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The paper aims to investigate if the performance of older adults on the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were associated or predictive of their functional performance in a geriatric evaluation and management (GEM) inpatient hospital setting. This will inform the occupational therapy assessment and management of older adults admitted to sub-acute GEM settings.

In all, 20 participants (11 men, 9 women, mean age 82 years, SD = 6.93) were recruited from a GEM ward in an Australian hospital. Participants’ cognitive abilities were assessed using the MMSE and MoCA, and their functional performance were assessed using the Functional Independence Measure (FIM). Spearman’s rho correlations and linear regression analyses were completed. Bootstrapping was applied to the regression analyses to accommodate the small study sample size.

No statistically significant correlations were obtained between the total and subscale scores of the MMSE and FIM or between the total and subscale scores of the MoCA and FIM. In other words, the cognitive and functional abilities of older adults admitted to a GEM setting were not significantly associated in this study.

The findings suggest that the MoCA and the MMSE were not predictive of participants’ functional performance as measure by the FIM in a sub-acute GEM setting. Occupational therapists should be cautious when interpreting participants’ MMSE, MoCA and FIM results and not depend solely on these results in the goal setting and intervention planning processes for clients on GEM wards. Further studies are recommended to confirm these findings.

In response to an aging population and rising prevalence of disability, reablement initiatives have been introduced yet the evidence base concerning the long-term effects remains inconclusive. The purpose of this paper is to examine the impact of reablement on physical independence, care plans and care packages post-discharge for older adults.

A retrospective cohort design was used to examine patient records who had completed a reablement programme. Measures on internationally renowned and psychometrically strong tools, completed by trained healthcare professionals, were examined pre-and post-intervention with a consecutive sample (n=416) of participants since the introduction of the reablement programme.

Reablement had a significant impact on physical independence living scores and a corresponding reduction in care needs and care plans post-discharge enabling the person to stay at home.

The study’s findings present empirical evidence on the value of reablement health service programme developed to promote independent living at home following a short illness, for older people. While no examination of financial data was recorded in this study, the increase in physical ability and corresponding reduction in care needs and care plans post-discharge indicates a reduction in costs and a better standard of living.

Traumatic brain injuries (TBIs) are a significant public health problem that affect an estimated 1.7 million US residents yearly. TBI patients experience a variety of symptoms related to physical functioning, sensory processing, cognition, communication, behavior, and mental health, all of which differ in severity by individual. Recent evidence suggests that hypothalamic pituitary dysfunction may be impacting recovery. The purpose of this paper is to increase awareness about the frequency of hypothalamic pituitary dysfunction following a TBI and its effect on functional recovery.

The paper reviews the literature regarding hypothalamic pituitary dysfunction following TBI and discusses the potential benefits of hormone replacement therapy for individuals with hormone deficiencies.

The rate of hypothalamic pituitary dysfunction following TBI has been reported as anywhere between 25 and 80 percent. Specifically, abnormal hormone levels, both chronic and acute, are generally estimated to be approximately 5-22 percent for thyroid hormones, 15-33 percent for growth hormone (GH), and 25-80 percent for testosterone. The effect of hypopituitarism has been reported on several aspects cognitive and physical function as well as overall quality of life. In these studies, GH and testosterone deficiencies appear to underlie the observed impairments.

The paper suggests the importance of understanding and screening for hypothalamic pituitary dysfunction as hormone replacement therapy may be a beneficial intervention to promote physical and cognitive rehabilitation.

The purpose of this article is to present a case study that documents how management science techniques (in particular data envelopment analysis) can be applied to performance improvement initiatives in an inpatient physical therapy setting.

The data used in this study consist of patients referred for inpatient physical therapy following total knee replacement surgery (at a medium‐sized medical facility in the Midwestern USA) during the fiscal year 2002. Data envelopment analysis (DEA) was applied to determine the efficiency of treatment, as well as to identify benchmarks for potential patient improvement. Statistical trends in the benchmarking and efficiency results were subsequently analyzed using non‐parametric and parametric methods.

Our analysis indicated that the rehabilitation process was largely effective in terms of providing consistent, quality care, as more than half of the patients in our study achieved the maximum amount of rehabilitation possible given available inputs. Among patients that did not achieve maximum results, most could obtain increases in the degree of flexion gain and reductions in the degree of knee extension.

The study is retrospective in nature, and is not based on clinical trial or experimental data. Additionally, DEA results are inherently sensitive to sampling: adding or subtracting individuals from the sample may change the baseline against which efficiency and rehabilitation potential are measured. As such, therapists using this approach must ensure that the sample is representative of the general population, and must not contain significant measurement error. Third, individuals who choose total knee arthroplasty will incur a transient disability. However, this population does not generally fit the World Health Organization International Classification of Functioning, Disability and Health definition of disability if the surgical procedure is successful. Since the study focuses on the outcomes of physical therapy, range of motion measurements and circumferential measurements were chosen as opposed to the more global measures of functional independence such as mobility, transfers and stair climbing. Applying this technique to data on patients with different disabilities (or the same disability with other outcome variables, such as Functional Independence Measure scores) may give dissimilar results.

This case study provides an example of how one can apply quantitative management science tools in a manner that is both tractable and intuitive to the practising therapist, who may not have an extensive background in quantitative performance improvement or statistics.

DEA has not been applied to rehabilitation, especially in the case where managers have limited data available.

The purpose of this paper is to compare the ability of the Morse Fall Scale (MFS) and Farmer's fall-risk assessment tool (FFAT) to identify correlations between risk factors and falls among older adult long-term care (LTC) facility residents.

This was a correlational retrospective study. 200 medical records of older adults hospitalized in a LTC facility in central Israel, from January 2017 to January 2018, were examined.

