaccreditation survey by CARF International (Commission on Accreditation of Rehabilitation Facilities). By pursuing and achieving accreditation, we have demonstrated that we meet the international standards of quality and are committed to continual excellence. Accreditation demonstrates that our organization is committed to reducing risk, addressing health and safety concerns, respecting cultural and individual preferences, and providing the best possible quality of care. The Advanced Rehabilitation Institute has the highest level of accreditation from CARF International for Comprehensive Medical Rehabilitation as well as Stroke Specialty Program, Brain Injury Specialty Program and Spinal Cord Injury Specialty Program. We are very proud to have the only CARF Accredited Spinal Cord Injury Specialty Program in eastcentral Florida. This coming year we will also be focusing on the growth of our neurorehabilitation programs – creating a vision and process improvement to continue to expand the services and the quality of care we provide. We will be leveraging our specialty certifications and knowledge, along with new technologies, to better meet the needs of those whom we serve. It’s important that all rehabilitation providers continue to be strong advocates for continued access to inpatient rehabilitation as facilities across the country face ongoing hurdles such as proposed payer reforms and prior authorization delays. It is important that we continue to educate our communities and leaders on what differentiates intensive inpatient rehabilitation from other levels of care. As I look back over my first year with Orlando Health Advanced Rehabilitation Institute, or OHARI as we affectionately call it, I know that I am blessed to be a part of an amazing team. May the information on the pages that follow provide you some insight into what a special program this is and why I Choose Orlando Health. Annette Seabrook, MPT, MHA, FACHE President, Orlando Health Advanced Rehabilitation Institute
3 O R L A N D O H E A LT H A DVA N C E D R E H A B I L I TAT I O N I N ST I T U T E N E WS | F E B R UA RY 2024 Orlando Health Advanced Rehabilitation Institute recently celebrated its grand opening with events held specially for their team members and families, referring physicians, Orlando Health leaders and area community organizations. It was a great time to show off the new space and advanced technology, as well as to meet the exceptional teams that will continue to care for our patients.
4 Caring for a Loved One After a Stroke The impact of a stroke is not just felt by the patient directly but also indirectly by their loved ones, especially those taking on the responsibility of “caregiver” or “care partner.” This is an overwhelming time for caregivers as they begin to process some of the physical and mental changes occurring with their loved one and how this may affect the dynamics of their relationship and daily responsibilities. Processing this “new normal” should not be done alone. More than 53 million Americans are caregivers, and it is important for you to know that there are a variety of resources and support systems that are designed specifically to help the unique challenges you are facing. I want to give you some helpful tips and reminders that may assist in making this transition as a caregiver more approachable. Stroke CJ Curran, PT, DPT, CBIS, NCS | Board Certified Neurological Clinical Specialist Stroke Clinical Specialist for Inpatient Rehabilitation
5 O R L A N D O H E A LT H A DVA N C E D R E H A B I L I TAT I O N I N ST I T U T E N E WS | F E B R UA RY 2024 Early Phase At this time, your loved one still may be receiving highly specialized medical care. You have probably not been so surrounded by healthcare professionals like this before and that alone can be overwhelming. Do know that you and your loved one have a voice. Advocate for your loved one and ask questions to the medical team. If your loved one is able, check with them to find out what concerns they want addressed. This also may be a good time to improve your understanding of what is going on with your loved one such as the type of stroke, the physical issues they may be dealing with, and the mental difficulties they may be having. Knowledge is power. You may be wondering how long the recovery will last. But there is not a specific time frame for recovery because it depends on several factors, including where in the brain the stroke occurred, the size of the stroke, the amount of time before medical intervention, as well as many other individual factors such as age, general health, activity level and social support. Recovery Phase As the medical elements of stroke recovery improve, you may see the involvement of physical, occupational and speech therapy increase. This comes in many forms and can be provided in the hospital, at inpatient rehab facilities, skilled nursing facilities, or once you are discharged from the hospital. The amount and speed of recovery is different for everyone. If your loved one is recovering at an inpatient rehab or a skilled nursing Once home, try and establish a routine and schedule again for both you and your loved one. Start with easier things like meal preparation and medical appointments and, depending on what you and your loved on can handle, build up from there. Remember to set aside time for yourself. This needs to be a conscious effort on a daily basis in order to avoid burnout. If you allow yourself to be totally immersed in your caregiver responsibilities, it can be harder to re-integrate into life. Continue to make regular physical activity and a healthy diet a priority. Set aside time to do things you like to do, go to your favorite coffee shop, attend an event at church, visit your friend. Keep up the activities you enjoy like gardening, reading, crafting or music. Stay connected to the outside world. Don’t allow yourself to become isolated. Stay connected with family and friends, even if it’s just by phone or online. Talk to friends and family about something other than your role as a caregiver. Being a care partner is challenging and unfortunately there is no “job description,” but it also can be rewarding. Begin to familiarize yourself with the resources at your disposal even now while at the hospital. The nursing and therapy teams, and especially the care coordinator, can be a wealth of knowledge. Some other excellent resources include the Orlando Health Stroke Support Group, The National Stroke Association and American Stroke Association. facility this gives you more time to firm up your discharge plan and support system. Be open and honest with your family and support system about the physical and emotional challenges you are facing. The role you are taking on is difficult, so ask for help when you need it, and be open to others helping however it may be. This is also a good time to begin to prepare your home for your loved one. Little things go a long way. Make sure hallways and doorways are clear of clutter, tuck away extension cords, and remove throw rugs, etc. Make sure there is a plan for any of your furry friends to have their own space so that an excited welcome home does not become a fall risk. It is important to ensure highly trafficked areas in your home are well lit and that commonly used household items are readily available and easily reached. If you plan on adding grab bars to bathrooms or ramps to front doors, this is a good time to begin that process. Remember, your family and friends want to help. This is a good way to involve other family members or friends who are eager to help but are unsure how. At Home Phase The goal is to always go home! But remember, the time frame and assistance needs are different for everyone. Just like the other phases, the transition home can bring new challenges and fears. Stay positive. You and your loved one have been through a lot and have already achieved so much to get home. Focus on all those small victories that got you here.
