Program Updates

Craig receives national award for outstanding quality
Tops all rehab hospitals for quality, patient outcomes, and sustained improvement

On January 27 the American Nurses Association (ANA) honored Craig Hospital in the Rehabilitation Hospital category for achieving outstanding nursing quality, based on the nursing performance measures they collect and report to ANA’s National Database of Nursing Quality Indicators® (NDNQI®), the only national database of nursing quality indicators. The awards were announced at the 5th annual NDNQI Conference in Miami, Fla., attended by more than 1,000 nursing and health care quality leaders.

Craig Hospital and the four other hospitals who received the 2010 NDNQI Award for Outstanding Nursing Quality® were identified for top performance from among the more than 1,700 hospitals that report their results to NDNQI. NDNQI represents one of every three hospitals nationwide, and their database allows individual nursing units to compare their performance to similar units at other hospitals at the local, state, regional, and national levels. Craig and the other award winners demonstrated superior results and sustained improvement in patient outcomes and high nurse job satisfaction on the broad range of nursing-sensitive performance indicators tracked by NDNQI, such as hospital-acquired pressure ulcers, patient falls with injury, infections acquired as a result of hospitalization, and nurse turnover.

“Quality and satisfaction are never an accident. It takes dedication, perseverance, and hard work. Craig nursing continuously demonstrates quality data results and high nurse satisfaction. Commitment to a ‘world-class’ experience for our patients and a superior work environment for our staff has resulted in Craig nursing receiving the 2010 NDNQI Quality Data Award,” says Diane Reinhard, Craig’s vice president of patient care services, who was present in Miami to receive the award. “I am very grateful to NDNQI for the recognition of our amazing nursing department.”

ANA President Karen A. Daley, PhD, MPH, RN, FAAN, says, “The common traits of the award-winning hospitals are strong leadership, teamwork, commitment to ongoing improvement in patient care quality, continuous staff education, and efficient use of resources.”

NDNQI, a program of ANA’s National Center for Nursing Quality® (NCNQ®), was established in 1998. In any given quarter, more than 15,000 nursing units report performance data. This data not only provides links between patient outcomes and the quality of nursing services, but also can indicate connections between patient outcomes and nurse staffing levels, education, and skills, leading to more effective staffing plans. NDNQI also measures nurse satisfaction through a Work Environment Survey. In 2010, Craig nurses scored 67.9 on the survey, not only exceeding the overall national average, but also exceeding the average among nurses in Magnet® designated hospitals.

Craig nursing hosts 6th annual research symposium

Craig Hospital hosted the 6th annual Research Symposium on February 24. As part of our dedication to providing our patients and families with high quality care, we recognize the importance of advancing and broadening the research available regarding the challenges faced by our patients every day. The Research Symposium is a chance to showcase, share, and brainstorm about research and evidence affecting our patients as well as to learn more about the research process.

Nursing and ancillary departments shared quality improvement projects and research results through colorful, high-quality posters displayed during the event. Nursing posters included the following: a falls improvement project that has resulted in no falls with injury on 2-West since the project was initiated, a project comparing changes in blood pressure readings with different-sized cuffs on patients emphasizing the importance of using the correctly sized cuff, information comparing different home mattress surfaces for spine patients, an evaluation of the literature on best practices for central lines, and many others.

Our invited keynote speaker, Patsy Cullen, PhD, CPNP, shared stories from the trenches about her personal experience with bedside nursing research and encouraged Craig nursing to continue to seek out and engage in bedside research. Many times one thinks of a laboratory with vials and beakers when referring to research, but the nursing field is backed by many qualitative and quantitative studies that compel us to understand experiences of patients and families and how we as nurses can affect and improve outcomes.

Symposium participants learned about the amazing research going on at Craig, as well as information about how to write a grant for funding, and how to write an abstract for presentation to a conference or for journal publication. Craig’s nursing department will continue to honor our
commitment to quality patient care by seeking out and understanding research and its importance to the patients and families we serve.
—Lisa Shelton, RN, BSN, CRRN, Magnet® program and special projects coordinator

Save the date! 2012 Brain Injury Summit

Mark your calendars! Craig is hosting a cutting-edge, unique TBI conference January 9-11, 2012, in Beaver Creek, Colo. — the 2012 Brain Injury Summit. This high-level conference is designed for experienced professionals: physicians, providers, clinicians, researchers, insurance executives, public policy executives, TBI administrators, attorneys, and others. The conference program will include tracks in acute care, clinical rehabilitation, community reintegration, lifelong living, and applied research. Program formats will include keynote presentations, plenary and panel presentations, breakout sessions, poster presentations, roundtables, exhibits, sponsorships, and networking opportunities.

