Programs

Orthopedic Rehabilitation Program

 

Orthopedic Rehabilitation Program Description

The goal of Burke’s Orthopedic Rehabilitation Program is to return you home ready to resume an active, productive lifestyle following an orthopedic injury or surgery. Most of our patients return home within one or two weeks. We serve adolescent through elderly patients with diagnoses such as bilateral hip and knee replacements, complicated single joint replacements, hip resurfacing, lower extremity fractures and multiple traumas. 

Within a safe, secure and structured environment, Burke offers intensive therapy seven days a week. Your schedule will be determined by your individual needs and goals. As a patient in any of Burke's inpatient programs, you will receive a minimum of 3 hours of therapy a day, 5 days per week, generally Monday through Friday, and additional therapy on Saturday and/or Sunday for at least 1.5-2 hours. Skilled therapy will be provided in a combination of physical therapy and occupational therapy and/or speech therapy as needed.  Rehabilitation nursing and access to a physician are available 24 hours a day, seven days a week.

 

Scope of Services 
The orthopedic program provides care to all patients admitted secondary to musculoskeletal dysfunction resulting in decreased functional ability. Patients present post surgically or following traumatic injury to the musculoskeletal system and require the level of care provided by an acute rehabilitation hospital. 

The Orthopedic Team is committed to ensuring that each individual’s needs are addressed by:

  • Providing rehabilitation through an interdisciplinary approach that emphasizes communication, collaboration and cooperation
  • Lessening limitations of activities by focusing on the individual’s capabilities and utilizing compensatory strategies and devices
  • Providing the highest quality, patient focused rehabilitation
  • Removing or lessening restrictions to participation in life situations to the extent possible
  • Providing counseling to the individual and family and/or caregiver on alternative possibilities for life participation when necessary
  • Preparing the individual, family and/or caregiver to make the transition to the next stage of the rehabilitation process

Cultural and religious needs are respected for each patient by the entire team. Accommodations to the patient’s schedule, dietary needs and requests, and the provision of appropriate equipment are provided to enhance the patient’s experience and support full participation in the rehabilitation program. All staff members participate in annual cultural diversity and sensitivity training. 

The Orthopedic Program serves patient populations from adolescence through geriatric. Over the past two years, the ages for the persons served has ranged from 19 to 101. Diagnoses of patients served include Unilateral and Bilateral Total Joint Arthroplasty, Uni-compartmental Knee Replacement and Hip Resurfacing, Lower Extremity Fracture with or without Fixation, Multiple Trauma, and Spinal Surgery.

In 2016 and 2017 the Orthopedic Team:

  • Served 783 patients ranging in age from 19 to 99 years old
  • Discharged patients to the following settings:
  • 88.6% (694) of the patients returned home with outpatient or home care services.
  • 7.15% (56) of the patients continued therapy at a sub-acute rehabilitation or skilled nursing facility.
  • 4.2% (33) of the patients returned to the acute care hospital.

Within the scope of the orthopedic program, patient evaluation and care planning are designed around traditional medical disablement models. These models assess three levels of dysfunction which stem from the patient’s admitting diagnosis (pathology). 

Impairments: Weakening, damage, or deterioration of function within a specific component of the musculoskeletal system, especially as a result of injury or disease.

Examples: Decreases in strength, active range of motion, passive range of motion, cognition, balance, and/or activity tolerance along with increases in pain and/or edema. 

Activity Limitations: The inability to perform a specific task as a consequence of the impairments mentioned above. 

Examples: Difficulty with ambulation, stair negotiation, dressing, grooming or self-care.

Participation Restrictions: The cumulative effect of impairments and activity limitations on the ability of a person to participate in life roles. 

Examples: Inability to perform duties as a parent, caregiver, employee or participant in social and leisure activities

Team Description
Led by Dr. Ellen Gitler, Dr. Maria Briones or Karen Pechman, M.D. the professionals on your interdisciplinary care team will assess your medical and rehabilitation needs and work with you to establish your individual goals. In close collaboration, the team designs and implements your treatment program. The physician monitors the overall team process and outcome. Throughout your treatment, the entire team meets formally once per week to discuss your progress. 

The philosophy of the Orthopedic Program is that the program’s mission can best be accomplished by providing rehabilitative care through an interdisciplinary team approach.

