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Magee Rehabilitation Hospital focused on its areas of expertise to avoid duplication of services with acute hospitals in the Greater Philadelphia Area. The Hospitals special population served includes adults with disabilities, many of whom have incurred life-changing injuries and illness including, but not limited to, spinal cord injury, stroke, acquired brain injury, amputation and major orthopedic issues.

As such, Magee Rehabilitation Hospital chose three health priorities which relate to the HospitalҒs mission: education, injury and illness prevention, and wellness.

These priorities all support adults with disabilities who are living in the community, as well as needs of the community at large. Several of these activities involve community partners.

EDUCATION

Through the survey, Magee identified a strong need for education in the special population served. This included education on living with new functional limitations, education on navigating the health care system, as well as education and support for family members of people living with disabilities. There are few outside community resources that provide this type of education. Thus, there is a need for more comprehensive education offerings.

Magee Rehabilitation Hospital offers a variety of peer mentoring programs and support groups aimed at educating adults living with disabilities and their families. These programs are open to all members of the community and are not limited to patients or former patients.

The Peer Mentor Program at Magee is designed to offer someone who is newly injured the opportunity to talk with a specially selected and trained person with a spinal cord injury, stroke, traumatic brain injury or amputation who has returned to a full and meaningful life. The program not only provides a support system and resource network, but also promotes independent living to the level that is attainable. Anyone in the community, regardless of whether or not they have been a patient at the Hospital, is able to become a Peer Mentor. This involvement includes training, which provides education for Peer Mentors. Working with inpatients has also been shown to help peers reintegrate into the community.

The Family Peer Mentor groups are set up similarly to the injury-based Peer Mentor groups. Mentors are family members of people who have sustained a spinal cord injury, stroke or brain injury. They are volunteers who are specially trained to guide and provide information and experiences to families and loved ones of newly-injured individuals.  Mentoring can be done in the form of participating in the family group which is held twice monthly at Magee or contacting a new family by telephone or face to face if possible.

In addition to the Peer Mentor Programs, Magee also offers several support groups open to the community that are designed to provide education to those living with disabilities on how to live a full life with their new functional limitations. The Spinal Cord Injury Support Group provides education, recreation and support opportunities to individuals with spinal cord injuries.  Traditionally, meetings are held at Magee on the second Thursday of every month, and regular social outings are scheduled. The Amputee Support Group consists of social meetings and events in additions to guest speakers on a variety of topics.  Meetings are held the second Tuesday of each month at Magee Rehabilitation Hospital.

There are also community support groups for people who have had a stroke or brain injury. The Stroke Club is a social group for people who have had strokes, but also provides a regular education component. The club meets every month to socialize, share experiences and provide support to one another. For those who have had strokes or brain injuries and are non-verbal, the Aphasia Community Support Group provides an opportunity to practice speech and language skills in a safe and supportive environment; provides education about aphasia; and encourages socialization among the members. Additionally, there are also specialty education groups Magee offers to members of the community. The Spinal Cord Injury and Sexuality Educational Support Group meets every other Tuesday at Magee Rehabilitation Hospital.

Lastly, Magee offers Day in the Life VideosӔ for individuals with spinal cord injuries. There are four educational videos featuring actual accounts of daily community skills from a person with a spinal cord injury who uses a wheelchair in a home or city environment. The videos will give individuals a foundation of skills to use when they return home and offer adaptations and techniques that have helped others to be successful in their home and community environments. Each video includes demonstration by someone using a wheelchair in different environments. The topics addressed in these videos include cooking and kitchen mobility, home mobility, community mobility and general health and fitness. These videos are available on the internet and Magee's website as well as through DVD distribution.

Each of these education programs aimed at individuals living with disabilities in Magees geographic community is open to the public. They address a health need otherwise unmet in the area. To build community awareness of these programs and to expand their reach, Magee Rehabilitation Hospital will add a special Ask a Peer section to the hospital blog at blog.mageerehab.org, which discusses issues in the disability and geographic community. For those unable to attend support group meetings or unsure about meeting with a peer mentor, this format will allow them to ask their questions in an anonymous venue and have them answered by a trained peer mentor. In this way, the hospital hopes to increase awareness of this service to the community and expand the ways people can participate.