6 The Invisible Scars of Brain Injuries Traumatic Brain Injury Brain injuries often are called an “invisible injury” because many who survive them don’t exhibit any physical differences. Although they may look like everybody else, their brain may no longer work like everybody else’s. The effects of injuries to the brain can be profound – from loss of long-term memory to shortened attention spans to mood swings. Jason Tia Atienza, MD, MBA Jessica R. Hooke, MA CCC-SLP The ranks of those with brain injuries expand every nine seconds. That’s how often someone in the United States sustains a brain injury, according to the Brain Injury Association of America (BIAA). It could come from a fall, an assault, a motor vehicle accident or as the result of disease, stroke or substance abuse. By the end of the year, all of those reasons (and more) will account for 3.5 million Americans experiencing an acquired brain injury (ABI). This refers to any brain injury that isn’t hereditary, congenital, degenerative or induced during birth. Common causes of ABI include electric shock, infectious diseases, lightning strikes, near drownings, oxygen deprivation, strokes, seizures, substance abuse, drug overdoses and tumors.
7 O R L A N D O H E A LT H A DVA N C E D R E H A B I L I TAT I O N I N ST I T U T E N E WS | F E B R UA RY 2024 More than 70% of ABI injuries are related to a trauma event. Some sources of sudden trauma-induced brain injuries include falls, assaults, being struck, motor vehicle accidents or other types of accidents and violent episodes. These traumatic brain injuries (TBIs) cause 137 Americans to die every day and, for the big picture, 50,000 to die every year. The Effects of Brain Injuries TBI is often defined as a change in brain function caused by an external force. While some people may heal completely, TBI can cause permanent damage to the brain and other parts of the body. The effects of TBI can impact all aspects of a person’s life, from the way they think and process information to the way they behave. Depending on the type and severity of brain injury suffered, these effects may include: • Loss of ability to speak and understand language • Mental confusion • Difficulty with learning • Loss of short term and/or long term memory • Personality changes, including irritability and impulsivity • Decreased control over mood and emotions • Shortened attention span • Anxiety and depression • Changes in sleep, such as insomnia or hypersomnia • Inability to work full-time or remain employed at all Brain injuries also can cause a range of physical symptoms. From paralysis to persistent headaches to seizures, these effects vary widely and depend on the type of injury suffered. How to Prevent Brain Injuries Often, accidents, acts of violence or internal issues are out of our control. But there are still many ways you can help prevent the occurrence of TBI. You can reduce your chances of sustaining a brain injury, according to the Centers for Disease Control and Prevention (CDC), by: • Always wearing a seatbelt when in a vehicle • Not engaging in distracted driving or texting while driving • Never driving under the influence of drugs or alcohol • Taking measures to prevent older adult falls • Making living spaces and play areas safer for children • Wearing a helmet whenever appropriate, such as while biking, skiing, skateboarding, horseback riding or playing sports such as baseball or football Our Goals Regarding Brain Injury Awareness From mild concussions to severe trauma, this is an event that can be frightening for many. TBI not only acutely affects a patient’s quality of life, it also can change their family life forever. Some patients with brain injuries may need long-term rehabilitation care for weeks, months or even years. While brain injuries may appear to be invisible injuries, it’s vital to understand the needs of those who have suffered a TBI. Through conversations with friends and family, outreach programs and education in schools and other public institutions, we can all work together to spread awareness and prevent brain injuries.
