Saint Thomas Revamps Neurosciences, Beefs Up Rehab

SHARON H. FITZGERALD

Saint Thomas Revamps Neurosciences, Beefs Up Rehab | Donna L. Nave, Saint Thomas Health Services, Life Therapies, neurorehabilitation, Bioness, neuropsychologist

Donna L. Nave
Ensuring that neurology patients receive comprehensive, multidisciplinary treatment is the impetus behind a dramatic expansion of the Neurosciences Service Line of Saint Thomas Health Services. With a particular emphasis on outpatient rehabilitation, the system has added more occupational, speech and physical therapists at three Middle Tennessee locations.

"People are surviving their stroke. They're coming in at younger ages. Many times the stroke is mild; and many times it's devastating, and they're alive. We want to make sure that their quality of life is the best it can be, and that's the rehabilitation component," said Donna L. Nave, service line leader.

Neurosciences Overhaul

STHS's neurosciences expansion has been several years in the making. After a wide-ranging review by physicians of the Center for Spinal Surgery, the Brain and Spine Tumor Center, the Center for Sleep, and stroke and multiple sclerosis services at individual hospitals, technologies were improved, more doctors were hired and collaboration was enhanced, Nave said. Neurology services are provided at STHS's three largest hospitals – Saint Thomas, Baptist and Middle Tennessee Medical Center in Murfreesboro.

"The comprehensive nature is what's different now," Nave explained. "People are coming together to share information, share resources, problem solve, assess quality and look at outcomes, and I've just been thrilled with how the clinicians and the doctors across our health system have rallied behind this." She said a February meeting of neuroscience personnel across the board revealed that the three hospitals had met all the criteria of the American Stroke Association's Get With the Guidelines program. In addition to patient satisfaction scores, another measure of success is that the length of stay in an acute setting by patients with neurological conditions is shorter, an indicator that patients are receiving the services they need in a timely manner and moving on to rehabilitation.

Rehab Boost

STHS calls its rehabilitation services for neurology patients Life Therapies, with two Nashville locations at Baptist Medical Plaza 1 on Church Street and in Green Hills on Richard Jones Road, plus one Murfreesboro location on Memorial Boulevard. A fourth site is in the works.

In addition to 10 new physical, occupational and speech therapists, STHS also hired Gary Solomon, PhD, a licensed neuropsychologist. The therapists already are booked, "telling us that there was and is a need out there," Nave said. "Neurorehabilitation is a different animal than sports rehabilitation," she said. "The patient is different, with different needs and different concerns. Even though it's still physical therapy or occupational therapy or speech therapy, it's specialized care in a setting that serves someone better who has suffered a life-altering event." In addition to a stroke, patients could have conditions such as traumatic brain injury, spinal cord injury, Parkinson's disease, multiple sclerosis or cerebral palsy.

"It requires a lot more psychological intervention than someone who maybe had a knee replacement and sees a lot of hope for the future, because they now can get back to their fun activities," Nave said. "Neurological patients have to deal with the fact that they may not get back to what was normal for them."

When it comes to neurorehabilitation, patients oftentimes need more than one type of therapy. For example, patients may need physical therapy to help improve their gait, occupational therapy to help them relearn daily activities like dressing and toileting, and speech therapy not only for talking but also chewing and swallowing. "At Life Therapies, all three divisions are together, and the patient gets the benefit of having the team come up with the treatment plan. So there's overlap between the therapists," Nave said.

Life Therapies boasts the Bioness NESS L300 Foot Drop System, a device that stimulates muscles and nerves during the swing phase of the gait. Nave said STHS is weighing the purchase of the NESS H200 for hand stimulation. Life Therapies also owns a system for vestibular rehabilitation to treat dizziness and similar disorders.