MESSAGE FROM THE CHAIRPERSON, DR SCOTT BROWN

2011 Annual Report

It is my privilege to in-troduce you to this in-augural annual report for the Department of Physical Medicine and Rehabilitation at Sinai Hospital of Baltimore, and for the Sinai Reha-bilitation Center. The department was found-ed in 1965, and was the first full department of Rehabilitation Medi-cine in an acute care community hospital in the state of Maryland. Our first chairman, Dr. B. Stanley Cohen, es-tablished the principles upon which we contin-ue to develop. The goals of the patients we serve create the frame-work for individualized treatment plans. Func-tional restoration is at the heart of our thera-peutic approach. The department has provid-ed a wide range of ser-vices, from consulting for the Baltimore Ori-oles to providing voca-

tional retraining for the disabled. What is now the LifeBridge Health and Fitness Center (one of the premier fitness centers in the Baltimore region), and the VSP vocational services pro-gram, had their start in the PM&R department. Both became enor-mously successful and have been spun off as independent entities in our health system. Inpatient rehabilitation services and a residency training program were added in the 1980s. Un-der the leadership of Dr. Gerald Felsenthal during the 1990s, the department grew to in-clude a broad array of inpatient and outpatient programs, many unique in the region. Our flag-ship programs include neurological rehabilita-tion and pain manage-ment and rehabilita-tion. As a tertiary

teaching hospital (the third largest in the state), our vision has been to offer the broad continuum of care for these and other patients with complex needs. Sinai has been commit-ted to the professional development of our staff since the expertise of the multi-disciplinary team is at the core of our treatment Today we have a staff of over 225. We look forward to the opening of our new state of the art inpatient Louis and Phyllis Friedman Neu-rological Rehabilitation Center in the fall of 2012. Despite the un-certainties in American health care, the Sinai Rehabilitation Center remains committed to providing the highest quality, expert, family centered care.

Volume 1, Issue 1 May 1, 2012

SPECIAL POINTS OF INTEREST:

SRC admitted 1310 patents to the Rehab Hospital in 2010

Dr Edward Soriano joins the Physician Practice

SRC was the main sponsor of the BIAM annual conference

SRC has highest number of ACBIS trained staff

Ellen Zerbst wins BIAM award

S i n a i R e h a b i l i t a t i o n C e n t e r

INSIDE THIS REPORT:

Brain Injury 2

Inpatient NeuroRehabilitation

2

RETURN! Community Re-entry

3

Mild Brain Injury 3

RETURN! To Work 4

Pain Management 4

Pain Management 6

THE BRAIN INJURY PROGRAMS AT SINAI REHABILITATION CENTER

2011 Annual Report Page 2

The Brain Injury Programs at Sinai Rehabilitation Center (SRC) provide a full continuum of neurorehabilitation services to persons recovering from acquired brain injury. These programs are designed to help restore individuals to their maxi-mum level of cognitive, physical, emotional, and behavioral abilities. 2011 was a year of tremendous growth and accomplishment for SRC brain injury programs. Emblematic of these achievements was the Brain Injury Association of America designating Sinai Rehabilitation Center as an ACBIS Alliance site. ACBIS, the Academy of Certified Brain Injury Specialists, is a practitioner certification adminis-tered by BIAA, and Alliance is their recognition of high-quality care for those with brain injury. We are proud to be the only facility in Maryland to achieve this high standard.

Other notable accomplishments include:

Staff members were instrumental in the crafting of the Maryland Student–Athlete Concussion Bill, which be-came law on July 1 .

Mild Brain Injury Program experienced a 40% increase in admissions.

RETURN!—To Work program was designated as a vocational case management company by the Maryland Workers’ Compensation Commission.

CONTINUUM, a monthly newsletter about the Brain Injury Programs at LifeBridge was introduced.

The TBI and Neurorehabilitation Unit, a CARF accredit-ed program, is the traditional entry point for Sinai Hospi-tal’s brain injury continuum of care. This 23-bed facility provides acute rehabilitative care to those recovering from acquired brain injuries, including TBI and stroke. It is one of two facilities in Maryland to be licensed for TBI inpatient rehabilitation and the only one located in an acute care hospital. Patients are treated using a struc-tured TBI care model named RESTORE, which clearly defines environmental and clinical approaches based on the patient’s stage of recovery. Led by physical medicine and rehabilitation physicians, the clinical team of ACBIS-certified brain injury professionals provides excellent care based on best practices in neurological care. Our brain injury continuum includes the RETURN! Community Re-entry and RETURN!—To Work programs, meeting the long-term needs of persons with brain injury.

THE TRAUMATIC BRAIN INJURY AND NEUROREHABILITATION UNIT

Sinai

State (Adjusted)

Functional

Change

21.7

21.5

Length of

Stay (LOS)

14.2

10.8

LOS

Efficiency

2.0

2.2

Discharge to Community

80% (193)

67%

THE MILD BRAIN INJURY PROGRAM

Volume 1, Issue 1 Page 3

The Mild Brain Injury Program (MBIP) at Sinai Hospital is a comprehensive, case-managed approach to the medical and rehabilitative treatment of acquired mild brain injury. Providing a full range of diagnostic services and relevant treat-ment modalities to meet the broad needs of this population, it remains the only program in Maryland that integrates physiatry, neurology, neuropsychology, and rehabilitative therapies, closely co-ordinated by a case manager. The fastest growing of the LifeBridge Health brain injury programs, the MBIP serves as a national model of excellence for this population.