8 Don’t Let a Spinal Cord Injury Stop You Spinal Cord Injury Experiencing a spinal cord injury is a life-altering experience that no one is prepared for when it occurs. Every aspect of an individual’s life is affected, from how someone moves around, gets dressed, goes to work or school, and interacts with their community. At Orlando Health Advanced Rehabilitation Institute, we recognize the importance of participating in rehabilitation outside of the four walls of a hospital building or rehabilitation clinic to help each person successfully return to a life that is meaningful to them. If the COVID-19 pandemic taught us anything, it is how scary social isolation can feel when confined to one’s home without a support system. We want our clients to avoid this feeling and prioritize helping individuals reintegrate into the Central Florida community we all love and call home. Kristen M. Cezat | Spinal Cord Injury Clinical Specialist Physical Therapist, Inpatient Rehabilitation
9 O R L A N D O H E A LT H A DVA N C E D R E H A B I L I TAT I O N I N ST I T U T E N E WS | F E B R UA RY 2024 Reintegrating back into the community after a spinal cord injury often requires a coordinated team effort to address physical, psychological and social challenges that may occur. Orlando Health Advanced Rehabilitation Institute’s spinal cord injury program has a collaborative team that helps individuals achieve their community reintegration goals. Physical, occupational and speech therapy services are only the beginning. We offer recreational therapy, where clients learn how to return to leisure and community activities, such as grocery shopping, going to the movies, fishing, or participating in other interests that a person may have. Neuropsychology services address emotional well-being, self-advocacy, and strategies to accomplish an individual’s goals following injury. Our spinal cord injury coordinator facilitates inpatient and community support groups, education classes and a peer mentor program to promote success following discharge from rehabilitation. “Every time I run into a former client in the community, eating at one of Central Florida’s amazing restaurants, picking up their kids from school, or enjoying the theme parks again, it reminds me of how proud I am to work for Orlando Health. Every member of our community is so important, and our community wouldn’t be the same if the individuals we serve could not return to enjoying the reasons that make living in Central Florida so special,” says Kristen Cezat, a physical therapist in the Orlando Health Advanced Rehabilitation Institute spinal cord injury program. In addition to rehabilitation services, Orlando Health Advanced Rehabilitation Institute is very busy coordinating events to promote successful reintegration into the community. Orlando Health hosts the annual Spinal Cord Injury Reunion, a free event held every September during Spinal Cord Injury Awareness Month. This event reunites current and former clients with their Orlando Health team, provides community resources, and brings together individuals living with spinal cord injuries in Central Florida. Multiple grants have been awarded to Orlando Health Advanced Rehabilitation Institute through the Craig Neilson Foundation to create community fitness programs for individuals with spinal cord injuries to return to health and wellness. Partnerships with organizations such as the Greater Orlando Spinal Cord Injury Network and Friends of Seminole State Forest help organize events such as accessible EcoRover powerchair trail access in our Florida state parks, picnics, and holiday parties throughout our community. Through the support of Orlando Health, our spinal cord injury program looks forward to serving this community for many years.
10 Steady on Your Feet: How To Prevent Falls as You Age As you grow older, a fear of falling can significantly hamper your ability to get the most out of life. It’s a valid concern. Falls are the leading cause of injuryrelated death for adults over the age of 65, and a recent study suggests the number of fall-related deaths has doubled in the past 20 years. But falling is not a normal part of aging, and there are ways you can lower your risk of taking a tumble. Balance is comprised of three systems that work together to keep you upright: your inner ear, your vision, and your muscles and joints. Each of these systems can be affected by health problems and medicines designed to control them. For example, some medications used to lower blood pressure can make you feel dizzy. Health and Wellness Christine Davidson, PT, DPT | Director, Rehabilitation | Board Certified in Neurologic Physical Therapy It’s good to be aware of side effects of any medications your medical provider has prescribed. You should also stay active and exercise to boost your muscles and joints as well as give you the strength needed to keep your balance if you falter. Keeping your home free of clutter can help avoid vision-related stumbles. Let’s take a look at what you can do on your own or with the help of a physical therapist.
11 O R L A N D O H E A LT H A DVA N C E D R E H A B I L I TAT I O N I N ST I T U T E N E WS | F E B R UA RY 2024 Make Your Home Safer There are many things you can do at home to create a safer living environment. Among them: • Keep walkways free of cords and clutter. • Secure or remove any loose mats or throw rugs. • Install non-slip surfaces in your shower and bathroom. • If there are steps into your home, make sure there is a rail. • Install nightlights along walkways and dark spaces. • Keep regularly used kitchen items within arm’s reach. • Install grab bars near the toilet or in the shower area. • Wear well-fitting slippers and shoes around the house. Focus on Balance Generally speaking, all exercise is good exercise. But when the goal is to reduce the risk of falling, your efforts should be targeted to activities that will preserve or improve your balance. Riding a stationary bike may be good for cardio and endurance, but it won’t keep you upright when walking in dimly lit spaces or on uneven surfaces. You should talk to your doctor or physical therapist before doing any exercises, but here are a couple that can boost your balance skills: Sit to stand: This exercise works on leg strength, while improving balance and mechanics. Start by sitting in a chair that doesn’t slide or roll. Your feet should be flat on the ground and there should be a sturdy surface (a desk or table, for example) in front of you for support, if needed. Next, slide forward to the edge of the chair and slowly stand. Then slowly sit back down, repeating the exercise 10 times. The goal is to not use your hands – unless you start to lose your balance. For added difficulty, you can hold hand weights. Standing balance: This exercise helps you prepare for being in the dark, like when you get up at night to go to the bathroom. Start by standing in a corner (without touching the walls) with a chair in front of you for support, if needed. With your feet shoulder-width apart, close your eyes for 30 seconds. You can increase the difficulty of this exercise with several variations: Put your feet together with a narrow base of support keeping your eyes open, and once you are balanced, close your eyes. Another option to increase difficulty is using a staggered stance, with one foot in front of the other like you were standing on a balance beam while keeping your eyes open. For the most difficulty, stand on one leg while keeping your eyes open. When To Seek Help When is it time to get help? There are several things that might spark a visit, including a previous fall or feeling dizzy when changing positions or after walking for a while. You might also seek help if your fear of falling is limiting your movements or the types of activities you feel comfortable doing. Your primary care doctor might also suggest a visit if you’ve reported “near misses” – brief stumbles that could have been much worse. A physical therapist can take a close look at your unique situation and help you develop a game plan – including exercises – for reducing risk. This starts with a thorough exploration of your strength, balance and vision skills. Your therapist will look at your medications and any health problems you might have to see if they have any impact on your fall risk. They’ll also explore your home environment – through a home visit or virtual tour – to minimize risks there.
