Outcomes 2016 - Baylor Hamilton Heart and Vascular Hospital FY 2016 | Page 60

The pioneering work that Baylor Hamilton Heart and
Vascular Hospital Cardiac Rehab professionals have done in
developing the “Keep Your Move in the Tube” program has
been recognized by other health care organizations around
the country. A Florida-based integrated delivery system has
embraced the program and integrated it into its cardiac rehab
curriculum, as has an Austin-based healthcare organization.
These organizations are joining with three Baylor Scott &
White Health facilities, including Baylor Hamilton Heart and
Vascular Hospital, to conduct additional studies to further
demonstrate the clinical effectiveness of the concepts taught in
the program.
“Traditional sternal precautions, given to sternotomy patients
as a part of their discharge education, are intended to help
prevent sternal wound complications,” explains Adams.
“They vary widely, but generally include arbitrary load and
time restrictions (lifting no more than a specified weight
for up to 12 weeks) and may prohibit common shoulder
joint and shoulder girdle movements. Having observed the
negative effects of restrictive sternal precautions for many
years, our research team performed a series of studies that
measured the forces exerted during various common activities
and their relationship to the sternum. The results, though
informative, led us to realize that the goal of identifying
‘the’ appropriate load restriction to prescribe for sternotomy
patients was futile. The alternative approach that we developed
with “Keep Your Move in the Tube” introduced and applied
standard kinesiological principles that teach patients how
to perform load-bearing movements in a way that avoids
excessive stress to the sternum. The approach is based on the
ergonomics that shorten the length of the outstretched arm
(lever arm reduction), it enables patients to perform previously
contraindicated movements. We allow patients to resume their
normal load-bearing activities at their own pace, within pain-
free limits, as long as they stay ‘in the tube.’”
Adams says that frequently the health care journey for many
sternotomy patients has been hospital to skilled nursing facility
to cardiac rehabilitation. “Traditional sternotomy restrictions
have limited patients’ abilities to do things for themselves, so
s killed nursing filled in the gap until they were strong enough
to enter cardiac rehab,” she says. “‘Move in the Tube’ has
enabled patients to regain their strength faster, in many cases
eliminating the costly and time-consuming step of going to
skilled nursing, enabling them to immediately begin cardiac
rehabilitation. Not only does this save money, it improves the
patient experience and the outcomes patients are able
to achieve.”
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While the Baylor Hamilton Heart and Vascular Hospital
Cardiac Rehabilitation program is innovative, it also uses the
traditional approach of three sessions per week for a prescribed
number of weeks. The cardiac rehab team is passionate about
measuring milestone metrics to gauge progress and adjust
exercise plans.
The numbers tell the story of the success that patients are
experiencing from the Baylor Hamilton Heart and Vascular
Hospital cardiac rehabilitation program. Inpatient visits grew
an impressive 78.8 percent from 2015 to 2016, totaling 833.
Outpatient visits also increased by 20.7 percent to a total of 8,878.
“At the heart of our success in cardiac rehabilitation is our
great team of physicians, nurses and therapists, dedicated to a
common purpose – to help the patient and his or her family
return to what they want and need to do as much as possible,”
says Adams. “We’re excited about the future and we look
forward to improving the lives and hearts of our patients.”
8,878
Outpatient visits (FY16)