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Clinical Outcomes


This report provides program information and data about outcomes achieved by patients in the acute rehabilitation program at the Fletcher Allen Inpatient Rehabilitation Center on the Fanny Allen Campus.

During the calendar year 2009, Fletcher Allen Inpatient Rehabilitation Center Rehab discharged 663 patients. Several standard measurements are used to assess the outcomes of these patients. These outcomes are compared with national acute rehabilitation benchmarks compiled by the American Medical Rehabilitation Providers Association (AMRPA) database called Erehabdata.

This report also includes data and information on patient satisfaction and program management collected through Press Ganey surveys. The outcomes described in this report are for patients discharged from Fletcher Allen Rehab Unit during 2009.

Our hope is that this report will help you feel confident in the Fletcher Allen Inpatient Rehabilitation Center as you consider choosing us as your provider of choice for all your rehabilitation needs.

Clinical Outcomes - questions and answers

How many patients are discharged from the Fletcher Allen Inpatient Acute Rehabilitation Center each year?

As you can see, nationally the total number of discharges from acute Inpatient Acute Rehabilitation is on the decline. Recent changes in Medicare rules governing who can be admitted to rehab, as well as increased competition in the community, are contributing to this trend. The changes in Medicare rules continues to frustrate patients, families, physicians, and providers. Despite these challenges, Fletcher Allen Inpatient Rehabilitation continues to advocate for the rehabilitation needs of patients through extensive patient review, evidence based services, careful planning, and case management. Case Mix Index (CMI) is commonly used to define the average acuity of patients. It is a metric addressing the question: "How much rehabilitation care did each patient require?" Higher numbers indicated an increase average acuity and thus an increased need for rehabilitative care.

What were the major diagnoses treated at the Fletcher Allen Inpatient Rehabilitation Center in 2009?


Our case mix at the Fletcher Allen Inpatient Rehabilitation is represented below. The trend in 2010 will be an ongoing reduction in the number of patients with single joint replacements since Medicare regulations limit admission for single joint replacement without significant co-morbid conditions. This reduction in cases will result in a higher percentage in all other categories. Therefore, the orthopedic group will represent a population with more bilateral joint replacements and fractures. The neurological diagnosis of stroke, brain injury, spinal cord injury, and other neurological conditions represents 51% of our total admissions.

How well did our patients do?


The IRF/PAI* is a nationally recognized instrument that measures a patient's functional abilities in areas such as eating, grooming, toileting, transfers, mobility, bowel/bladder management, communication and cognitive skills. Patients receive a Functional Independence Measure (FIM) score upon admission and again at discharge, based on those functional abilities. Erehabdata compares the functional gains to those reported by other Inpatient Acute Rehab facilities nationally. A lower score indicates a lower level of function as compared to a higher score. Our patients' admission and discharge scores are higher than the region and nation. For many of our patients, an essential skill to going home is being able to transfer in and out of a bed or chair. The graph below shows that, upon admission, patients need maximum assistance from one helper and a device to transfer. At discharge they require minimal assistance or supervision by one person. (* Inpatient Rehabilitation Facility/Patient Assessment Instrument)

How long did our patients stay with us?

The length of stay for patients at the Fletcher Allen Inpatient Rehabilitation Center varies significantly based on each individual patient's rehabilitation needs, personal goals, and discharge supports.

Where did our patients go after their stay with us?

Fletcher Allen Inpatient Acute Rehabilitation Center's discharges to the community are higher than the nation. Many of the patients discharged to a continuing rehab setting also eventually return home.

 

How satisfied are our patients?

Data taken from IT HealthTrack, Inc. and Press Ganey Follow-up Services Overall, our scores indicate that we are in the 83th percentile, as compared to the national database. This means our satisfaction exceeded 83 percent of the facilities to whom we are compared.