12 Advanced Rehabilitation Technology Helps Patient Outcomes Orlando Health Advanced Rehabilitation Institute incorporates cutting-edge advanced technologies into rehabilitation process to maximize patients progress and outcomes. Bionic Exoskeleton is an advanced wearable device designed to assist individuals with mobility impairments and utilized as part of mobility training. Since January 2022 Orlando Health Advanced Rehabilitation Institute patients have completed a remarkable 62,830 steps. This device provides the necessary support for patients with impaired motor function, allowing them to initiate walking programs early in the rehabilitation process and maximize functional gains. Moreover, it minimizes the workload for healthcare providers when compared to traditional walking aids further optimizing functional recovery. Zero G Body Weight Support System is an innovative technology that provides partial body weight support to individuals during gait training. This system allows clients to safely participate in high intensity walking programs and other functional activities, even if they have limited mobility. It has proven particularly beneficial for patients with stroke, traumatic brain injury and spinal cord injury, as it enabled them to regain confidence in their ability to walk and move independently. However, this equipment has been utilized for clients with various neurological and other diagnoses. Since January 2022, 481 Orlando Health Advanced Rehabilitation Institute patients participated in walking training and collectively completed an impressive 221 miles of training using the Zero G system with total of 1,562 sessions. Functional Electrical Stimulation (FES): Orlando Health Advanced Rehabilitation Institute rehabilitation program utilizes 12 channel FES for stationary cycling and task specific functional training activities. This advanced technology allows stimulation to multiple groups of muscle to facilitate completion of the entire functional task. More than 73 patients benefited from FES equipment during their rehabilitation since 2022 collectively completing a total of more than 1,121 miles of cycling and 432 sessions of functional training. The majority of these patients were diagnosed with stroke and spinal cord injuries. As rehabilitation technology continues to advance, we can anticipate even more promising outcomes for patients in the future, offering them the chance to regain their independence and enhance their quality of life. Team Members Participate Orlando Health Advanced Rehabilitation Institute team members submitted research to these regional and national conferences throughout 2023. Poster Presentations, American Physical Therapy Association Combined Sections Meeting, February 2023: • “High Intensity Gait Training in Older Adults with Acute Motor Incomplete SCI: A Case Series” Christina Voigtmann, PT, DPT, NCS, Brittany Rohan, PT, DPT, NCS, Kristen Cezat, PT, DPT, NCS, ATP/SMS • “Free Community Seating Clinic for Individuals Living with Paralysis” Stacy McGinnis, OTR/L and Christine Davidson, PT, DPT, NCS • “Functional Outcomes Following Implementation of a High Intensity Locomotor Program in Acute Spinal Cord Injury” Kristen Cezat, PT, DPT, NCS, ATP/SMS, Christina Voigtmann, PT, DPT, NCS Poster Presentations, Florida Physical Therapy Association Conference, 2023: • “Physical Therapy Plan and Outcomes Following Spinal SCI Secondary to White Cord Syndrome: A Case Study” Kristen Cezat, PT, DPT, ATP/SMS; Rachel Gonzalez, PT, DPT, NCS; Uzair Hammad, PT, DPT, NCS • “Examining the Effects of Inpatient Rehabilitation on Balance and Walking in Individuals with Cerebellar Stroke” Uzair Hammad, PT, DPT, NCS; Christina Voigtmann, PT, DPT, NCS Research and Continuing Education
13 O R L A N D O H E A LT H A DVA N C E D R E H A B I L I TAT I O N I N ST I T U T E N E WS | F E B R UA RY 2024 Physical Therapy Neuroresidency Program Reaccredited The University of Central Florida (UCF) and Orlando Health Neurologic Residency Program was notified by the American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE) that they have renewed our accreditation for 10 more years! Accreditation by ABPTRFE is a reliable indicator of the value and quality of the Residency Program. In receiving renewal of accreditation, the program demonstrated its commitment to educational standards and ethical business practices indicative of quality, accountability and continuous improvement that enhances the physical therapy profession. Our Neurologic Residency program is one of only six in Florida, and the only one in the Orlando metropolitan area. The partnership between UCF and Orlando Health continues to result in exceptional programs and opportunities for growth, mentorship, and quality outcomes! Logan Brown PT, DPT I first graduated from the University of Central Florida in 2019 with my bachelor’s in health sciences. I then pursued my Doctor of Physical Therapy from the University of South Florida, graduating in May, 2023. Just before officially beginning my journey towards earning my DPT, my mom suffered an unexpected stroke requiring extensive neurologic rehabilitation. She now holds the title as my “first unofficial patient” and since then my interest in neurologic rehab has only continued to grow. The clinical puzzle of the neurologic system and personal connection to this population is ultimately what motivated me to pursue a neurologic residency program. Chloe Atrip, PT, DPT My education journey began in 2015 as I pursued my Bachelor of Science degree at UCF. I attended UCF DPT from 2020 to 2023, where my passion for neurology developed. Throughout my clinical