Impact of Matheny’s habilitation model

Dr. Gary E. Eddey.

What impact will Matheny’s habilitation model have on care for persons with medically complex developmental disabilities in New Jersey? It ensures continuation of the following:

• Seamless collaboration of an interdisciplinary and/or transdisciplinary team.

• An environment that accommodates all medical and therapeutic needs while providing a maximum level of social interaction that includes educational and recreational activities and frequent community engagement.

• Conservation of public health dollars by providing a continuum of health care services that minimize expensive, unplanned acute care services and hospital readmissions.

• Assurance that healthcare students in a broad range of disciplines will receive training that instills recognition of the need to accommodate this challenging population. It also helps these students be more comfortable and competent in doing so.

(The last in a series of articles by Gary E. Eddey, MD, Vice President and Chief Medical Officer at Matheny, on the habilitative healthcare model.)

Dr. Gary E. Eddey

By Gary E. Eddey, MD

Matheny’s data consistently demonstrate that care provided here reduces the risk for much more costly acute care hospitalizations. Our daily bed rate, in fact, is lower than that of acute care hospitals.

Morbidity and mortality data for 2011 and 2012 show that Matheny has consistently reduced transfers of our patients to acute care hospitals over the preceding years. Factors contributing to this reduction include: 24/7 on-site coverage; an advanced respiratory therapy department; a fully staffed onsite pharmacy, which has increased the availability of urgently needed medications; and  interconnected informal relationships with several acute care hospitals.

Our transition nursing program, developed with a grant from the Robert Wood Johnson Foundation, has enabled us to reduce the chances of readmission for those patients who have been transferred to acute care hospitals. Rehospitalizations within 30 days of the original admission have been reduced to 7.4% from 25%. Also, patients with routine planned preventative surgery admissions are quickly readmitted back to Matheny.

All individuals have the right to have their potential maximized, regardless of whether they have mild, moderate or severe developmental disabilities. Matheny has always focused on improving and prolonging the quality of life of its patients. In addition to our medical expertise, we believe that the therapies and activities we provide are absolutely crucial in maximizing our patients’ functioning and their ability to actively engage in and enjoy life experiences.

(Fourth in a series of articles by Gary E. Eddey, Vice President and Chief Medical Officer at Matheny, on the habilitative healthcare model).

Dr. Gary E. Eddey.

By Gary E. Eddey, M.D.

For individuals with complex developmental disabilities, who are totally dependent on care with a lifetime ahead of them, an inpatient habilitation healthcare model may be the most appropriate healthcare approach.

What distinguishes this individual from someone who can be adequately cared for in the community? Here are four determining factors for recommending inpatient habilitation care:

• The chronic neurologic disabling condition is accompanied by many other healthcare disorders.

• Significant musculoskeletal conditions impact mobility.

• The patient is totally dependent for care.

• Social/family supports are unable to keep the patient from improving or even maintaining function.

The above issues significantly increase the care-load burden of the patient. These patients require much closer monitoring throughout the day than those who can live in the community because they have multiple associated clinical conditions requiring the most complex medical, physical, therapeutic and nursing care needs.

At Matheny, 100% of inpatients are complex and ambulatory-dependent. Almost all have 15 to 20 accompanying diagnoses in addition to their primary underlying chronic neurologic disability. The Matheny inpatient habilitation healthcare model is the essential standard of care for all those with significant developmental disabilities and should be the standard of care for all persons with developmental disabilities who are medically  complex.

(Second in a series of articles by Gary E. Eddey, MD, Vice President and Chief Medical Officer at Matheny, on the habilitative healthcare model).

By Gary E. Eddey, MD

The term “habilitation” refers to an approach to healthcare services for individuals with developmental disabilities. It includes comprehensive medical, nursing, therapeutic and educational care, is designed for children and adults and can be provided in either a community or inpatient setting. Habilitation services are essential for those with congenital disabilities, or disabilities acquired early in life, and are often best provided in a community setting for the majority of individuals with developmental disabilities.

Habilitation focuses on the individual, improving his/her functioning and overall health in a supportive environment. It takes into consideration needs in a wide variety of areas including social services, psychology, psychiatry, recreation, therapies, integrated medical and nursing services and, depending on age, educational services. Research confirms the two-way relationship between a full and active lifestyle and physical health for persons with disabilities.

A successful habilitative model must maximize potential at all points along the lifespan continuum. With its emphasis on an integrated approach to care and services, the habilitative model reverses or impedes a decline in health among this at-risk population.

The goal of habilitation is to normalize the life of the individual with developmental disabilities as well as his/her family. Families are a critical element in the care and support of people with disabilities. They are advocates and guardians in most instances. However, the abilities and needs of families must continually be assessed throughout the life cycle. Frequently families can and do provide care when the individual with disabilities is young. This becomes more difficult and, impossible for some, as the individual with disabilities ages.

(The first of several articles by Gary E. Eddey, MD, Vice President and Chief Medical Officer at Matheny, on the habilitative healthcare model).