Update from Craig’s adaptive technology lab

Looking for the latest and greatest things offered by the world of technology? Tech Lab has its finger on the pulse! Craig’s Mark McKenzie Tech Lab is staffed by specially trained occupational and speech therapists and provides hands-on education and training for Craig patients and families about the most current equipment, software, and technical devices on the market. Such equipment has value in improving safety, decreasing attendant care, helping return to work, and raising quality of life.

Cell Phones
These days everyone uses cell phones to connect to the world, and it’s no different for someone with a brain or spinal cord injury. Cell phones have a vast number of capabilities beyond calling and texting. With cell phone access, patients can call for help in case of emergency which can be invaluable to individual independence. New apps can also assist with memory, organization, and hands-free operation. Tech Lab offers expertise for a wide range of phones from basic flip phones to the latest iPhone and Android smart phones. When physical access to a phone is challenging, Tech Lab can help determine solutions for accessing touch screens, using bluetooth headsets, and taping into speech recognition apps.

Computer Access
Want to check email? Let Tech Lab show you how! Patients in Tech Lab learn ways to access a mouse and keyboard and simplify their computer screen so they can rejoin the cyberworld. Tech Lab specialists also stay current with developments in speech recognition software for Mac and PC that enable patients to surf the Web, send emails, and create documents simply by using their voice.

Augmentative Communication
Life can be frustrating when people are trying to guess what you’re saying. For those who are unable to communicate with their voices, augmentative and alternative communication devices can be essential to getting daily needs met. Tech Lab helps patients explore everything from low-tech options such as communication boards to high-tech Dynavox and iPad options to find the best fit.

Environmental Controls
For those who are tired of sleeping with the light on because the light switch is out of reach or are tired of having someone else change the TV channel, Tech Lab may have the solution. Tech Lab teaches patients how to control aspects of their home environment such as the television, door, lights, and more via touch switch, sip-and-puff switch, or voice control. An electric door opener can be essential for independence when trying to exit the house in case of an emergency if a person is unable to open a door. Smart phones and iPads can now also be used for environmental control. Tech lab educates patients and families about a wide range of options to best fit individual needs.

Future
The world of adaptive technology changes daily. Tech Lab is continually striving to increase our knowledge through collaborations with local universities and engineers, by attending technology conferences, and by learning from our patients. Tech Lab specialists are excited about the progress of speech recognition, the future of smart phones and apps, and the advancements of home automation that will help patients in all aspects of life.

Tech Lab provides individualized and group therapy services by appointment. Grants and generous contributions from donors help support Tech Lab operations. If you would like to contribute, please visit www.craighospital.org/foundation. If you have any tech questions or suggestions, please email techlab@craighospital.org.

Time for an Adventure!

Once again, thanks to help from grants and community donations, Craig is offering a wide variety of exciting summer trips and adventures for Craig graduates and their family/friends. This year’s adventures include:

• Apostle Islands, Lake Superior wilderness inquiry trip
• Coffeman Cove, Alaska fishing lodge fly-in trip, for the hearty
• South Dakota Black Hills trip, treehouse lodging, and more
• Colorado whitewater rafting
• Hot-air ballooning
• Denver activities such as sailing, canoeing, kayaking, handcycling, and other team sports
• Hobie Day: July 29 (mark your calendar!)
• Trish Downing Women’s Wheelchair Camp in Empire, Colo.: August 18-21
• Adaptive fishing trips in Wyoming and Montana
• Jam the Damz Bike Ride, Littleton, Colo.: September 24

Join us! For more info, see www.craighospital.org/TREC or email Claire Cahow at ccahow@craighospital.org.

Craig achieves Magnet® status, again
Continues distinguished record of nursing excellence

For the second time in five years, Craig Hospital was awarded the prestigious Magnet®designation by the American Nurses Credentialing Center. Craig’s first designation was in August 2005. Currently 370 hospitals in the world — including just two free-standing rehabilitation hospitals — have this notable recognition.

According to Lois Kercher, Magnet® commissioner, “Your inviting pictures on your website look like you work hard and play hard. This prestigious award is designated because of the outstanding care that your patients receive as well as your exquisite teamwork. You are one of seven designated hospitals in the state of Colorado, and are unique in your field of spinal cord and traumatic brain injury rehabilitation. Your reputation is well known, and Mike Fordyce’s comment on your website, ‘the longevity of staff at Craig is remarkable…’ says it all. Congratulations!”