rotations, I firsthand witnessed the life changing effects that physical therapists had on these patients. It was here that I was challenged the most, from rare genetic neurologic disorders in pediatrics, to stroke and Parkinson’s in adults. It was priceless to grow bonds with my patients and have a hand in their life-altering journey. As a Neurologic Physical Therapy resident with UCF Orlando Health, I have been striving to practice at my highest level everyday by learning and absorbing the wealth of knowledge and experience in all the talented clinicians around me. National Recognition Gained At the American Physical Therapy Association (APTA) 2023 Combined Sections Meeting in San Diego, CA, Kristen Cezat PT, DPT, NCS, ATP delivered a presentation titled “Can Physical Therapists Predict Future Function? Prognosis in the Weeks Following Spinal Cord Injury.” She was honored with an invitation to copresent and share the evidence and results from her clinical practice, representing Orlando Health on the national level. Kristen’s success was evidenced by a high level of engagement from the attendees followed by questions and comments after the already two-hour presentation, which was conducted in collaboration with other esteemed researchers in the field of physical therapy. Following her triumph at the largest national physical therapy conference, Kristen received another invitation to participate in the 2024 Combined Sections Meeting in Boston, MA, scheduled for February 2024. During this event, she will present her ongoing research and investigate deeper into her specialization in spinal cord injury with a talk titled “The Chasm Between Spinal Cord Injury Research and Clinical Practice: Can We Bridge the Gap?”
14 Stacy McGinnis, OTR/L, ATP Over the past 11 years, I have been an occupational therapist entirely at Orlando Health. I served the first eight years of my career in the inpatient rehab setting with a passion for neurological injuries including stroke and TBI on the BIRC unit for four years, followed by transitioning to a specialty in SCI in the subsequent four years. During my time with SCI patients, a passion for the treatment and management of neurogenic bowel and bladder was developed, as well as pursuing a specialty certification as an Assistive Technology Professional for complex wheelchair seating and positioning. With an opportunity to advance these skill sets further and serve patients in the community outside of the hospital setting, I have worked in the outpatient rehab setting for the last three years focusing on these specialty areas. I recently received status of Clinical Specialist with goals to further develop the Adult Wheelchair Seating Clinic and to contribute to program development for the neurological OT lines of service. Emerging Leaders has provided the unique opportunity to take a look at the “behind the scenes” work that Orlando Health collaboratively contributes toward as an organization and exposes us to the resources that we have available to help us best serve our patients and grow as professionals. Investing in Team Member Development Congratulations to team members DJ Mihu, Darby Santora, Stacy McGinnis and Kristi Secrest for bcohort of the Orlando Health Emerging Leaders program! They were chosen from a pool of 165 apavailable. Emerging Leaders learn about leadership through a series of workshops, learning activitdiscussion during this immersive six-month program. Team Member Spotlight DJ Mihu, RN, BSN, CRRN I currently work as an assistant nurse operations manager for the Orlando Health Institute for Advanced Rehabilitation! I graduated from Florida State University with my BSN and started as a nurse with Inpatient Rehab right out of school. I always thought I would end up in sports medicine but ended up finding a love for patient care of complex traumatic brain injury patients. Over the years, I accelerated my practice by stepping into the charge nurse role, then developed for a couple years as a clinical nurse manager, and most recently I have served in the ANOM role for a little under a year. In early 2023 I was accepted into the Emerging Leaders Program and have had the pleasure of growing beside 35 other incredible, like-minded peers who are dedicated to propelling each other to new heights. My passion in leadership is growing and developing the next generation of healthcare clinicians and helping Orlando Health Advanced Rehabilitation Institute become a Top 50 Rehab Hospital! Kristi Secrest, OTR/L, CLT-LANA I am an occupational therapist and Certified Lymphedema Specialist working as the supervisor for the Orlando Health Advanced Rehabilitation Institute Outpatient Center specialty clinic. I earned my bachelor’s degree from the University of Florida in 1990 and my certification in lymphedema in 1997. I have worked in many different areas of rehabilitation including neuro rehab, orthopedics and oncology and developed the lymphedema program at Orlando Health in 1997. I am a LANA certified therapist in lymphedema focusing my time on expanding the comprehensive specialty services for the clinic focusing on oncology, lymphedema, and pelvic health populations. Through the Emerging Leader program, I have enjoyed getting to know people from a variety of departments and realizing how much there is in common. The opportunity to learn about the various parts of the organization and how they function has been incredibly valuable as well as what leadership looks like in this health system and the directions to take to grow and develop. I am honored by all of the time our executive leaders and educators have given us throughout this process.
