In late October, the National Rehabilitation Hospital continued its commitment as the nation’s advocate on the health policy issues shaping post-acute rehabilitation by launching its newest research center – the Center for Post-acute Studies (CPS).
CPS aims to provide leadership on major issues shaping the organization, delivery, quality and financing of post-acute rehabilitation across all post-acute settings in the U.S. and abroad. One-third of all patients discharged from acute care hospitals receive some type of post-acute care in a variety of settings including hospital-based rehabilitation centers, skilled nursing facilities, day treatment centers, outpatient centers, or in the home under the auspices of a home health agency.
NRH Senior Fellow Gerben DeJong, Ph.D., serves as Director of the new research center. “During the last 20 years,” notes DeJong, “post-acute care has been one of the fastest growing segments of American health care, but research capacity in this area has not kept pace. In fact, it is a sector that has been neglected by the mainstream health services research community. There is a real need for research leadership in this area.
”DeJong is supported by a core team of three Ph.D. level researchers — all with strong clinical backgrounds in occupational therapy, physical therapy, and pediatrics, as well as doctoral-level training in epidemiology, aging and health services research.
“We are fortunate to have a team that can blend clinical knowledge with core clinical and health services research skills,” adds DeJong, who envisions a center that reaches well beyond its core team of investigators. He believes that post-acute care is desperate for new ideas to make it more responsive to the growing needs of an aging population and of policymakers who are seeking greater rationality in the organization and financing of post-acute care. The success of the center will depend in part on its ability to forge “a national and international network of investigators that will be viewed as the go-to source for innovative ideas and accurate information on post-acute issues,” DeJong contends.
Focus on Practice-Based Studies
CPS is currently involved in eight ongoing research projects that have received funding from both public and private organizations including the National Institute on Disability and Rehabilitation Research (NIDRR), the American Rehabilitation Providers Association, the Federation of American Hospitals, the Brooks Health System, the National Rehabilitation Hospital, the HealthSouth Corporation and others.
The most widely known of these projects is the JOINTS (Joint replacement Outcomes in Inpatient rehabilitation facilities and Nursing Treatment Sites) study. The study, which came on the heels of a recent call by the Centers for Medicare and Medicaid Services (CMS) urging groups to conduct research in this area, was launched in the summer of 2005. The two-year practice-based evidence (PBE) study aims to identify the types of joint-replacement patients that are best served in each type of post-acute facility, taking into account the types of services and therapies rendered in the settings of care. In order to capture the diversity of practice in skilled nursing facilities and inpatient rehabilitation facilities, the study will enroll 22 facilities and 2,400 patients from across the country.
More recently, CPS received a grant for another PBE study of pressure ulcer prevention in spinal cord injury (SCI) management and rehabilitation in conjunction with NRH’s designation as a NIDRR model system for SCI and the launching of the National Capital Spinal Cord Injury Model System (NCSCIMS). This study seeks to reverse this disturbing trend by identifying strategies and interventions that can prevent the onset of pressure ulcers among individuals with SCI in both acute care and rehabilitation facilities.
The CPS team is also involved in a larger PBE study that examines SCI rehabilitation outcomes and best practices. NRH is one of six rehabilitation centers involved in this multi-site study led by Craig Hospital of Denver, Colo. The project is examining interventions in acute rehabilitation for individuals with SCI in order to create sophisticated, outcomes-based tools for clinical decision making.
In addition to its externally funded research studies, CPS will produce a biannual report and hold a biannual forum to summarize major post-acute trends across all post-acute industries. The report will highlight a number of providers and facilities across post-acute industries, recent data on industry growth and consolidation and post-acute market responses to larger changes in health care system, health-plan policies, and consumer demands. The new center also plans to inaugurate a Web blog to provide a free and open forum on major issues in post-acute health care.
Visit the CPS website