During the Magnet® site visit in January, the SCI Nurse Advice Line, developed by Craig nurses, was cited as one example of innovation, application of evidence-based practice, and quality patient care.

“Providing quality care is a priority for Craig Hospital,” says Diane Reinhard, RN, BSN, MBA, MSCS, CRRN, NE-BC, vice president of patient care services and chief nursing officer at Craig. “In the nursing department, we have worked hard to operationalize our shared governance model and demonstrate to our Magnet® appraisers that we are Craig! It is a great honor to receive this designation and it’s a validation of the commitment of the nursing program here.”

Jeanine Rundquist, RN, MSN, CRRN, Magnet® program and clinical scholar coordinator, says, “Achieving redesignation is a wonderful reflection of the dedication of the entire interdisciplinary team in achieving high quality patient outcomes. I am particularly proud of the nursing staff for their continued focus on excellence.”

The Magnet Recognition Program® was created in 1990 by the American Nurses Credentialing Center to recognize healthcare organizations that provide the highest quality nursing care and uphold the traditions of professional nursing practice.

Craig held a hospital-wide barbecue for staff, patients, and families in August to celebrate this tremendous award.

Leading the way: Introducing three special new programs at Craig

Equine experience
A horse? Of course!

Patients with spinal cord injury who are almost ready to be discharged from Craig, and who are interested in trying something new, now have the opportunity to interact with horses. An adjunct to standard patient education, the new equine program is an interdisciplinary education outing that pairs each patient with a horse handler and therapist as an additional way to address personal issues and attitudes, knowledge, and skills needed for life after rehabilitation.
“Horses are big! Learning about safety, reading their language, and learning from them offers many possibilities. As an educator, I see working with horses as an experiential opportunity for learning lessons of life,” says Terry Chase, MA, ND, RN, coordinator of patient and family education, who has developed the project over the past two years. Terry is also completing training through the Gestalt Equine Institute of the Rockies.

The program is a coordinated effort between patient education, therapeutic recreation, and physical and occupational therapy. Participants learn horse handling and grooming, barn rules, personal safety, groundwork leading, and more.

Four patients have participated so far, and all four recommend that others have the opportunity. Sessions are held at the SaddleUp! Foundation in Parker, Colo., just south of Denver. The program is appropriate for patients with any level of spinal cord injury who have completed all SCI LifeStyles or Tetra Topics classes, who are medically stable, and who have the ability to be in a manual wheelchair for three hours.

For more information, please contact Terry at tmchase@craighospital.org or 303-789-8211.

Child care training

Like so many people who come to Craig following a traumatic injury, Chinda Misra, ’96, Toledo, Ohio, learned a great deal — how to get around, how to care for herself, how to ask for help when she needed it. Later, as she and her husband started a family, she found she could learn physical skills for caring for children at Craig, too.

“Raising a child is a daunting proposition for anyone, and raising a child from a chair at first thought might be out of the question,” Chinda says. “But working with you at Craig made it feel very achievable.”

Guiding patients toward independence in self care and improving functional potentials in all aspects of their lives, including how to care for their children, has always been a focus of occupational therapy at Craig. But in 2009, a long-time dream of Nena Robbins, OTR, came true — establishing a formal child care training program with accessible child care equipment and a designated space for the practical development of child care skills.

Through the efforts of Craig Hospital’s child care work group (Holly Anderson, OTR; Dana Boyster, COTA; Michelle Graf, OTR; Lorraine Keeth, OTR; Jeanine Lucas, COTA; and Jennifer Phillips, OTR; along with Nena who retired in January after 43 years at Craig), the hospital dedicated a room for child care training and purchased accessible equipment. A number of Craig’s former patients donated adapted equipment, as well. Our patients now can experiment with various carriers, cribs with slide rails and swing-out gates, a feeding/bathing table with adjustable height, a changing table, and bathing tubs. Additionally, patients have access to DVDs, a resource notebook, and a network of alumni who are able to share their parenting experiences.

“Our child care training room is one more element that adds to the many excellent, innovative programs available to Craig patients,” Nena says. “It’s unique, practical, and very important.”

Patients have expressed much gratitude.

“My memories of early motherhood will forever be linked with the memory of the wheelchair-accessible equipment Nena designed,” Chinda continues. “I’ll never forget your compassion and quiet determination in helping me create what I needed to function as a mom.”

Stephanie Martinez, ’09, Pueblo, Colo., says, “The sleeper really helped me with managing my baby, Derek, through the night and to have him close to me. The DVDs and Nena’s suggestions were such a good resource.”

