This is archived programming for CSM 2012. See current programming.
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Monday, January 21 | Tuesday, January 22 | Wednesday, January 23 | Thursday, January 24
* Should you choose to preselect regular (not preconference) Tuesday-Thursday sessions during the registration process, please be advised that preselection is not a guarantee of a seat. Attendees are asked to preselect to better determine room size and all efforts will be made to accommodate sessions in the largest rooms possible. All attendees are encouraged to show up to sessions early. Attendees are also encouraged to select alternative sessions in the event their first choice is full.
Location: Hilton Bayfront | Elevation Room (30th Floor)
Time: 8:00 am - 5:00 pm
Speakers: Karen McCain, PT, DPT, NCS; Patricia S. Smith, PT, PhD, NCS
CEUs: 0.9 (9.0 contact hours/CCUs)
Preconference Pricing: Standard Plus (1B)
The typically slow, inefficient gait after stroke often results in sequelae, such as heart disease, diabetes, and low aerobic capacity. What has yet to be determined is if this outcome is inevitable. Based on our current knowledge, is it possible to construct clinical interventions that will produce better gait and diminish these unwanted consequences? This preconference course is designed to challenge the advanced clinical practitioner to raise expectations for gait recovery in individuals post stroke. Current evidence suggests that effective interventions must include high-intensity, task-specific training initiated as soon as possible after the onset of the stroke. Research data, case studies, and patient videos will be used to explain the development and application of early, standardized, task-specific interventions for gait recovery after stroke. Course content will include a brief review of the neurophysiology of gait control and a review of neuroplasticity principles as they apply to stroke. Specific elements of gait-training interventions will be discussed, including an in-depth look at the role of lower-extremity bracing in gait recovery. Attention also will be given to the use of effective evaluation methods for gait recovery as well as the application of these principles across the continuum of care.
Upon completion of this course, you'll be able to:
Time: 8:00 am–10:00 am (See Program for Room)
Speakers: Jane K. Oeffner, PT, DPT, MBA; Edward Dobrzykowski, PT, DPT, MHS, ATC; Cathy Currier, PT, MBA; Deborah C. Wojcik, PT, MPT, MEd; Trevor Carlson, PT, DPT; Patrick J. Tarnowski, PT, MBA, SCS
The discussion of therapists' productivity in the acute care setting is not new. An urgency has emerged due to economic forces driving lowered hospital payment rates and pressure on financial margins. Penalties for qualified readmissions and postacute medical management are increasing the demand for physical therapy services. Acute care physical therapists are challenged by higher patient referrals for evaluations and consultations without additional staffing resources. This interactive session will discuss measurement of therapist productivity in acute care. New models for formulating productivity metrics that reflect the actual costs, including use of support staff, will be reviewed. Attendees will learn about factors that affect productivity at an individual therapist, team, discipline, and unit level.
A panel of clinical administrators, representing diverse regions and various types of acute care facilities, will present strategies to increase productivity. Examples include utilizing therapy aides during bedside care, implementing a triage system to decrease inappropriate consults, employing interdisciplinary patient mobility programs to optimize the utilization of skilled physical therapy services, and completing a process improvement project to increase timeliness of physical therapy interventions. The panel presentations will be followed by a rich dialogue with the audience to share successes and setbacks.
Speakers: Jennifer J. Cline, MS; Deanna Dye, PT, PhD
The need for early mobilization in the ICU has been widely acknowledged over the past few years. Challenges still remain on many levels for physical therapists to increase access to patients who are critically ill. This course will apply change theory to the hospital environment and provide the participants with the tools needed to be the change agent within their facilities. Participants will be exposed to one change theory model and its application in the hospital environment. The course will challenge participants to consider the complexities of cultural change within their facilities and provide them with the evidence and confidence to begin the educational process.
Speakers: Beth A. Smith, PT, DPT, PhD; Glenn Irion, PhD
The Journal of Acute Care Physical Therapy (JACPT) is a recently introduced peer-reviewed journal associated with the Acute Care Section of the American Physical Therapy Association. The journal publishes research reports, case reports, clinically relevant reviews, and letters to the editor that promote evidence-based practice specific to acute care physical therapy. This session is aimed at potential authors, particularly those who are unfamiliar with or have limited experience with the peer review process. The speakers will describe the submission and peer review process for JACPT and provide examples of submitted manuscripts, the comments of peer reviewers and associate editor, and successfully revised manuscripts accepted for publication. Attendees will learn about the responsibilities of the authors, peer reviewers, and editors throughout the process. The goal of this session is to familiarize potential authors with the process in order to support and encourage the submission of appropriate manuscripts. There will be ample time during the session for discussion with the editor and deputy editor.
