title: Evaluation of patient-centered rehabilitation model targeting older persons with a hip fracture, including those with cognitive impairment.
abstract: BACKGROUND
  The purpose of this study was to evaluate outcomes for older persons post-hip fracture repair, including those with cognitive impairment (CI), following implementation of a novel model of care - the Patient-Centered Rehabilitation Model including persons with CI (PCRM-CI). The PCRM-CI is an interdisciplinary rehabilitation program that incorporates education for healthcare professionals (HCPs), including nurses, which is focused on geriatric care including management of dementia and delirium, support for HCPs from an Advanced Practice Nurse, and family support and education. Primary outcome measures were mobility gain from admission to discharge and whether or not patients returned home post-discharge.
  
  
  METHODS
  The PCRM-CI intervention was evaluated using a quasi-experimental design, following implementation in two community hospital inpatient rehabilitation units. One hundred forty-nine patients aged 65 and older participated as patients in the usual care (76) or PCRM-CI intervention (73) groups. Patient mobility was assessed at admission and discharge by the Functional Independence Measure Motor Subscale (FIMM); the difference in mobility scores was defined as mobility gain. Patient discharge location was also captured to determine whether or not patients returned home from inpatient rehabilitation.
  
  
  RESULTS
  No difference in mobility gain was found between the usual care and PCRM-CI groups as measured by the FIMM. Patients in the intervention group were more likely to return home post-discharge than those in the usual care group (p = 0.02).
  
  
  CONCLUSIONS
  Results of the PCRM-CI evaluation suggest that older adults with CI can successfully be rehabilitated post-hip fracture repair using this novel, interdisciplinary rehabilitation program.
authors: Department of Research, Toronto Rehabilitation Institute, E,W, Bickle Centre for Complex Continuing Care, 130 Dunn Avenue, Toronto, ON M6K 2R7, Canada. kathy.mcgilton@uhn.ca.
authors: Katherine S
authors: KS
authors: McGilton
authors: Aileen M
authors: AM
authors: Davis
authors: Gary
authors: G
authors: Naglie
authors: Nizar
authors: N
authors: Mahomed
authors: John
authors: J
authors: Flannery
authors: Susan
authors: S
authors: Jaglal
authors: Cheryl
authors: C
authors: Cott
authors: Steven
authors: S
authors: Stewart
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D006620:Hip Fractures / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000639:trends; D018802:Patient-Centered Care / Q000592:standards* / Q000639:trends; D012047:Rehabilitation Centers / Q000592:standards* / Q000639:trends; D016896:Treatment Outcome