We encourage Craig Hospital alumni who are parents to share tips and suggestions with us and with each other. Stop by the child care training room next time you are at Craig.

Graduate liaison

Attention, Craig grads: We hear you loud and clear!
Mike Fordyce, Craig’s president, has created the new administrative position of graduate relations coordinator — based on important feedback from our graduates, professional colleagues, staff, and the community at large. After an interview process with some great candidates, Craig alum Chris Chappell was hired.

Chris, who lives in the Littleton, Colo., area, sustained a C6-7 injury in a mountain bike accident in 2000 and quickly returned to his career in finance after his rehab at Craig. Over the past decade he has volunteered at Craig as a peer mentor and re-entry speaker. He recently retired from his finance career to pursue this opportunity, and we’re pleased to congratulate him on this new venture.

Chris says he is excited about this new chance for Craig to further forge relationships with inpatients, outpatients, and graduates, and to work inside and outside the hospital to help Craig serve our community better. Away from work he enjoys his backyard of Colorado, four-wheeling, family, friends, and traveling. He would love to hear from Craig alums! Email him at cchappell@craighospital.org.

Colorado School of Mines and Craig Hospital join forces in adaptive technology

Engineering students from the esteemed Colorado School of Mines teamed up with Craig staff this year to begin work on projects to assist Craig’s patients and former patients.

Students formed three groups. One designed a switch-activated trigger device for the sip-and-puff rifle. Another designed an updated version of the current pan-and-tilt rifle platform. The third group designed — and made! — a completely new and different fishing pole, using a paint ball gun, and have taken Craig patients fishing with it. All students will take their ideas into their senior design projects for further development and manufacturing.

The engineering students worked closely with Robert Knecht, School of Mines professor; Dave Birkle, Craig rehab engineer; Amanda Carr, OTR, Craig occupational therapist; and Peter Pauwels, fishing guru and Craig volunteer.

Due to the success of this collaboration, a new group of sophomore students will start this fall to begin work on developing other projects to benefit Craig patients.

Annual Motor Sports Day, with a twist

The 18th Annual Craig Hospital Motor Sports Day was held at Bandimere Speedway on August 26. In addition to the regular highlights, this year’s event featured wheelchair drag races on the track — a first at Bandimere, we think! A new wheelchair was presented to former Denver firefighter Walt Salazar injured recently in a motorcycle accident (see related story on the back cover). Corey Fairbanks organized the event, and proceeds went to the Craig Paralympic Sports Club. Thanks to all for a fun day, and special thanks to John Bandimere, Fineline Graphics, and Cruisin’ Productions. For more, see www.craigparasport.org/EVENTS.html.

Exciting and new

Here’s what’s cooking: Remodeled training kitchens
Craig’s training kitchens in the 2nd and 3rd floor treatment gyms were remodeled this year and are fantastic! Patients use the kitchens to practice meal preparation skills and safety, and also gain ideas they may use to remodel their own kitchens at home.

Craig hosts its first-ever respiratory therapy conference
In an effort to give back to the community, Lonnie Martinez, RRT director, and the Craig respiratory therapy department teamed up with the Metro Chapter of the Colorado Society for Respiratory Care and Swedish Medical Center to host the first-ever respiratory therapy conference at Craig Hospital on August 26. Quite well received, it sold out within six days.

Lonnie opened the conference and also spoke on diaphragmatic pacing. Darlene Dumont, RRT, spoke on VCO2 and NICO monitoring; Brigitte Trace, RRT, on “giving your patient a voice”; and Tera Chalupa, RRT, on high volume ventilation and study protocol.

Craig’s respiratory therapy department is renowned in Colorado and throughout the U.S.

SCI Nurse Advice Line awarded grant from Paralyzed Veterans of America

Diedre Bricker, RN of the SCI Nurse Advice Line, accepted a grant from Mark Shepherd, Sr. of the Paralyzed Veterans of America. The funds help support this free nationwide service.

Craig a Colorado leader in youth sports concussion issue

Concerned about youth sports concussions in Colorado, Craig’s Don Gerber, PsyD,
founded the Colorado Youth Sports Concussion Special Interest Group (SIG) within the Brain Injury Association of Colorado (BIAC) in November 2009. Dr. Gerber invited Kenny Hosack of Craig and Gavin Attwood of BIAC to help him co-chair the SIG, a volunteer group of Colorado physicians (including Craig’s Dr. Alan Weintraub), psychologists, certified athletic trainers, nurses, educators, Colorado High School Activities Association representatives, coaches, attorneys, parents, and advocates. The purpose of the SIG is to study the issue of concussion in youth sports in Colorado; to develop a network of concussion experts and resources; and to make recommendations to BIAC, CHSAA, school districts, private clubs, coaches, certified athletic trainers, educators, nurses, parents, athletes, legislators, and the general public. For more information, see www.biacolorado.org/resources/sports_concussion.

