Development and Evaluation of an Inpatient Rehabilitation Model of Care Tailored to Solid Organ Transplantation

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-09-24 DOI:10.1111/ctr.70324

Mindi R. Manes, Heather A. Kendall, Mark G. Bowden, Chloe E. Bailey, Trevor Paris, Joanne S. Hoertz, Parag Shah, Kerry Maher

{"title":"Development and Evaluation of an Inpatient Rehabilitation Model of Care Tailored to Solid Organ Transplantation","authors":"Mindi R. Manes, Heather A. Kendall, Mark G. Bowden, Chloe E. Bailey, Trevor Paris, Joanne S. Hoertz, Parag Shah, Kerry Maher","doi":"10.1111/ctr.70324","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Postoperative rehabilitation is essential to post-transplantation recovery and a key component of comprehensive transplant care, with inpatient rehabilitation providing intensive, interdisciplinary support to restore function and enhance quality of life. In 2019, the Brooks Rehabilitation Transplant Program (BRTP) was implemented to address the specialized rehabilitation needs post solid organ transplantation as an interdisciplinary, comprehensive, and tailored model of care.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Five main pillars comprise BRTP: (1) organizational commitment; (2) collaborative relationship with acute care providers; (3) early identification of appropriate patients; (4) interdisciplinary rehabilitation care tailored to transplant needs; and (5) continuous evaluation of quality outcomes. A retrospective observational cohort study evaluated both implementation and clinical outcomes over the program's first 5 years. Implementation outcomes included feasibility, fidelity, and sustainability. The primary clinical outcomes were changes in the CMS standardized functional assessment Section GG Mobility and Self-care scores. Wilcoxon signed rank sum test was used to compare admission and discharge scores. Secondary outcomes included IRF length of stay, discharge to community, acquired pressure injuries, falls, and feeding tube removal.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Between January 2019 and December 2023, 202 solid organ transplant patients participated in BRTP. For the 154 completing their inpatient rehabilitation facility (IRF) stay, significant functional improvements were observed for the Section GG Mobility and Self-Care composite scores and across all individual functional items (<i>p </i>< 0.001). Ultimately, 82% of the cohort discharged to community, with eight returning to inpatient rehabilitation following an acute readmission and zero patients acquiring a pressure injury. Implementation outcomes indicated that the program was feasible, delivered with fidelity, and demonstrated sustainability over time.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The BRTP provides effective, sustainable, evidence-based approaches to improve function and quality outcomes following transplantation.</p>\n </section>\n </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 10","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Transplantation","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ctr.70324","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Postoperative rehabilitation is essential to post-transplantation recovery and a key component of comprehensive transplant care, with inpatient rehabilitation providing intensive, interdisciplinary support to restore function and enhance quality of life. In 2019, the Brooks Rehabilitation Transplant Program (BRTP) was implemented to address the specialized rehabilitation needs post solid organ transplantation as an interdisciplinary, comprehensive, and tailored model of care.

Methods

Five main pillars comprise BRTP: (1) organizational commitment; (2) collaborative relationship with acute care providers; (3) early identification of appropriate patients; (4) interdisciplinary rehabilitation care tailored to transplant needs; and (5) continuous evaluation of quality outcomes. A retrospective observational cohort study evaluated both implementation and clinical outcomes over the program's first 5 years. Implementation outcomes included feasibility, fidelity, and sustainability. The primary clinical outcomes were changes in the CMS standardized functional assessment Section GG Mobility and Self-care scores. Wilcoxon signed rank sum test was used to compare admission and discharge scores. Secondary outcomes included IRF length of stay, discharge to community, acquired pressure injuries, falls, and feeding tube removal.

Results

Between January 2019 and December 2023, 202 solid organ transplant patients participated in BRTP. For the 154 completing their inpatient rehabilitation facility (IRF) stay, significant functional improvements were observed for the Section GG Mobility and Self-Care composite scores and across all individual functional items (p < 0.001). Ultimately, 82% of the cohort discharged to community, with eight returning to inpatient rehabilitation following an acute readmission and zero patients acquiring a pressure injury. Implementation outcomes indicated that the program was feasible, delivered with fidelity, and demonstrated sustainability over time.

Conclusion

The BRTP provides effective, sustainable, evidence-based approaches to improve function and quality outcomes following transplantation.

Abstract Image

查看原文本刊更多论文

针对实体器官移植的住院康复护理模式的开发与评估。

术后康复是移植后康复的关键，也是综合移植护理的关键组成部分，住院康复提供密集的跨学科支持，以恢复功能和提高生活质量。2019年，布鲁克斯康复移植计划（BRTP）实施，以解决实体器官移植后的专业康复需求，作为跨学科，全面和量身定制的护理模式。方法：BRTP由五个主要支柱组成：(1)组织承诺；(2)与急症护理人员的协作关系；(3)早期识别合适的患者；(4)针对移植需求的跨学科康复护理；(5)质量结果的持续评价。一项回顾性观察队列研究评估了该项目前5年的实施和临床结果。实施结果包括可行性、保真度和可持续性。主要临床结果是CMS标准化功能评估部分GG活动能力和自我保健评分的变化。采用Wilcoxon符号秩和检验比较入院和出院评分。次要结局包括IRF住院时间、社区出院、获得性压力损伤、跌倒和拔除饲管。结果：2019年1月至2023年12月，202例实体器官移植患者参加了BRTP。对于完成住院康复设施（IRF）住院的154名患者，在GG活动度和自我护理综合评分和所有单项功能项目中观察到显著的功能改善(p结论：BRTP提供了有效、可持续、基于证据的方法来改善移植后的功能和质量结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.