RETURN! COMMUNITY REENTRY PROGRAM

The, CARF accredited, RETURN! Communi-ty Reentry Program entered its 30th year of ser-vice in 2011 and continues to provide the best in neurorehabilitative care to individuals with moderate to severe brain injuries. In this comprehensive day program, a multidisciplinary team of brain injury professionals provides intensive, inte-grated outpatient therapy. This level of care is essential in aiding our clients with recovery. High functional outcomes and customer satis-

faction continue to be the norm for clients in RE-TURN! Given its close working relationship with the RETURN!—To Work Program, many of RETURN!’s clients have resumed gainful employment. The vast majority of those in the program are successfully dis-charged to manage their homes, attend school, and re-sume work. Most importantly, they are well-equipped to advance and maintain their recovery. Graduates re-ceive follow-up services via the monthly MindMenders support group.

Etiology of Injury

falls

assault

blunt force

MVC

CVA

sports

other

Case-Mix Profile

40% males, 60% females

Average age at referral: 45.9 yrs

Average time from injury to referral: 7.32 months

70

89

126

0

20

40

60

80

100

120

140

CY09 CY10 CY11

MILD BRAIN INJURY REFERRALS: 2009-2011

PROGRAM ACCOMPLISHMENTS

In collaboration with the NFL and the Brain Injury Association, played a primary role in passage of the Maryland Student–Athlete Concussion Law

Hired a rehabilitation neuropsychologist, resulting in greater accessibility

Hired an occupational therapist with specialty in ocular-motor interventions

Hired a vestibular physical therapist, reducing treatment waiting period

Collaborative relationship with Sheppard Pratt Neuropsychiatry streamlined referrals and improved patient outcomes

47% increase in referrals to program; 170% increase in Workers’ Comp cases

RETURN!—TO WORK PROGRAM

2011 Annual Report Page 4

RETURN!—To Work (RTW) pro-vides the most comprehensive ap-proach to re-employment after brain injury in the state of Maryland. From initial diagnostics to work preparedness to job coaching, all services are managed by a vocation-al case coordinator. Most clients are referred by the Maryland Division of Rehabilitation Services and are beneficiaries of the Governor’s Brain Injury Re-employment Fund. This funding allows for intensive and long-term involvement with those returning to work, ensuring the best outcomes possible. A 2011 study performed by the Uni-

versity of Maryland demonstrated high reemployment rates for those in the Governor’s Program, of which RTW was a leading partici-pant.

In 2011, RTW was approved by the Workers’ Compensation Commis-sion as a vocational case manage-ment company. This status allows the vocational case coordinators to provide primary oversight of pro-gram participants and to be respon-sible for developing viable employ-ment plans. Expectations are for this element of RTW to grow con-siderably in 2012.

FUNCTION PLUS! OUTCOMES

worker. Following individual as-sessments, the team collectively constructs a treatment approach that targets the cause of pain and methodically engages the person in functional activities. Outcome measurements of those treated indi-cate improvements in medication management, sitting and standing balance, walking, and personal cop-ing strategies. Outpatient follow-up care is provided to ensure long-term maintenance of these improve-ments.

The Function Plus! Program, locat-ed at Sinai Hospital, uses an integra-tive, inpatient approach to manage intractable pain. It focuses on identi-fying and addressing the cause of chronic pain, while reducing func-tional restrictions related to such. All interventions are designed to im-prove the person’s ability to engage in routine daily activities, to main-tain psychological well-being, and to live a full, productive life. The treat-ment team consists of a physiatrist, nurse, physical and occupational therapist, psychologist, and social

FUNCTION PLUS!

“I wish there were

adequate words to

express my

appreciation for the

care I received.”

C.J.

100% of the patients were weaned from unwanted or unnecessary medications. Virtually all patients experienced improved function toward their targeted goal with pain control.

RETURN! OUTCOMES

Volume 1, Issue 1 Page 5

INPATIENT OUTCOMES

Functional Change = The amount of functional progress made from admission to discharge.

Length of Stay (LOS) = Represents how many days a patient is in the Rehabilitation Hospital (RH)from admission to discharge.

Length of Stay Efficiency = Represents a measurement of daily functional progress while in the RH.

Discharge to Community = The discharge destination inclusive of home alone, with family or to an assisted living facility.

Improved functional independence 81%

Functional gain per treatment day .68

Client satisfaction 99%

Positive discharge placement 87%

70.00%

75.00%

80.00%

85.00%

90.00%

95.00%

100.00%

Sinai

State

Discharge to the community by Diagnosis

0

1

2

3

4

Stroke BrainInjury

Ortho Pain Other

Sinai

State

LOS Efficiency by Diagnosis

16

17

18

19

20

21

22

Stroke BrainInjury

Ortho Pain Other

Sinai

State

Functional Change by Diagnosis

0

2

4

6

8

10

12

14

16

Stroke Brain Injury Ortho Pain Other

Sinai

State

LOS by Diagnosis

Phone: 410-601-8823 E-mail: SinaiRehab@lifebridgehealth.org

2401 W Belvedere Ave Baltimore, MD 21215

S i n a i R e h a b i l i t a t i o n C e n t e r

SINAI REHABILITATION CENTER

The outpatient departments of the Sinai Rehabilitation Center are located in the Schoeneman build-ing.

Creating a Healthier Community One Person at a time.

We’re on the Web WWW.LIFEBRIDGEHEALTH.ORG

Coming Soon The Louis and Phyllis Friedman Neurologic Rehabilitation Center at Sinai. A new, state of the art, acute inpatient rehabilitation unit.