Donald T. Stuss, PhD, delivers 33rd annual John S. Young lecture

Donald T. Stuss, PhD, of The Rotman Research Institute of Baycrest at the University of Toronto, delivered the prestigious John S. Young lecture to the Craig staff in September. His state-of-the-art presentation, “Is There a Dysexecutive Syndrome? Evidence from Focal Lesion Research, and Application to Rehabilitation,” captured the interest of all.

Photo Left to Right  Alan Weintraub, M.D.  Dr. Stuss, Tom Balazy, MD. Dr. Jim Schraa

A new van for driver’s training

Craig Hospital’s adaptive transportation/driving program recently received a new trainer van for our fleet.

This was made possible through a program with BraunAbility and Freewheel Mobility Solutions established in 2005. It allows for a van to be provided to Craig at little-to-no cost, and replaced every two years. Braun provides the van and completes actual structural vehicle conversions to make it wheechair accessible. Freewheel donates the adaptive driving equipment.

Craig’s van is a lowered floor wheelchair accessible vehicle, fully equipped with mechanical hand controls, variable effort steering, and a variety of steering devices. The van is used regularly throughout the week to complete rehab driving evaluation/training programs. It is also used often in demonstration to help patients and families deternube their best options for safe passenger transportation. This vehicle allows Craig Hospital to be one of the country’s few rehabilitation driving programs that can evaluate and train drivers who must remain in their wheelchairs.

Staffed by three OTR/CDRS (Certified Driver Rehabilitation Specialists), Craig’s adaptive driving program is the only one in a multi-state Western region that has a trainer van fully equipped with an Aevit/EMC high-tech driving system. The program offers the following:

• Full driver’s evaluation and training programs for people with paraplegia, quadraplegia and traumatic brain injury,
• Help with determining best options for wheelchair-accessible vans as either driver or passenger,
• Assistance with adaptive equipment options for personal and wheelchair loading for unmodified vehicles, and
• Help with motor vehicle licensing/permit guidelines, regulations, and compliance for persons with disabilities.

Craig treats patients from 47 states in 2009

Outcomes and service support referral decisions
For decades patients with spinal cord injury and traumatic brain injury have come to Craig each year from virtually every state in the country. Craig has dominated the national referral base for these patients because referring physicians, insurance companies, and case managers value the outcomes our “graduates” achieve and the service they receive at Craig. They understand the value of maximum functional independence and productivity in terms of improved lives and cost-effectiveness of catastrophic injury rehabilitation.

Insurance companies and case mangers also enjoy working with physicians and staff who have worked at Craig for more than two decades, with whom they have long-term relationships and with whom communication is efficient and effective. Referring physicians have confidence in Craig’s specialty expertise in SCI and TBI, and know that their patients and families will be well cared for and achieve maximum outcomes. They know that with the remarkable depth and breath of resources at Craig, the staff and programs address the whole person and family, in all aspects of life.

Craig also sees patients from virtually every state each year because of the more than 27,000 Craig graduates who live all over the world and who are ambassadors about their Craig experience. We appreciate that Craig alumni counsel with newly injured patients and families about the value of specialized catastrophic injury rehabilitation and the benefits of coming to Denver.

Craig patient outcomes are remarkable. The average age of our patients is 37, approximately 80 percent are male, 91 percent are discharged home following Craig, functional independence gain scores average 37 points, and 50 percent of our patients are back to work or school in one year. Ninety-five percent of patients and families were extremely satisfied or satisfied with their overall Craig experience, and 94 percent of staff would recommend Craig as a good place to work to their friends. Considering the horrific nature of these injuries and the difficulty involved with catastrophic injury rehabilitation, these results are extraordinary.

The word “rehabilitation” comes from the Latin “to make able.” Rehabilitation should not be viewed as a cost, but rather as a financial and social investment. It is an investment in people and their families who have been injured, and an investment in society. When individuals reach their highest levels of functional independence, productivity, and community participation after catastrophic injuries, it is a return on investment for that individual, their families, their employer, and society as a whole. Craig maintains its continual commitment to this mission.

