How The MedStar NRH Care Team Handles Complex Cases

In an instant with the crack of a bullet, the spin of a car, or the sudden burst of vessels in the brain, lives are irrevocably changed. For U.S. Congressman Steve Scalise, the innocence of a baseball game was shattered when a gunman aimed his weapon at the field where members of Congress were practicing for an annual game scheduled for the next evening.

His grave bullet wounds and his difficult journey through multiple surgeries and infection have been well documented. But like so many other patients with complex injuries, survival is just the first step in a recovery that may continue for months or years.

When the Congressman left his stay at MedStar Washington Hospital Center, he was immediately admitted to MedStar National Rehabilitation Hospital (MedStar NRH). His eight week stay at MedStar NRH demonstrates the critical importance of acute rehabilitation for patients who have suffered serious injury and who continue to have complex medical needs, as well.

For Congressman Scalise—and other patients with more complicated injury or illness—rehabilitation begins even before they enter the doors of MedStar NRH, explains John Aseff, MD, the physiatrist who cared for Rep. Scalise while in acute rehab.

Multidisciplinary Care Team
When the Congressman arrived at MedStar NRH, a team of rehabilitation experts had already been assigned to his care and provided an initial review of his immediate needs.

Every patient has a multidisciplinary care team that works collaboratively with one another, the patient and the family throughout hospitalization. Physiatrists, nurses, physical and occupational therapists, speech language pathologists, recreation therapists, neuropsychologists, case managers and dietitians work in concert to develop an individualized treatment plan to help ensure the best possible recovery.

The care team meets weekly to share updates on the patient’s progress—and to address problems that may impede recovery. “Family meetings are also held to provide the patient and loved ones with a more global picture of the present—and the future,” explains Social Worker Joan McKinon Reeves, LICSW, MedStar NRH director of case managers.

“From the very beginning of a patient’s hospitalization, we provide an evaluation and create open communication between us and the patient and family,” she adds. “With patients who have more complex injuries, it’s important to understand what kind of support system they have at home and even begin to look at what they may require when they are discharged.

Rigorous Therapy, Six Days a Week
Working with patients who have an array of issues, care teams included therapists with special expertise working with patients suffering some type of neurological injury.

“Some patients need to relearn to walk,” says Meaghan Minzy, PT, DPT. “Our goal in physical therapy is to improve endurance, strengthen a patient’s upper body and help them use their legs.”

Amanda Summers, MS, OTR/L, ATP, says patients who present with physical weakness need to be mindful of overexertion. “Occupational therapy is focused on improving cardiovascular fitness and strengthening the upper body so that daily living tasks can once again be performed.”

For three hours-a-day, six-days-a-week, the Congressman pushed himself and his body, moving from wheelchair, to a walker and onto crutches. “In time, he went from walking 20 feet to 200,” says Minzy.

Progress like this is the result of a patient’s determination, the skill of rehab experts—plus the latest technology, such as FES, functional electrical stimulation to muscles, and the ZeroG® --the robotic body weight support system first developed at MedStar NRH.

Patients with very complex injuries face enormous challenges as they learn to “accept the injury and adjust to a new normal,” says Minzy. “For us, it never gets old to watch as patients improve and leave us able to move on with their lives.”