In addition to these current programs, Magee is in the beginning stages of creating an online educational resource of caregivers, family members and friends of people living with disabilities. The online caregiver
educational resource is a program designed to assist caregivers of persons with traumatic brain injury. This resource provides educational modules to read or view to increase caregiving knowledge. Family members and friends can access the online modules through MageeҒs website at MageeRehab.org. The current modules available include brain physiology, community resources and coping.

While there are few, there are also community resources addressing these educational needs. The Center for Independent Living of South Central Pennsylvania provides supportive services to persons with disabilities who wish to increase or maintain their level of independence in the community or at home.

ILLNESS AND INJURY PREVENTION

Through the survey, as well as results from public data, the Hospital identified illness and injury prevention as a health need for the geographic community. Of those surveyed, only 6% have had their disability since birth, and a majority of the remaining respondents indicated their disability was caused by something preventable.

In addition to the programs at Magee, there is also a community resource addressing this need. The Public Health Management Corporation (PHMC) is a nonprofit public health institute that works to improve the health of the community through partnerships with government, foundations, businesses and community-based organizations. They offer services for special needs populations, health promotions, injury prevention and environmental health.

The Philadelphia County Department of Healths Philadelphia County Health Profile 2010 found assaults and homicides are the leading causes of death of people age 5 to 24.4 As such, there is a particular need to address violence as a cause of disability in youth in the geographic community. To address this health need, Magee Rehabilitation Hospital offers the Think First program. This award-winning program for teens and young adults is offered to schools and organizations in the Delaware Valley, and stresses prevention and "thinking first" in order to prevent permanent brain and spinal cord injuries. The program is presented in assembly forum to groups of young people, ranging from 15 to 500. The program is led by Joe Davis, M.S.W., C.A.C., who is a wheelchair user and visible community leader. The program is offered to more than 50 schools and community groups annually, and offered free of charge. The program annually reaches more than 10,000 individuals ages 13 to 19.

Another preventable, disability-causing illness prevalent in the community is stroke. The Philadelphia County Department of HealthҒs Philadelphia County Health Profile 2010 found that stroke is the third leading cause of adult death in the Delaware Valley, trailing behind only heart disease and cancer. To address this health need, Magee Rehabilitation Hospital is very active within the Delaware Valley Stroke Council, and also hosts preventative blood pressure screenings open to the community.

Other Magee offerings designed to address the community health need of injury and illness prevention include Magees Brain Injury Prevention Program, the Osteoporosis Clinic and Concussion Clinic. The Brain Injury Prevention Program provides brain injury education to survivors of brain injury, their families, and those who are at risk for suffering brain injury. Magee participated in two Brain Safety Fairs run by the Brain Injury Association of Pennsylvania in May 2011 and June 2012. Approximately 340 individuals received bicycle helmets and brain injury prevention information, and 17 Magee staff members volunteered. The Magee Osteoporosis Clinic offers free consumer education on osteoporosis to interested audiences, which include local Senior Centers and professional groups.  Additionally, the program offers free screenings using heel densitometer to these same groups, as well as Magee employees.  Free screenings are also available and open to the community monthly at our Riverfront outpatient facility. In 2012, Magee provided six osteoporosis presentations (with an average 25 people in attendance per event).  The Hospital also provided heel densitometer screenings to five groups outside of Magee (with an average 20 people per screening). Lastly, MageeҒs Concussion Clinic provides concussion prevention and treatment education for high school and college students, nurses and staff as well as for sports teams, trainers and coaches. More than 25 groups were educated in 2012.

Another education resource available at Magee is the Legal Clinic for the Disabled. This non-profit organization is housed within and partially funded by Magee Rehabilitation Hospital, as Magee provides office space free of charge, as well as related overhead expenses such as supplies, computer support, etc. Its mission is to provide civil law legal services at no charge for financially eligible, disabled clients. Individuals with disabilities are referred to lawyers who have volunteered their services to LCD. Cases include wrongful evictions, consumer fraud, employment discrimination and compliance failures related to the Americans with Disabilities Act of 1990. Other services include estate planning and benefit consulting. Magee supports and promotes the services provided by the Legal Clinic for the Disabled as an educational resource for the community.