Craig Hospital continues leadership and innovation: Ventilator and weaning programs

Spinal cord and traumatic brain injuries often result in insult or injury to the cardiopulmonary system. As a consequence, a host of respiratory problems and/or diseases can ensue. At Craig Hospital, respiratory care is an integral part of the interdisciplinary team dedicated to providing excellence in patient care. When patients experience a high, cervical spinal cord injury, often they are dependent on a ventilator. Craig’s ventilator and weaning program continues as one of the largest specialty programs of its kind in the U.S. Our program has an excellent reputation for weaning patients off ventilators. “Our success in weaning spinal cord injured patients from mechanical ventilation is the result of teamwork between the respiratory staff and the patient,” says James Fenton, MD, pulmonary medical director for Craig. “It highlights the spirit of compassionate quality care at Craig Hospital.” Additional goals of the program include medical stabilization, plus training the patient and family in home care and health management in anticipation of the patient returning home. In fact, 95.2 percent of Craig’s patients on ventilators are discharged to home as opposed to subacute facilities or nursing homes. Craig actively recruits top respiratory care professionals from around the country. Currently, the staff consists of 26 highly skilled therapists, collectively averaging over seven years of service. Many have more than 20 years of service at Craig, and 70 percent have their advanced registry practitioner designation. Each therapist must complete a rigorous orientation process upon hire, and pass annual exams and competencies to maintain employment. Every therapist is certified in Advanced Cardiac Life Support.

Key clinical practices that contribute to Craig’s successes

• Craig’s pre-admission process includes on-site consultation assessment of the patient, as well as preliminary recommendations about pulmonary goals, home discharge plans, equipment for mobility, transportation, ventilation, and tentative timelines and costs.
• Since 1974, Craig Hospital has been recognized as a Model SCI System by the U.S. Department of Education and the National Institute on Disability and Rehabilitation Research. The Model System consists of long-established ventilator and weaning protocols that are continually refined with advances in technology.
• Our physician- and respiratory therapist-led ventilator program development committee consists of specialists from National Jewish Health, named the No. 1 respiratory hospital in the U.S. for 11 consecutive years by U.S. News & World Report.
• SCI and TBI clinical research at Craig Hospital is un-precedented. We are on the edge of a new era in research, and we appreciate the support of administration, physicians, and surgeons for our diverse research agendas.
• We use aggressive and comprehensive airway clearance techniques to improve lung mechanics and gas exchange, and to prevent atelectasis (lung collapse) and infection.
• We use non-invasive carbon dioxide monitoring technology (carbon dioxide is a metabolic byproduct) to access a patient’s ventilatory and oxygenation status. This reduces the need for repeated invasive procedures, such as the drawing of arterial blood gas samples.
• Our hospital-wide alarm system provides constant monitoring of a patient’s condition including ventilator performance and key vital signs.
• Our comprehensive sleep program evaluates and treats patients with sleep apnea so they are adequately rested, ready for therapy, and able to heal.
• Our pulmonary team conducts daily patient rounds to discuss patient progress and treatment and to provide consistent care.
• An interdisciplinary program development forum meets quarterly with goals of investigating and improving ongoing practices, reviewing programs, and developing or enhancing policy and procedural standards.
• Additional monthly patient/family conferences are conducted for each patient with and among physicians, nurses, respiratory therapists, dietary technicians, pharmacists, speech therapists, OTs, PTs, recreation therapists, psychologists, and patient and family counselors.
• We emphasize patient and family training in preparation for home, one-to-one training, group training, video tapes, and manuals.
• Our outpatient clinic allows a continuum of care after discharge and provides a wide range of services. For information, see www.craighospital.org/SCI/reEvaluation.asp.
• We emphasize therapeutic community outings and community reintegration activities. See www.craighospital.org/InfoResources/craigsTRecPrograms.asp.
• Our flight team accompanies many of our patients on a ventilator and their family members home. The respiratory therapist and RN remain with the patient and family at home for several days following discharge.

For more information about Craig’s ventilator program, contact Lonnie Martinez, director of respiratory care, at lmartinez@craighospital.org. Patient referrals to the program should be made to Maggie Rose, RN, admissions director, at 303-789-8344 or admissions@craighospital.org.

Introducing the Chapel Channel

Thanks to the new Chapel Channel, Craig will be better able to meet the spiritual needs of our patients and families. Those who are unable to leave their beds for medical reasons can now experience worship in the chapel from the TV in their rooms. In addition to alleviating recent space issues due to markedly increased attendance, the channel will enhance communication, as it can be used to broadcast announcements of special services, ways to contact the chaplain, and the schedule of Sunday services. Spirituality is very important to many of our patients; it continues to be a central part of their lives while they are at Craig.

