October 09, 2013
By Greg Peters
|Physical therapy student Rachel Bradrick with clinic patient Della Ratliff|
A clinic at the University of Kansas Medical Center is giving patients diagnosed with acute and chronic medical conditions the physical and emotional support needed during treatment and recovery.
Clinic directors Lisa VanHoose, Ph.D., PT, and Rhonda Johnson, Ph.D., have formed an interdisciplinary team that focuses on a patient's wellness and quality of life by tailoring a treatment plan to the individual. During the first visit, a team of occupational therapists, physical therapists, psychologists and the patient work to develop an individualized care plan.
"The clinic addresses the person and not just the impairments," says VanHoose, who has been practicing physical therapy since 1996.
KU HealthPartners Rehabilitation and Wellness Clinic opened in March in the child development unit of the medical center and during the summer moved into space provided at Kirmayer Recreation Center. The clinic is open from 9 a.m. to 5 p.m. on Mondays and Wednesdays and from 9 a.m. to noon on Thursdays.
The clinic offers interprofessional experiences for students in KU's occupational and physical therapy programs as well as job shadowing for students applying to health professions programs. Kelli Reiling, OTD, and Dory Sabata, OTD, make up the occupational therapy staff, while Johnson and Lora Black provide psychological support and mentoring of psychology students. Physical therapy services are provided by physical therapy students under VanHoose's supervision.
The majority of the clinic's current patients have been diagnosed with cancer. Team members work with patients from the time the individual is diagnosed -- to get their minds and bodies ready for treatment -- until care is no longer needed.
"We prefer to treat existing medical conditions, improve aerobic capacity and provide patient education prior to cancer treatment to reduce the risk of long and late-term side effects," says VanHoose, one of the few health care providers in Kansas and Missouri with national certification in the management of lymphatic disorders. "In the clinic, we work with cancer patients from diagnosis to the end of life. "
While most of the clinic's patients have been diagnosed with cancer, the clinic is open to all individuals in need of support. Health care providers who have worked with the clinic say they have seen results.
"I recently referred a complicated patient with type I diabetes to Lisa for wound care," says Cypress LaSalle, a family nurse practitioner at the Silver City Health Center. "I referred her for help managing her non-healing wounds from chronic diabetes. Little did I know Lisa and the psychologist she works with would help address far more than the patient's skin issue."
VanHoose's team treated the patient's wounds and also gait issues from an earlier toe amputation. The psychologist helped the patient work through emotional and social issues.
"I am so grateful for the physical management of the patient's wounds, but the most significant thing they did for my patient was give her hope and self-confidence, which has dramatically improved her compliance with care," says LaSalle.
VanHoose dreamed about this type of clinic years ago, but the idea didn't seem plausible. Although many rehabilitation clinics have multidisciplinary care, she says the providers often work in individual silos. So after a decade of working in these settings, VanHoose returned to KU Medical Center to work on her doctorate.
"I remember having a conversation with department chair Lisa Stehno-Bittel during my first year as a faculty member about my career trajectory," she says. "She envisioned a career that combined my clinical expertise and research interests. It was the first time someone had validated my dream."
A chance encounter in 2012 with Johnson, who is a faculty member in the occupational therapy and obstetrics and gynecology departments, fanned the flames to start a clinic, and the two began planning.
They first sought approval from department chairs Stehno-Bittel (physical therapy) and Winifred Dunn (occupational therapy), and from there they moved on to KU HealthPartners. Mentors helped them outline clinical operations, identify providers, establish a billing process, and set the teaching and research goals.
The two then started building rapport with doctors. VanHoose credits Drs. Gary Johnson, Julia Chapman and Evelyn Reynolds and their staffs for helping refine the clinic's processes in providing quality service.
The clinic recently created a community advisory board, which consists of both patients and community members, to guide its growth. The clinic also established the "Advancing Interdisciplinary Care and Wellness" endowment fund to provide services to the community and expand the staff. Peggy Person, development director for the Schools of Nursing and Health Professions at KU Endowment, helped the start-up get on its feet and continues to provide support.
"It was definitely a team effort to make the clinic a reality," VanHoose says. "We had the support of Dean Karen Miller all the way down to the students who work in the clinic and the patients who have been committed and invested in the clinic's growth."
The clinic conducts about 20 visits a week, ranging from initial evaluations to follow-ups. During the next year the clinic would like to increase to five days a week, doubling the number of visits. The staff tries to meet the patient's needs, whether it is at the clinic or elsewhere.
"We are able to see patients in the clinic but also in their natural environments, like their home, work and community, which might include the grocery store, a favorite park or a walking trail," VanHoose says.
The clinic is talking with physical therapy and occupational therapy faculty to provide more specialty services, such as vestibular rehabilitation - an exercise-based program designed to promote central nervous system compensation for inner ear deficits. VanHoose says KU HealthPartners has provided a solid infrastructure allowing individuals from the Schools of Nursing and Health Professions to use their clinical and research expertise to treatment of patients.
The clinic plans to have an open house from 11 a.m. to 1 p.m. on Oct. 11.