15 O R L A N D O H E A LT H A DVA N C E D R E H A B I L I TAT I O N I N ST I T U T E N E WS | F E B R UA RY 2024 being selected to the next plicants to fill one of the 30 slots ties, assessments and group Awards and Certifications Orlando Health physical therapists recently achieved board-certified clinical specialist designations by the American Board of Physical Therapy Specialties (ABPTS) of the American Physical Therapy Association (APTA). Specialist certification recognizes physical therapists who have demonstrated advanced clinical knowledge and skills in a specific area of physical therapy practice. Erin Schultz and Uzair Hammad at Orlando Health Advanced Rehabilitation Institute, were designated board-certified neurologic clinical specialists. Congratulations to Orlando Health Advanced Rehabilitation Institute RN Tetyana Ponkin - in addition to having her CRRN from Association of Rehabilitation Nurses (ARN), she recently earned Stroke Certified Registered Nurse (SCRN) certification through American Board of Neuroscience Nursing. Certification is an important credential that attests to the achievement of specialty knowledge beyond basic nursing preparation and it is evidence of clinical expertise and leadership in stroke nursing practice. Orlando Health therapists also won two awards presented at the 2023 Florida Physical Therapy Association Conference. Ryann Cahill was recognized by the Florida Consortium of Clinical Educators (FCCE) as the 2023 PT Outstanding Clinical Instructor of the Year for Florida, recognizing her dedication to clinical teaching. Brittany Tarin also won the Excellence in Clinical Practice Award, given to a physical therapist assistant who exudes outstanding clinical practice. Brittany was recognized for her work with the spinal cord injury population, her commitment to her team and her community. Earlier this year, Uzair Hammad with the Orlando Health Advanced Rehabilitation Institute was presented with the Early Career Award from the Academy of Neurologic Physical Therapy, “which supports new professionals who have already demonstrated early contributions in education, research, clinical practice or professional service.” Uzair started at Orlando Health Advanced Rehabilitation Institute in the PT Neurological Residency program and we are lucky to have him continue his career with us! AHA Award Jessica Hooke was nominated and selected to join the National American Stroke Association Advisory Committee for the 2023-2024 year. The committee consists of approximately 15 members and meets several times through the year in different areas across the country to provide input on ways to improve prevention measures, advocate, improve care and provide resources for survivors across the nation. During this time, Jessica will assist the organization on strategic planning; positioning within stroke marketplace; social business, marketing and messaging needs for brain health, stroke risk, acute treatment/recognition and recovery and; the development of culturally relevant programs, products, services and strategic alliances needed to achieve ASA goals and improve patient outcomes. Jessica also received a Heart of Orlando award at Orlando’s Heart Ball for her advocacy in the community. Darby Santora, M.S. CCC-SLP I completed my graduate internship in 2015 at the Orlando Health Advanced Rehabilitation Institute and have since dedicated nearly seven years of my career as a speech language pathologist. I graduated from UCF with my bachelor’s degree and FSU with my master’s degree, both in communication sciences and disorders. My professional journey spans over 13 years, during which I have gained experience in various settings such as the school system and home health. I am deeply passionate about patient care, with a particular focus on individuals suffering from traumatic brain injuries, strokes, and spinal cord injuries. In the past year, I have expanded my responsibilities by assisting the Orlando Health Advanced Rehabilitation Institute admissions team with the process of evaluating patients’ medical and therapy needs prior to admission. I have thoroughly enjoyed the Emerging Leaders program, which has given me the opportunity to learn from Orlando Health’s leadership team and collaborate with other like-minded peers across many departments.
16 Patient Spotlight George’s story: George has demonstrated a selfless nature and desire to support others. George is a pillar in his community who supports each of his friends and neighbors. On May 4, 2021, George and his son, John, ran a 5K in Viera. Two days later, he had a stroke that left him battling for his life. He has made a remarkable recovery thanks to the staff at Orlando Health Advanced Rehabilitation Institute Outpatient Center. George provides motivation and support and is an advocate for recovery for others around him who are going through a similar scenario. It was George’s goal to walk a 5K surrounded by family, friends and those who have supported him on his journey. He had an idea to host a 5K fundraiser, where proceeds were directed to the clinic to support underserved individuals. George has named the event “Feet for Feat” and he considers the finish line “The Beginning Line.” We applaud his perseverance to never giving up on his continued improvements, no matter how long it may take, while thinking of others who face the same challenges who may not be as fortunate. George raised and donated more than $11,000 to the Orlando Health Advanced Rehabilitation Institute Outpatient Center to support others going through the same recovery journey as he did. His therapy team was there to cheer him along as he achieved this goal, it is an honor and privilege to have shared in George’s recovery.