Introducing the Craig Hospital Paralympic Sports Program

U.S. Paralympics, a division of the U.S. Olympic Committee, and Craig Hospital have partnered to create the Craig Hospital Paralympic Sports Program and be recognized as an official Paralympic Sport Club. This new community-based sports club will complement Craig’s already extensive therapeutic recreation program and will involve youth and adults with physical disabilities in team sports and physical activity, regardless of skill level. Programs and activities will be based in Englewood and run by Craig. “U.S. Paralympics is dedicated to creating opportunities for individuals with physical and visual disabilities to be physically active in their own communities. Participation in physical activity enhances not only self-esteem and peer relationships, but also results in greater achievement, better overall health, and higher quality of life,” says Mike Mushett, U.S. Paralympics director of community programs. Craig Hospital has been an international leader in recreation and sports programs for decades, including leadership in some of the first competitive wheelchair games in the U.S. and the world back in the 1960s and 1970s. “Craig Hospital is honored and excited to be part of the Paralympics family,” says Mike Fordyce, Craig’s president and CEO. “Last year we had eight Craig-affiliated athletes who competed in Beijing, and we could not be more proud.” U.S. Paralympics is committed to working with community organizations across the country to create 250 Paralympic Sport Clubs by 2012. For more information about the Craig Hospital Paralympic Sports Program, contact Claire Cahow, 303-789-8341 or ccahow@craighospital.org.

Craig implements diaphragm pacing

In an effort to expand its ability to serve patients on ventilators, Craig Hospital’s respiratory therapy (RT) department has become the first program in the region to implement diaphragmatic pacing. The NeuRx™ Diaphragm Pacer System (DPS) is unique technology engineered by Synapse Biomedical Inc. of Oberlin, Ohio. The DPS offers people dependent on ventilators the potential to become ventilator free. Desired results of this new program are less time on a ventilator, increased independence, and reduced risk of respiratory complications. With thorough guidance and education from Synapse Biomedical, Craig’s RT department and physician teams have successfully performed this procedure for seven individuals since November 2008. Craig has also accelerated its independence from Synapse Biomedical over the last few months. As a result, the Craig team performed the last two procedures independently — the only center in the U.S. thus far to do so. The presurgical clearance process requires patients to have a radiologic exam to determine function of the phrenic nerve. Once this test is complete the patient can be assessed for potential implementation. Placement of a diaphragmatic pacer is performed as a laparoscopic procedure in an operating room. Once placed, the pacer uses gentle electrical stimulation of the diaphragm, causing it to contract, creating a more natural form of breathing. The surgery lasts approximately two hours. Following the recovery period, patients are brought directly back to Craig. The weaning process begins within hours of the surgery. The process is strategically focused on increasing the individual’s independence from the ventilator. He or she is admitted to Craig for three to five days to learn how to use the pacer and transition to ventilator-free breathing. If successful, the DPS can potentially replace his or her mechanical ventilator, battery, cables, and tubing. The items are replaced with a diaphragm pacer box that is 6 inches tall, 3 inches wide, and 1.5 inches deep. “I am very enthusiastic about it,” says Kathy Mulledy, RRT, tenured Craig respiratory care practitioner. “Seeing patients whose lives are so compromised, you feel like you have done everything you can for them but they are still on a mechanical ventilator.” She continues, “The first patient I saw with a DPS was a long-time patient at Craig. She initially left Craig on a ventilator but came back with a pacer. When I saw her smiling and breathing on her own, the other respiratory therapist and I were very emotional. We couldn’t believe our eyes. The progress of each person is different, but what I have seen with the DPS is that it makes a huge difference in their lives.” Further testimony of the diaphragm pacer comes from Ned Church, ’09, Burlington, Vt., who recently received the pacer. “As a high-level quadriplegic, I have adapted to life with a ventilator for the past 17 years,” he says. “But for nearly three months now, after having DPS implanted in early June, I am breathing free of the respirator and would describe my experience as life transforming.” Craig’s respiratory therapy department hopes to improve the lives of each patient who is mechanically ventilated by offering this new technology. If you have questions about diaphragm pacing, please contact Lonnie Martinez, director of respiratory care services, at lmartinez@craighospital.org.

Attention, re-eval patients: Know your meds

Craig Hospital’s outpatient nursing staff, in conjunction with Craig’s pharmacy staff, is participating in a national educational campaign intended to help people understand and use their medications more efficiently. Our goal is to help you protect yourself, by teaching you how to be an active partner in your medication program. You cannot depend on all health care providers being well acquainted with your history and health conditions. Some drugs used by SCI and TBI patients have different uses than are commonly seen by most providers, and you must be able to explain why you are using these medications. Most importantly, always have your personal information and medicine list with you. Keep it on your person, or in your wallet or purse, and update it every time you visit the hospital, doctor’s office, dentist, or pharmacy.