The team consists of the following:

  • Individual with orthopedic injury/surgery
  • Individual’s family and/or caregiver(s)
  • Physician
  • Rehabilitation Nursing
  • Occupational Therapy
  • Physical Therapy
  • Recreation Therapy
  • Social Work/Case Management
  • Nutrition

Additional services available to meet the needs of each individual patient include:

  • Medical consultations (Podiatry, Urology, Plastics, ENT, Dermatology, etc.)
  • Pastoral care
  • Orthotic/Prosthetic services
  • Pharmacy
  • Psychiatry
  • Radiology
  • Laboratory services
  • Complimentary therapy
  • Wheelchair seating/positioning
  • Peer support

From admission through the discharge planning process, team members work collaboratively with each other, the individual with orthopedic diagnoses and the family and/or caregiver(s) to ensure that the specific needs of each individual are addressed. Patient and family and/or caregiver involvement and participation is strongly encouraged throughout the entire rehabilitation process.

Based on the results of the initial assessment, goals are determined with the individual and/or family, and a treatment plan is implemented. The individual’s progress is discussed formally once per week at team conference/medical rounds. Team consultation and collaboration occur throughout the treatment program. In addition to speaking directly with members of the team regarding the patient’s medical condition, progress, functional status and participation in therapy, achievement of established goals, family members and/or caregivers are strongly encouraged to attend and participate in treatment sessions and patient care as appropriate.

Patient and Family/Caregiver Education
Ongoing patient and family/caregiver education is the first priority for all of Burke's programs. Family members and caregivers are encouraged to attend and participate in treatment sessions and patient care as appropriate. Each interaction with therapy and social work should serve as educational, and additional education classes and materials may be provided. In order to maximize the benefit, education will be diagnosis-specific with a focus on functional independence, adherence to precautions, progress and well-being. Dependent upon need, individual sessions may be dedicated to family training, during which a therapist will train family members in the appropriate provision of care and assistance for mobility, self care or exercise performance.  

Diagnostically exclusive educational classes will be held for all patients. Classes will exist for total knee replacement, total hip replacement and fracture. These sessions will be used to provide educational materials, encourage group discussion and group problem solving and serve as support sessions. 

Admission Criteria
Every potential patient who may benefit from our care is discussed with the screening staff, physician, and/or program director. The rehabilitation potential for every patient is evaluated prior to admission.  In 2017, 440 patients were admitted to the Orthopedic program.

Screening Process: 
Referrals to Burke are usually made by physicians, social workers, discharge planners or case managers. A reasonable medical and functional profile must be provided and appropriate sections of the medical record from the acute care process are included. A rehabilitation nurse may also perform a detailed evaluation at the referring institution. Recommendations are then made to the appropriate member of the medical staff who renders a final decision with regard to admission.

Discharge Planning
The discharge planning process begins when the patient is first admitted to the program. The social worker/case manager leads the planning process, coordinating information from all members of the interdisciplinary team and acting as the primary liaison between the team and the patient and family. Based on the individual’s functional status for self-care, mobility and other daily life skills, family/caregiver support, medical needs, pre-morbid living situation and level of function, and available health insurance, the team, in collaboration with the patient and family, makes recommendations for the most appropriate and suitable discharge plan for the patient. At the team or family’s request, a meeting with the team and patient/family is scheduled to discuss available discharge options. The patient’s and family’s preferences are of primary concern and the team will make recommendations for a safe discharge when options for continued care and rehabilitation are considered. 

Recommendations may include, but are not limited to:

  • Home with home care services
  • Home with outpatient services
  • Sub-acute rehabilitation services
  • Long term care services
  • Hospice services

Financial Information
For information regarding fees and insurance, please click here.

Location
Located in White Plains, New York, Burke Rehabilitation Hospital's Orthopedic Rehabilitation Program attracts orthopedic patients from Westchester County, New York City, Long Island, Northern New Jersey, and Connecticut. Burke also welcomes orthopedic patients from across the country and around the world.

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Orthopedic Program Outcomes

See how our Orthopedic Program has impacted patients' lives.

What Our Orthopedic Rehabilitation Patients Are Saying

Read about the experiences of former orthopedic rehab patients.

Susan Feingold-Klepper