17 O R L A N D O H E A LT H A DVA N C E D R E H A B I L I TAT I O N I N ST I T U T E N E WS | F E B R UA RY 2024 Inpatient Rehabilitation Data and Outcome Metrics 38.8 33.7 35 34 36 34.3 45 40 35 30 25 20 15 10 5 0 SCORES Change in Mobility OHARI NATIONAL OHARI NATIONAL Traumatic Brain Injury *Mobility Scores are based on the Inpatient Rehab Facility Patient Assessment Instrument (IRF-PAI) Quality Indicators scoring for Section GG Functional Abilities and Goals. Incomplete Spinal Cord Injury Stroke OHARI NATIONAL Orlando Health Advanced Rehabilitation Institute Percentage of Patients Discharged Back to the Community, FY23 (October 1, 2022 - September 30, 2023) for our Specialty Programs: We were proud to serve 1,060 patients and their families in fiscal year 2023. On average our patients were with us 13.3 days to prepare to return home. We were able to discharge over 82.2% of our patients back to the community, which is higher than national average (81.2%). 77.1% Stroke Specialty Program 80.7% Spinal Cord Injury Specialty Program 78.5% Brain Injury Specialty Program
18 Friends of Seminole State Forest Run for the Woods February 2023 Twenty-six team members sponsored Friends of the Seminole State Forest 5K, 10K and half-marathon runs in support of the Forest’s EcoRover Trek power wheelchair program. During the fundraiser, the founder of EcoRover Chairs brought a dozen of the machines for people with disabilities to use. The battery-powered EcoRover Chairs are equipped with rubber tracks, like tanks, and are easily controlled with an armrest-mounted joystick. The chairs are designed to navigate almost any type of terrain, no matter how rugged. After first being available in Seminole State Forest, the chairs, which are available for use at no cost, are now offered at two other state parks. Orlando Health is proud to be a donor to this program which helps those with mobility impairments enjoy time in the woods. Community Outreach Head for the Cure February 2023 Orlando Health Advanced Rehabilitation Institute had the privilege to support the Head for the Cure 5K, which was held in Lake Baldwin. The race, which raises funds, awareness and hope for the Orlando community who suffer with brain tumors, was attended by at least four team members and also benefits the Orlando Health Cancer Institute in addition to other organizations. While at the race, our team shared information about our inpatient and outpatient rehabilitation programs. Ramp Build February 2023 At least six team members partnered with the Center for Independent Living to build a ramp to help with accessibility for a person in our community. Community Initiatives
19 O R L A N D O H E A LT H A DVA N C E D R E H A B I L I TAT I O N I N ST I T U T E N E WS | F E B R UA RY 2024 Healthy Community Day of Action June 2023 Big Brother and Big Sisters of Central Florida hosted this event to increase exposure to inpatient rehabilitation careers. Team members assisted and the following were some of the outcomes. • 63 participants fitted for helmets and were also given a free helmet • 8 bags of clothing to 6 individuals (Teen Xpress/Rehab took some also) • 132 bags of fresh produce given by Hebni Nutrition • 25-30 participated in mindfulness activities • 25 fall risk screens completed, 5-6 referrals were made to OH outpatient clinic • 100-115 attendees came to the PA wellness check booth - Blood Pressure checks on 60-70 attendees were completed along with one-on-one medical counseling regarding blood pressure control and diet and activity recommendations - 40 attendees also took the educational forms that provided direct links to health educational sites - 10-12 attendees needed referrals to establish care with either a PCP or a specialist at Orlando Health - Approximately 30 children were seen, given a wellness check and we listened to their heart and lungs - 10 eye exams completed for children attendees CORE’s Survival of the Fittest April 2023 Three team members attended this event where 15 athletes, some of who are former Orlando Health Advanced Rehabilitation Institute patients, competed in adaptive CrossFit activities. The Institute was a financial sponsor of this event which was hosted by the Center of Recovery and Exercise.
20 Neuro-Friendly Restaurant Initiative Launches The Orlando Health Advanced Rehabilitation Institute held a soft launch of its Neuro-Friendly Restaurant Initiative in December 2023 at Dajen Eats. Offering vegan cuisine with a Jamaican flair, Dajen Eats is located at 323 E. Kennedy Boulevard F, Eatonville, Florida. Each restaurant that participates in the program must meet certain criteria, which includes training staff to strengthen their skills with working with individuals from these communities, pictorial menu books, assistive utensils (at some participating restaurants), modifications to food (at some participating restaurants), low-traffic hours and meal options identified by the three following categories — heart healthy, blood-sugar friendly and brain wellness. The purpose of the Neuro-Friendly Restaurant Initiative is to further community inclusion for those living with a neurological injury and to promote healthy eating habits to assist with the prevention of and recovery of certain neurological injuries, such as strokes and traumatic brain injuries. Within the first week of its soft launch, the restaurant owner stated that she has received several replies from customers applauding the initiative. Their first survivor to come in and use the picture menu stated everything went smoothly and that she was very appreciative of of the menu for her needs. The institute looks forward to lining up additional restaurants with this initiative in 2024. 2023 Institute Events 6th Annual Stroke Reunion May 2023 7th Annual Spinal Cord Injury Reunion September 2023 6th Annual Brain Injury Reunion October 2023
