Two new community-based clinics operated by TIRR Memorial Hermann are now serving cancer survivors and patients who have lost a limb. The clinics are conveniently located, with free parking, at the Belmont Village assisted-living facility in West University at 2929 West Holcombe Blvd.
“Several factors have converged to create a need for cancer prehabilitation and rehabilitation,” says physiatrist Carolina Gutiérrez, MD, who focuses her practice on cancer rehabilitation at TIRR Memorial Hermann. “First, we have a growing population of cancer patients. Because of education, screening programs and advances in cancer treatment, more patients live longer and many have multiple functional deficits, ranging from cognitive issues in brain tumor patients, to swallowing and eating in head and neck cancer patients.”
The goal of prehabilitation is to prevent or lessen the severity of anticipated treatment-related problems that could lead to later disability. “By educating patients on the benefits of a prehabilitation plan, we’re giving them the opportunity to be active participants in their own cancer care,” says Dr. Gutiérrez, a clinical assistant professor of physical medicine and rehabilitation at UTHealth’s McGovern Medical School. “Early engagement and compliance with the rehabilitation plan can result in fewer deficits after treatment, better outcomes, better function and improved quality of life. We’re giving patients the tools and motivation to help preserve function, allowing them to become stakeholders in their journey to healing and recovery.”
The new Limb-loss Clinic meets Tuesdays, Wednesdays and Fridays under the direction of physiatrist and amputee specialist Danielle Melton, MD, director of the Limb-loss and Orthotics and Prosthetics Program at TIRR Memorial Hermann and a clinical associate professor of orthopedics at McGovern Medical School. “Approximately 185,000 amputations are performed in the United States each year, and nearly 2 million Americans live with limb loss,” Dr. Melton says. “Changes in Medicare and other health plans have made it more difficult to justify prosthetic coverage by insurance companies. Documentation in the medical record of functional objective measures and prosthetic components must be provided by the treating physician, rather than a prosthetist. Our clinic makes it easier for patients to be evaluated and get the documentation they need for insurance coverage.”
Dr. Melton and her team provide a holistic team approach to limb loss that includes evaluation, prescription for a prosthesis, adaptive devices and an overall rehabilitation program with physical therapy, occupational therapy, neuropsychology, onsite nursing, wound care and pain management. Separate clinics are offered for patients with upper-limb and lower-limb amputation, creating a peer visitor and support group within the clinic itself.
“We’re an inclusive clinic, open to all prosthetic companies who demonstrate that they provide good patient care and follow-up,” Dr. Melton says. “Much of our patients’ success depends on how engaged they are in the process and whether they’re comfortable with a particular prosthetic company. We’ve been very efficient at getting our patients in and out, making the new clinic a great fit for them.”
Therapy manager Zahra Kadivar, PT, PhD, NCS, describes the clinic as a unique space. “Because we’re a small clinic, there are more opportunities for physicians and clinicians to work closely together and share information about clients,” she says. “The physicians are on hand, which is unique to this location. We’ve found this improves patient satisfaction.”
A healthy support system is the key to achieving success as a new nurse, which is why the Nurse Residency Program at Memorial Hermann follows a cohort-focused model that allows graduate nurses to grow and develop their nursing skills in a supportive setting. The 12-month program provides an evidence-based curriculum to support new nurses as they progress to a competent level of practice.
“Studies show that turnover among graduate nurses is high within the first one to three years after hire,” says Mary Ann Euliarte, RN, CRRN, chief nursing officer at TIRR Memorial Hermann and vice president of nursing for the Memorial Hermann Post-acute Care Network. “Our goal is to invest time and energy in focused education programs to ensure that newly hired nurses make a smooth transition into practice and that rehabilitation nursing is what they want for their careers. We believe strongly that bringing new people into the organization creates new ways of thinking, and that new thinking challenges us all to think better.”
After 12 weeks of orientation, nurses start working on the floor. They attend a four-hour professional development class every month as part of their training, with the program structured to help nurses develop in three critical areas: leadership, quality outcomes and their professional roles. “We’ve found that this creates a supportive learning environment to which nurses have responded positively,” says Darlene Clayton, RN, MSN, CRRN, residency coordinator at TIRR Memorial Hermann “Surveys are done at different points of the experience – on hire and at six, 12, 24 and 36 months. Nurses are asked to evaluate their experience as it relates to stress, professional satisfaction, program organization, prioritization, support, skills acquired and ease of transition in leaving the new graduate world to function as an experienced nurse. We review all surveys and make modifications as needed. At TIRR Memorial Hermann, we’ve had one of the highest rates of success.”
During the residency, Clayton works closely with nurses to find experiences to expand their knowledge. Allison Reimers, RN, MSN, CRRN, is also involved in the program as nursing education director at the rehabilitation hospital.
Jerry A. Ashworth, FACHE, has been appointed COO/VP of Operations for TIRR Memorial Hermann. In his new role, Ashworth will assume responsibility for clinical support services as well as patient flow and capacity management, with a focus on improving the experience of patients from referral through admission, discharge planning and return to the community.
Mary Ann Euliarte, RN, MBA, MSN, CRRN, CNO/VP of Nursing for TIRR Memorial Hermann and the Memorial Hermann Post-acute Care Network, will lead the hospital’s efforts to achieve Magnet® designation at TIRR Memorial Hermann, to standardize nursing clinical practice across the rehabilitation network and to drive the growth and development of centralized staffing for the Post-acute Care Network.
TIRR Memorial Hermann invites applications for the Craig T. Nielsen/Memorial Hermann Assistive Technology Scholarship for Individuals with SCI/D. The funds will be used to allow an occupational therapist with assistive technology provider (ATP) certification to complete an evaluation of needs with scholarship recipients, purchase necessary technology, provide training in the use of the technology and complete installation.