In addition to the programs at Magee, there is also a community resource addressing this need. The Public Health Management Corporation (PHMC) is a nonprofit public health institute that works to improve the health of the community through partnerships with government, foundations, businesses and community-based organizations. They offer services for special needs populations, health promotions, injury prevention and environmental health.


WELLNESS

Through the survey and review of public data, Magee identified a strong need for programs that address wellness for the geographic community and the special populations served. The survey found that 48.3% of respondents, who are adults living with disabilities, do not regularly participate in exercise. This is significantly more than adults in Philadelphia County. According to the PHMCs Community Health Data Base Southeastern Pennsylvania Household Survey, 2012, only 21.7% of adults in Philadelphia indicate they never exercise or exercises less than once a week. Of the survey respondents that did not participate in regular exercise, some of the most common reasons were lack of knowledge about the types of exercises they should do, and that their local gyms were not accessible.

To address this health need, Magee Rehabilitation Hospital created the Magee Health and Wellness Center at the HospitalҒs Riverfront Outpatient Center in South Philadelphia. The Wellness Center offers flexible hours, levels of membership and equipment that can be used by both able-bodied and people with disabilities, and most pieces are wheelchair accessible. Treadmills, free weights, elliptical, arm bike and NuStep (a cross between a recumbent bike and an elliptical machine), accompany more specialized equipment, such as the RTI bike with its electrical stimulation, Motomed, multi-fitness trainer and total gym so individuals with a broad array of disabilities can participate in physical activity. Membership is open to the community and is $50 per month. Scholarships are provided as needed. Additionally, to address the common concern that people living with disabilities were unsure of the exercises appropriate for them, all Health Center users meet with the director of the Center before they become members to talk about their health and fitness goals. The director then develops a personalized fitness plan, and shows them how to use all the equipment. Physical and occupational therapists are available if any questions arise during workouts. The Wellness Center also offers yoga classes.

Of the total survey respondents, 87% indicated they have not participated in adaptive sports in the past three years, but when asked how they would like to be involved in their community or what they would like to do that their disability has prevented, sports and athletics was a common desire. To address this need, Magee offers a Wheelchair Sports Program, which includes basketball, rugby, tennis, and hand-cycling for individuals with disabilities. While most Magee athletes participate for recreational outlet, several do compete in regional, national, and even international sporting events. Magee employs a wheelchair sports coordinator to lead the program, which has over 50 individuals participating. The annual budget for the program is approximately $150,000. Any adult with a disability can participate in the program free of charge. 

A variety of Magees support groups and clubs, including the Stroke Club, peer mentors and others, as referenced in education section, support the HospitalҒs geographic and special communities in a wellness capacity. These are documented and explained in the Education section of this report (see page 20).

There are also community organizations that offer adaptive sports programs for people living with disabilities, many of which act as Magee partners. Philadelphia Department of Recreation offers a year-round program in a 6.4 acre indoor and outdoor complex called the Carousel House, which includes a playground, fitness track, gymnasium, exercise room with wheelchair accessible weight equipment, and swimming pool with an adjustable floor.  Activities include swimming, dance, athletics, summer day camp, martial arts, weight lifting, nature walks, track meets and other athletic tournaments. The Philadelphia Center for Adapted Sports is a non-profit organization providing sport and recreation programs for people with disabilities. Magee refers individuals to this organization. Similarly, YMCAs in the Greater Philadelphia area offer adapted aquatics at all locations, and some locations offer additional adaptive sports options for children with physical or emotional limitations including martial arts, soccer, basketball or gymnastics.

More specialized community adaptive sports programs include the Eastern Amputee Golf Association, a non-profit organization designed to assist in the rehabilitation of amputees and provide for their general welfare, both physical and psychological, through the medium of golf and its associated activities; American Dance Wheels, an artistic organization that trains individuals with disabilities, their able-bodied partners, ballroom dance teachers and occupational and physical therapists the art of Wheelchair Ballroom and Latin Dancing; and All Riders Up, a non-profit charitable organization that provides area residents with special needs a way to exercise, improve balance and coordination, strengthen core muscles, and develop self-confidence by learning to ride horses.