This prospective study focused on elderly patients with hip fractures progressing from an acute rehabilitation unit to home care, with and without case management. The intervention included case managers in both settings and care planning tools. The case managed group evidenced shorter lengths of stay on the rehabilitation unit and reduced resource utilization in home care while maintaining functional outcomes as measured by the Functional Independence Measure (FIM). The use of case management allowed two unaffiliated institutions to improve communications and maintain patient care outcomes across a portion of the post-acute continuum of care.
Phillips: Instructor, Harvard Medical School, Department of Physical Medicine and Rehabilitation, Director, Outpatient Medical Services, Spaulding Rehabilitation Hospital, Boston, Massachusetts; Landis Abrandt: Director of Rehabilitation Services, Hudson Valley Hospital Center, Peekskill, New York; Cesta: Director of Case Management, St. Vincent's Hospital and Medical Center, New York, New York, Director of Case Management Programs and Adjunct Professor, Pace University, Pleasantville, New York; Gallucci: Academic Faculty Associate, Program in Physical Therapy, New York Medical College, Valhalla, New York
The authors gratefully acknowledge the Visiting Nurse Services of New York (VNSNY) Center for Home Care Policy and Research, Penny Hollander Feldman, PhD, Director; and Beth Israel Medical Center (BIMC), Department of Physical Medicine and Rehabilitation, Erwin Gonzalez, MD, Director; for spearheading and supporting the project. We also thank Ilene Wilets, PhD, for the statistical analysis, Carol Samuels, SPT, New York Medical College, for literature reviews, and all the staff at VNSNY and at BIMC including Margaret Putnam (project manager), Roger Herr, Jennifer Ash, Laura Taylor, Annette Rivera, Chantell Dalpe, Christine DeCapua, and John Personius. All were critical to the project's success. A grant from the Beatrice Renfield Division of Nursing Education and Research Grant supported this project at Beth Israel Medical Center.