Your list should include:

• Over-the-counter drugs (including vitamins, cold medications, etc.).
• Herbal medications.
• Prescriptions.

For each medication on your list, know:

• What the drug is for.
• What the dosage is.
• What time it needs to be taken.
• What special instructions you have with the medication (needs to be taken with food, before meals, etc.).

In addition to medications, also record on your list:

• Health conditions.
• Allergies.
• Medical providers and their phone numbers.
• Pharmacy address and phone number.
• Emergency contact and your health insurance information.

You will receive a medication list in the mail or at your next visit. Complete this form and bring it with you each and every time you are seen at Craig. Stay informed, stay safe.

Nurses complete capstone projects

Eleven nursing leaders participated in Leadership Development Training in 2008-2009. As part of the training, the nurses completed “capstone” projects to develop their leadership skills. This program was offered by the Colorado Center for Nursing Excellence and supported through a HRSA grant. The program was a huge success. Below is a brief synopsis of the projects completed. Autonomic Dysreflexia (AD) Craig patients have reported serious negative outcomes as a result of AD episodes that went untreated because their providers did not recognize it. Outpatients were surveyed about their confidence in their PCP to recognize and treat AD. Programs targeted teaching in various healthcare communities. —Mary Vidmar, outpatient nurse manager Magnet™ Education Craig was recognized in August 2005 as a Magnet™ hospital and re-applied this year to maintain the designation. Magnet™ status is given for excellence in patient care and nursing services. As we continue on the Magnet™ journey, staff education was needed. We developed fun, interactive education for the nursing staff. —Cindy Claren and Janet Rife, 2-East RNs, weekend charge nurses Night Shift Forum In an effort to keep night shift connected to the rest of the hospital, the Night Shift Forum was created. Staff from each unit meets once a month to discuss issues of the night shift, solutions to problems, educational needs, and opportunities. —Ann King and Suzanne Retzer, night shift clinical nurse coordinators Self-care and Stress Management Stress management and self-care are vital com-ponents in increasing job satisfaction and preventing compassion fatigue. This project attempts to tackle some of the issues through education about compassion fatigue, nutrition, exercise, and general self care. Join the Craig Hospital Health and Fitness website at http://craigfitness.ning.com/. —Brigette Bayles, 2-East clinical nurse coordinator Teamwork and Communication Through a survey, staff identified a need to increase communication and improve teamwork among staff. Creative ideas are being implemented to accomplish the goal of making 3-West THE place to work! —Lisa McGraw, 3-West clinical nurse coordinator; and Bevin Peterson, 3-West RN, weekend charge nurse Tech Retention Project For a variety of reasons, Craig’s turnover among nursing techs has been high which has detrimental effects on patient care, staff morale, and staff recruitment and training costs. This project helped us tackled tech turnover and decrease the rate dramatically, from 58% to 15%. —Jennifer Biggs, 2-West clinical nurse coordinator; Jane Emanuelson, director of nursing; and Nicole Maas, 3-East clinical nurse coordinator

We’ve known it for decades: Craig is one of the best, and people love working here

No surprise, but Craig is one of the Top 10 rehabilitation hospitals in the country, as ranked by U.S. News & World Report in its 2009 survey. This marks the 20th consecutive year in the Top 10 for Craig, every year since the rankings began — thus, the “20 in 10” slogan. It’s also no surprise people love working at Craig. There are lots of reasons, of course. Contact with patients and their families, opportunities to make big differences in people’s lives, stellar special events, an emphasis on health and wellness, and a pervasive sense of “can do” all rank right up there — as do the general feelings that supervisors care, that people have opportunities for personal development and growth, and that people who work here have a voice. The results of our most recent employee satisfaction survey show that Craig ranks significantly higher than the healthcare/hospital workplace norms on such survey items as “Courtesy and customer service come first when dealing with patients, families, and staff,” “Craig Hospital places a high priority on staff and patient safety,” “I would recommend Craig to a friend as a good place to work,” and “I have confidence that Craig will continue to be successful in the coming years.” Generally, organizations are fortunate to have 50 to 60 percent of their staff participate in an employee survey process. At Craig, that number was closer to 80 percent, clearly demonstrating our staff’s commitment and compassion about who we are and what we do as an organization. The feeling is mutual: Craig loves its people.