Category: Cancer Rehabilitation; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Objective : Describe an acute inpatient rehabilitation facility (IRF) cancer program employing two tracks addressing the dynamic needs of the oncology population
Design : A description of the development and implementation of a cancer rehabilitation clinical program.
Setting : Free standing acute IRF.
Participants (or Animals, Specimens, Cadavers) : Adults, 18 and older, with a cancer diagnosis or cancer related impairments. Criteria includes: requiring 24 hour medical and nursing oversight, demonstrate ability to actively participate in multiple therapies with rehabilitation goals.
Two pathways have been established to address needs of this population: Restorative and Supportive. The Restorative Pathway includes individuals with good oncologic prognosis and functional potential. The Supportive Pathway includes individuals with limited oncologic prognosis and functional potential. The admitting pathway is established prior to admission by the oncology team (nurse liaison, oncologists and oncology nurses) based on diagnosis, prognosis and treatment plan, including medical treatment and frequency of therapy. The interdisciplinary team at the IRF reassesses the individual’s dynamic needs weekly at team conference meetings, including maintaining or changing pathway and discharge disposition. Extensive education is provided, including educational material from American Cancer Society and hands-on family training. Home evaluations/modifications are performed as necessary.
Main Outcome Measure(s) : The following information is collected: FIM™, CMS Quality Indicators, Brief Fatigue Inventory and FACT G-7 on admission and discharge; Numeric Rating Scale for pain, missed time and rescheduled time tracked daily; The Montreal Cognitive Assessment on admission; discharge disposition and patient satisfaction gathered prospectively
Results : A multi-campus interdisciplinary program team has been developed to address the specific needs of the population and provide education to nurse liaisons, physicians, nurses and therapy department.
Conclusions : Established expert interdisciplinary team, identified measures and tracks. Data collection is needed to evaluate program efficacy.
Dana Zeitlin– Clinical Specialist Physical Therapist, Kessler Institute for Rehabilitation, Saddle Brook, New Jersey
Gilleanne Lenart– Senior Occupational Therapist, Kessler Institute for Rehabilitation, Saddle Brook, New Jersey
Sara Ilenko– Senior Speech Language Pathologist, Kessler Institute for Rehabilitation, Saddle Brook, New Jersey
Irene Ward– Brain Injury Clinical Research Coordinator, Kessler Institute for Rehabilitation, West Orange, New Jersey
Michael Stubblefield– Medical Director for Cancer Rehabilitation, Kessler Institute for Rehabiliation, West Orange, New Jersey