Of all the residents, 75% and 99.5% of the residents were identified as having a high fall risk according to the MFS and FFAT, respectively. Only 12.5% of residents actually fell. MFS score was weakly correlated with actual falls (odds ratio = 1.035). It was also found that all fallers fell during their first week at the facility.

Future research should explore the ability of the tools to capture changes in the fall risk by repeat assessments, as this has not been examined in the present study.

The MFS and FFAT tool may have little value in assessing fall risk in older adult LTC facility residents. Therefore, nurses should perform a clinical evaluation of each individual patient. In addition, nurses should place a particular emphasis on fall risk and prevention during the first week following admission.

The findings of the present study raise doubts regarding the utility of the common practice of assessing fall risk in older adult LTC facility residents using the tools MFS and the FFAT, thus emphasizing the need to adopt a different approach.

This study aims to evaluate the relevance of telerehabilitation during the spread of the COVID-19 pandemic based on the prevalence of participation and activity International Classification of Functioning, Disability and Health (ICF) domains in a population with disabilities.

We perfomed an observational study of ICF files of people with disabilities pre- and post-three-months lockdown imposed by the government to stop the spread of the COVID-19 pandemic.

ICF qualifiers such as performing the daily routine (d230), using communication devices and techniques (d360) and doing housework (d640) showed a significant decrease of the disabilities (p < 0.05). Instead, a significant increase (p < 0.05) in disability was evident in relating with strangers (d730); informal social relationships (d750); acquiring, keeping and terminating a job (d845); complex economic transactions (d865); community life (d910); and recreation and leisure (d920).

Telerehabilitation should not be regarded as home-based rehabilitation delivered through technology. The results show how telerehabilitation should be a functional diagnostic tool and monitoring of patients’ rehabilitation needs.

Through a comprehensive classification scale of disability, it is possible to redefine the term telerehabilitation.

The aim of this study was to test whether the client homebound score (CHS), the case management intensity score (CMIS) and the client priority visit score (CPVS) could be used to predict in‐home time of professional caregivers in the Aspen community care program. A random sample of 34 community care clients from the different geographical areas of the Aspen Regional Health Authority was selected and the home visits for each client were tracked for three months. Information such as client demographics, the client diagnostic category, number and in‐home time of visits was collected. In addition, the CHS, the CMIS and the CPVS were measured for each client. Data were analyzed, using a robust variance estimator regression model. CMIS was found to be the best predictor of in‐home time (coefficient 9.521, p > 0.001), followed by the CHS and the CPVS.

This paper aims to present a two-decade effort to improve team functioning and patient outcomes in inpatient stroke rehabilitation settings.

The principal improvement effort was conducted over a nine-year period in 50 Veterans Administration Hospitals in the USA. A comprehensive team-based model was developed and tested in a series of empirical studies. A leadership development intervention was used to improve team functioning, and a follow-up cluster-randomized trial documented patient outcome improvements associated with the leadership training.

Iterative team and leadership improvements are presented in summary form, and a set of practice-proven development observations are derived from the results. Details are also provided on the leadership training intervention that improved teamwork processes and resulted in improvements in patient outcomes that could be linked to the intervention itself.

The practice-proven development observations are connected to leadership development theory and applied in the form of suggestions to improve leadership development and teamwork in a broad array of medical treatment settings.

This paper includes suggestions for leadership improvement in medical treatment settings using interdisciplinary teams to meet the customized needs of the patient populations they serve.

The success of the team effectiveness model and the team-functioning domains provides a framework and best practice for other health care organizations seeking to improve teamwork effectiveness.

This paper provides an overview of an improvement project that explored whether the implementation of IoRN2, a validated freely available tool designed for any health or social care professional to use, resulted in improved conversations across professions within an integrated rehabilitative reablement service.

A qualitative descriptive evaluative approach was applied underpinned by quality improvement Lean and Total Quality Management (TQM) to capture perceptions, variables and IoRN2 value-add. Professionals' (N = 8) across Nursing, Allied Health Professions, Social Work, Quality Improvement and Support Workers participated in one-to-one semi-structured <1 h interviews. Recurring themes and experiences were identified.

IoRN2 improved collaborative conversations. The evaluation of the tool demonstrated greatest impact when all professionals were IoRN2 trained. Participants, regardless of profession, believed that their conversations, professional relationships and outcomes improved when using IoRN2. When differing judgments arose with colleagues who were not IoRN2 trained, fear and tension emerged around trust, cultural manners and power play causing disconnects. Incorporating IoRN2 led to psychologically safe environments where trust, confidence and motivation to explore new creative conversations enhanced strength-based outcomes and helped to generate transformational change.

The small sample size offered transferable learning worthy of larger future study. The project lead was also the reablement service manager, which may have generated unintended influence.

IoRN2 has the potential to improve how HSC professionals converse, acting as a catalytic tool for system-level integration, transformation and sustainable improvement.

This chapter discussed the role of business intelligence (BI) in healthcare twofold strategic decision making of the organization and the stakeholders. The visualization techniques of data mining are applied for the early and correct diagnosis of the disease, patient’s satisfaction quotient and also helpful for the hospital to know their best commanders.

In this chapter, the usefulness of BI is shown at two levels: at doctor level and at hospital level. As a case study, a hospital is taken which deals with three different kinds of diseases: Breast Cancer, Diabetes, and Liver disorder. BI can be applied for taking better strategic decisions in the context of hospital and its department’s growth. At the doctor level, on the basis of various symptoms of the disease, the doctor can advise the suitable treatment to the patients. At the hospital level, the best department among all can be identified. Also, a patient’s type of admission, continued their treatments with the hospital, patient’s satisfaction quotient, etc., can be calculated. The authors have used different methods like Correlation matrix, decision tree, mosaic plots, etc., to conduct this analysis.