Faculty Bibliography

Introduction:Safe transitions of care are an essential component of safety and quality for the patient community. It is imperative that providers choose appropriate discharge settings to reduce avoidable hospital readmissions. Additionally, providers must also ensure that the multifaceted needs of each patient are met with every discharge recommendation. There is often a lack of formal instruction in medical school on the various discharge dispositions, indications for rehab, and clinical indications for each setting. This is problematic for new interns who are tasked with entering discharge orders and relaying critical information between lead physicians and the interprofessional team. Methods:A 60-minute workshop with both didactic and experiential components provided medical students with opportunities to gain an overview of discharge dispositions while also exercising critical thinking using case examples. The workshop was part of a 2-week Transition to Residency course at a single institution. Results:Twenty-two fourth-year medical students participated in the workshop. Following the workshop, 100% of the participants stated that they had learned something new and that they intended to use the content in practice as interns. Subjective responses indicated that workshop content ought to be incorporated earlier in medical training. Discussion:These results suggest that a 60-minute workshop including didactic instruction as well as experiential and inquiry-based learning can impact medical student knowledge and intent for practice change in regard to providing safe transitions of care for the patient community.

Background and Purpose: Existing iterature demonstrates the beneficial impact of rehabilitation interventions on functional status in patients necessitating prolonged mechanical ventilation (PMV).^1-3 However, there appears to be a void in the literature addressing the effects of specific physical (PT) and occupational therapy (OT) interventions on functional status of persons with PMV in the context of the acute care oncology setting. This case report describes the PT and OT management of a patient with PMV in the acute care oncology setting. Case Description: The patient in this case report is a 41-year-old woman with metastatic breast cancer and malignant pleural effusions who required PMV following an acute episode of respiratory failure. Examination and Intervention: The patient presented with deconditioning, decreased strength, and decreased functional status upon PT and OT initial evaluation. Targeted and intense PT and OT interventions including deep breathing exercises, limb strengthening, reconditioning, functional training, and early mobilization were implemented. Outcomes: Primary outcomes of interest were level of function qualified by need for assistance as defined on the FIM and ambulation distance. Following PT and OT, the patient showed substantial gains in functional status. She was weaned from the ventilator and was discharged home to resume her role as mother. Discussion and Conclusion: Consistency between the outcomes of previous studies examining the effects of rehabilitation on functional status among persons with PMV and KB's experience lends support to the use of this management approach for patients with PMV the acute care oncology setting.^1-3.

The purpose of this study is twofold: (1) to describe the hand strength, self-reported manual ability and health status in individuals with osteo- or rheumatoid arthritis, and (2) to evaluate the scale (psychometric) properties of the 36-item Manual Ability Measure (MAM) as it applied to this sample. We administered four self-report assessments to the participants and measured their grip and pinch strength. The results indicated that persons with arthritis had decreased grip and pinch strength, more functional limitations, compromised health status and restricted participation in everyday occupations when compared to the general population. Manual ability was not related to grip strength, but was significantly related to role restriction (i. e., SF-36 Role Physical domain). The study provides evidence that the MAM has adequate psychometric properties when used with patients with osteo- or rheumatoid arthritis.