21 O R L A N D O H E A LT H A DVA N C E D R E H A B I L I TAT I O N I N ST I T U T E N E WS | F E B R UA RY 2024 FY23 Data from Orlando Health Ambulatory Rehabilitation Programs 85% of Patients Reintegrated into Their Community* of SCI Patients 91% Maintain Independence at Home During the Day* 500+ Persons Impacted by Community Programs** 88% of Patients Reported No Falls Post Discharge from Rehabilitation* Continuum of Care: Specialty Outpatient Rehabilitation Orlando Health is committed to ensuring care for our patients across the healthcare continuum. After discharge, the team will recommend outpatient services to support progress toward individual goals. Our CARF-accredited Outpatient Centers consist of multidisciplinary teams taking a collaborative approach by providing top notch, evidence-based and individualized delivery of patient care. Outpatient Center Locations: Stroke, Brain Injury, and Spinal Cord Injury Orlando Health Advanced Rehabilitation Institute Outpatient Center 100 W. Gore St., Suite 104 | Orlando, FL 32806 (407) 841-8911 Neuromuscular and Movement Disorders Orlando Health Advanced Rehabilitation Institute Outpatient Center 32 W. Gore St. | Orlando, FL 32806 (407) 841-8911 Lymphedema Orlando Health Advanced Rehabilitation Institute Outpatient Center 125 W. Copeland St. | Orlando, FL 32806 located inside Orlando Health Aesthetic and Reconstructive Surgery Institute (321) 842-3700 Oncology/Lymphedema/Pelvic Health Orlando Health Advanced Rehabilitation Institute Outpatient Center 1222 S. Orange Ave. | Orlando, FL 32806 located inside Orlando Health Heart and Vascular Institute (407) 649-6888
22 Scan this QR code to watch the ribbon cutting video. World-Class Rehabilitation Is Now Here To best meet the increasing need for rehabilitative care in Central Florida and beyond, the Orlando Health Advanced Rehabilitation Institute opened a new, free-standing facility on the Orlando Health – Health Central Hospital campus in Ocoee. The building opened in October 2023 as a 54-bed inpatient facility, distinctively designed to provide high-quality post-acute care for patients requiring medical and rehabilitative services. “Through a major renovation, we were able to tailor this space to set up our patients and talented interdisciplinary team for success,” said Orlando Health Advanced Rehabilitation Institute President Annette Seabrook. “We wanted to create an environment that has all the tools our patients need to feel confident when they head home.” A few facility features include: • All private patient rooms. • Dedicated therapy space, including three therapy gyms, quiet areas for patients with brain injuries/strokes, bariatric access and an expansive outdoor space for additional therapeutic activity. • Simulated apartment for activities of daily living, plus an additional training suite with four different home bathing designs. • Gym with state-of-the-art rehabilitative equipment including body-weightsupported gait systems, robotics for training in arm/hand coordination and walking, and communication assistance technology. • Specialty programs including Disorders of Consciousness, adolescent rehabilitation, community outreach initiatives and research in the fields of stroke, brain injury and spinal cord injury will continue to expand in this new setting. The seasoned team of therapists working at the Orlando Health Advanced Rehabilitation Institute specialize in care for patients with complex neurological and musculoskeletal conditions including spinal cord injury, traumatic brain injury, stroke, amputation and major multiple trauma. “We work with people during some of the most difficult days of their lives,” said Orlando Health Advanced Rehabilitation Institute Chief Quality Officer Dr. Jason Atienza. “Even with challenging medical diagnoses, we’re amazed at the progress our patients make during their stay and the goals they’re able to accomplish with our care team at their side.” The rehabilitation program, recognized by the Commission on Accreditation of Rehabilitation Facilities, became the first freestanding comprehensive medical rehabilitation facility in Orange County, Florida.
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Superior Inpatient Rehabilitation Care To learn more, visit OrlandoHealth.com/AdvancedRehabilitation As a free-standing specialty hospital, we are committed to providing high-quality, intensive rehabilitation services, solely dedicated to serving the needs of patients following a stroke, brain injury, spinal cord injury, trauma, or other significant neurological or musculoskeletal condition. Our inpatient hospital is distinctively designed to meet the increasing need for intensive rehabilitative care that is expertly provided by our highly specialized teams. Applying an interdisciplinary approach to rehabilitation, our comprehensive care teams include board-certified rehabilitation physicians and clinical specialists, certified rehabilitation registered nurses, certified brain injury specialists, stroke specialists, speech and language therapists, physical and occupational therapists, neuropsychologists, therapeutic recreation therapists, registered dietitians, case managers, chaplains, and other necessary services. Orlando Health Advanced Rehabilitation Institute will always be dedicated to providing world-class rehabilitative care that is second to none. Our commitment is only surpassed by our sincere desire to help our patients achieve the best possible outcome on their journeys to recovery. BGD 2136002 2/24 ©2024 Orlando Health, Inc. Recognized by the Commission on Accreditation of Rehabilitation Facilities We are extremely proud of our accreditation by the Commission on Accreditation of Rehabilitation Facilities, which magnifies our commitment to maintaining the highest standards of care, and also focuses on our pursuit of continuous improvement in every aspect of our commitment to you. A right-care philosophy is the foundation of our program, and that means that concentrated attention is directed toward ensuring that you are always our number one priority. We are proud to have achieved CARF accreditation for our Brain Injury Program, Spinal Cord Injury Program, Stroke Program, and Comprehensive Inpatient Program.