Time: 11:00 am–1:00 pm (See Program for Room)
Speakers: Deanna Dye, PT, PhD; Jennifer J. Cline, MS
A continuation of Part 1, this session will explore recent evidence supporting the need for a cultural change within the critical care environment through the application of early mobilization and the systematic use of outcome measures. Attendees will be encouraged to examine best practice within the ICU through identification of skilled physical therapy interventions. Outcomes measures designed specifically for the ICU, in addition to others that show potential for application in the ICU, will be identified. Attendees will be challenged to consider the ramifications of implementing specific outcome measures in order to track individual progress over time, compare across patient populations, and enable data collection for future systematic review.
Time: 3:00 pm–5:00 pm (See Program for Room)
Speakers: Speakers: Michelle E. Kho, PT, PhD; Jennifer M. Zanni, PT, DScPT
Level: Multiple Level
Randomized controlled trials support implementation of early rehabilitation in patients with critical illness. For some patients, it may be clinically appropriate to initiate active physical therapy within 24 hours of ICU admission. However, knowledge translation of evidence into clinical practice in the acute care setting poses clinical decision-making challenges for acute care physical therapists because of patient acuity, complex technology, and resource requirements. While knowledge of a patient's lines and tubes in situ is important, physical therapists need to integrate many other factors about a patient's clinical condition before initiating physical therapy interventions.
In this session, attendees will be introduced to the knowledge-to-action framework and learn how to apply it to patients with critical illness. The speakers will review and critically appraise the evidence supporting early physical therapy interventions in patients with acute critical illness receiving life-sustaining therapies (eg, mechanical ventilation, dialysis, vasopressors). The session will use case examples to discuss explicit clinical decision-making strategies to initiate, conduct, and evaluate physical therapy interventions in patients with acute critical illness. The speakers will demonstrate how therapists can successfully integrate many types of data to inform their clinical decision making, including vital signs, laboratory results, mechanical ventilation settings, pharmacological therapies, and delirium assessment, . Attendees will take away practical strategies to measure implementation success.
Speakers: Diane E. Madras, PT, PhD; David Kennedy, PT, MS, CCS
Early mobilization of patients in the intensive care unit has been the subject of research since the 1990s. In light of the increased national attention on evidence-based, cost-effective medicine, there is no better time than now to highlight the benefits of early mobilization in high-risk patients in the intensive care setting. This program will discuss the effects of prolonged bedrest coupled with mechanical ventilator support, and the role of the physical therapist in the health care team in providing appropriate exercise, secondary prevention, and positive, cost-effective care, while improving physical and psychological patient outcomes.
Upon completion of this course, you’ll be able to:
Speakers: Michael S. Silverman, PT, MSPT; Maya Caspi, PT, DPT; Elizabeth Niedbala, PT, DPT
Surgical techniques regarding joint arthroplasty have evolved over the years. Unicondylar knee arthroplasty (UKA) is an alternative to the traditional total knee arthroplasty (TKA) that has been gaining in popularity among surgeons and patients. This educational session will allow attendees to gain knowledge regarding the surgical techniques, inpatient rehabilitation considerations, as well as a review of functional milestones associated with UKA at the Hospital for Special Surgery.
Speakers: Laura C. Driscoll, PT, DPT; Mary Beth Holmes, PT, NCS
This course will use a case-based approach to examine different ways in which acute care physical therapists can use the current literature to support their recommendations and advocate for discharge planning. The session will encourage discussion to break down the thought process behind the discharge recommendations of an acute care therapist. The speakers will provide useful guidelines to write more compelling assessment statements to help achieve the most appropriate outcome for the patient. They also will demonstrate how outcome measures can aid in decision making in the hospital setting and discuss the importance of a multidisciplinary team-based approach to discharge planning.
Speakers: Jennifer M. Ryan, PT, DPT, MS, CCS; Sharon L. Gorman, PT, DPTSc, GCS
Many therapists practicing in acute care encounter multiple health care professionals who lack understanding of the fast-paced, complex decision making required to determine a safe physical therapy plan of care that challenges a patient without exceeding his or her physiological limits. Conversations occur in which the therapist is confronted with statements such as, "Just get them up" or, "Just walk them." The word "just" diminishes the comprehensive clinical reasoning and decision making of the therapist. These interactions also raise ethical questions related to the use of best available evidence, over or underutilization of scarce physical therapy resources, and increased variability in practice. A broader view of clinical reasoning, not solely focused on deductive reasoning, is necessary for therapists to recognize and resolve these difficult situations. This presentation seeks to define the cultural limiters to therapists’ autonomy and professional development, as well as address strategies to address these concerns. Discussion of these clinical challenges in hospital culture, methods to improve the lack of interprofessional understanding of the therapist's expertise and clinical reasoning, and strategies to use to overcome these challenges will be explored using current research.
Time:11:00 am–1:00 pm (See Program for Room)
Speakers: Mary Fran Delaune, PT, MPT
There are many standard setting and visionary documents that can guide physical therapists and physical therapy program toward quality of care. Examples include APTA's Standards of Practice for Physical Therapy, the Criteria for the Standards, the Code of Ethics, and Vision 2020. Together these documents set forth the profession's statements of conditions and performances that are essential for the provision of quality physical therapy. This workshop will help attendees identify key strategies for building and sustaining strong organizational principles to support safe, high-quality patient care.
Speakers: Christiane Perme, PT, CCS
Critical illness polyneuropathy (CIP) and myopathy (CIM) are complications of critical illness that result in complex challenges for physical therapists working in the intensive care unit (ICU). Muscle weakness is a common complication of prolonged critical illness and is associated with ventilator weaning failure, prolonged rehabilitation, and hospital mortality. Survivors of critical illness can experience muscle weakness, fatigue, decreased exercise tolerance, and decreased quality of life long after hospital discharge. This course will address CIP and CIM diagnosis, current approaches to treatment, and physical therapy implications. Case reports will be incorporated to demonstrate how an early rehabilitation program can positively impact functional recovery. The purpose of this presentation is to review and discuss the available evidence-based literature, which will assist physical therapists in the management of patients CIP and CIM across the continuum of care.
Time: 6:30 pm–7:30 pm (See Program for Room)
Speakers: Sharon L. Gorman, PT, DPTSc, GCS
The acute care environment exemplifies the height of technological sophistication, yet in many aspects physical therapists have not used these advances in their practice. How can acute care physical therapy continue to grow and advance if therapists don’t take advantage of technology in the realms of education, research, and practice?
Speakers: Jacqueline Pokorney, PT, MSPT, GCS; Amanda Lalonde, PT, MPT
Level: Multiple Level
With an ever-growing aging populace, improvements in health care that allow for longer lifespans, and the significant ongoing cuts to health insurance, physical therapists working in geriatrics and acute care are in an optimal position as health care providers to address these challenges. This session plans to demonstrate the unique way that physical therapists can practice within an Acute Care for Elders (ACE) team, advocate for starting an ACE team at their respective institutions, and practice autonomously to promote the best evidence-based interventions when dealing with geriatric patients in the acute care setting. As patients who have dementia and/or delirium are common in acute care, this course will address strategies for working with these prevalent patient diagnoses.
The speakers will describe the components of an ACE team with various implementation strategies, the role of physical therapy within the ACE team as participant and advocate for best practices when it comes to mobility, and the specific components of the ACE consult team at the University of Wisconsin Hospital in Madison, Wisconsin. The course will provide a review of how ACE was implemented, how it has grown, the financial aspects of justifying the team and its growth, and plans for future demonstration projects within the hospital. Additionally, the speakers will discuss the ACE team in relation to other aspects of an organization, including home health, outpatient, the geriatric medical home, and the transitional care program.
Speakers: Jose Kottoor, MS; Kathryn Meyvis, PT; Michael Cagle, OTR
Many health systems have implemented process improvement initiatives into their operations to cope with changes in health care. Lean processes are not about changing the clinical practices, but rather to improve patient safety, reduce waste, and improve efficiency. Hospitals have implemented several versions of lean processes. The principles of the speakers' lean process are to specify what creates value for customer; identify all the steps of process chain; make those processes flow; make what is pulled by the customer; and strive for perfection by continually removing wastes or "heijunka," which is the Japanese word for "production leveling." The speakers, from Beaumont Health System, took an approach of "find it and fix it." This improves processes, in a short time period, with sustainability. The lean concept of "kaizen" (or "improvement" in Japanese) was used to make process improvements in the department, which produced immediate results. The real power of the kaizen process is the continuous, small improvements in all aspects of the health care system. In this session, attendees will be shown how to apply lean principles and kaizens to improve patient safety and staff efficiency.
Speakers: Jan Reynolds; Patricia J. Ohtake, PT, PhD
Rehabilitation in the critical care setting is emerging as an important strategy in improving functional outcomes in the acute care population. The latest research suggests that early interventions aimed at restoring and maintaining physical function in patients with critical illness are associated with improved physical function and well being. During this session, authors who contributed the recent special issue of APTA's Physical Therapy journal (PTJ) will share their insights on the role of rehabilitation in the management of critical illness; outcome measures; new rehabilitative interventions; and issues related to optimal timing, intensity, and dosage.