Pelvic Health Network🎙️

How a patient recovers from an abdominal surgery, fracture repair, and joint replacement is a shared responsibility between the patient, their medical team, and their rehab provider. How a patient recovers from a cesarean section, hysterectomy, and mastectomy is largely the responsibility of the patient and if they’re lucky: the medical team’s explanation of their discharge paperwork🗂️ To say it’s a privilege to receive an individualized recovery plan from a rehab professional is a gross understatement. Early access to rehab encompasses early access to mental health support, physical performance, and human connection at a time when individuals need it the most. It’s been a privilege in my career to serve on a patient’s recovery team, whether a surgeon has asked me to or the patient was at risk of being discharged without a plan. Do you see rehab as a privilege or a patient’s right to maintain their dignity while receiving care? Why or why not?⬇️

Have you ever had a physician question why you as an Occupational or Physical Therapist Practitioner monitor vital signs of hospitalized patients? How did you respond? Were you flustered and rapidly searching for research articles to justify your practice? My recommendation is to review one of the most robust resource guides on this topic with over 150 citations to help you develop your ability to communicate your expertise. It will guide your practice in every setting and every unit of the hospital - especially in acute maternal care where the greatest threat of cardiopulmonary complications are the highest in the first few days to weeks postpartum. The introduction is my favorite: https://lnkd.in/g6si4emU #maternalvitalsigns #postpartumpreeclampsia #postpartumpulmonaryembolism #postpartumhemorrhage #postpartumcomplications #maternalrehab #acutecareot #acutecarept

It’s an honor to attend the 2024 Education Leadership Conference in Oakland, CA hosted by the American Council of Academic Physical Therapy (ACAPT) and the APTA Academy of Education. Oakland, CA is home to the Black Panther Party museum. Over the past year, we have been navigating maternal health disparities in rehabilitation and I’m here on a personal mission. The night before I left, I had a message from a therapist who wants to know what evidence do we have that would make it profitable for her hospital to offer rehab to mothers? She wants to justify an investment in a program that expands access to OT and PT services for patients on the maternity unit. Was she serious? I think so. She reached out to the Black co-founder of a maternal health-centered organization to inquire how hospitals can profit from providing a fundamental rehab plan of care to patients after unexpected birth outcomes like an unplanned c-section. She was not joking. Was she aware of the data collected through the National Bureau of Economic Research of 1 million births in NJ that Black mothers are 25% more likely to undergo a c-section regardless of comorbidity? Was she aware that U.S. hospitals on average profit $15,000 from each cesarean section performed across both rural and urban facilities? Was she aware that the United States has the highest maternal mortality rate of all high-income nations, with Black women 2-3 times more likely to die during pregnancy and after birth? After speaking with leaders today at ELC, it’s crystal clear that Oakland was intentional. The Black Panther Party recognized that health is a human right. I sent the therapist the application to our Trauma-Informed Maternal Health Scholarship. It’s apparent to us that we cannot change the conditions of the healthcare systems that our clinicians operate in. However, we must prioritize their education to influence the way they prioritize human life. If a hospital makes a profit from providing rehab services to mothers during hospital admission, they are saving costs they would otherwise incur from adverse health events. This is wonderful and necessary to keep their lights on. However, our primary aim as an organization is not to make hospitals more money by providing rehab, a standard component of care after the most commonly performed surgery in the United States: the cesarean section. Our primary aim is to preserve human dignity and function after any birth experience. I am attending ELC 2024 to be a better educator, a better communicator, and a better leader. It’s an honor to be in Oakland, CA. References: 1. ELC 2024 https://lnkd.in/gAU6TZwp 2. Drivers of Racial Differences in C-Sections: https://lnkd.in/gHWCXvyG 3. Evaluation of Hospital Cesarean Delivery-Related Profits and Rates in the United States: https://lnkd.in/gDAuEqqz 4. Trauma-Informed Maternal Health Scholarship: https://lnkd.in/gFC3PBqi

I wanted to know how adjunct and full-time OT and PT faculty were including women’s health in their rehab curriculum. So, I asked Dr. Katherine Sylvester PT, DPT for her input. Q: What schools do you adjunct for? Dr. Sylvester: 1. Augusta University 2. Brenau 3. Emory 4. Mercer 5. Regis University 6. University of Minnesota Q: Do you identify as a pelvic health therapist? Dr. Sylvester: No, I do not. I identify as a women’s health therapist with a passion for neuro. I find joy in working with patients who have suffered a stroke and with women throughout their lifespan. Q: What do you teach PT students? Dr. Sylvester: I teach students to use every number at their disposal to provide women with the education, resources, and data driven decision support to help them avoid experiencing preventable pregnancy-related deaths and complications. The traditional numbers I teach them to gather are: • Heart rate • Blood pressure • Oxygen saturation • HGB • Glucose • ALT • GFR • BNP The not so traditional numbers I teach them to ask their patients about are: • The number of gunshots they hear at night • The number of appointments and opportunities they’ve missed due to a lack of transportation • The number of children they care for • The number of people they can call on and count on • The discrepancy between how much money they make and how much they need All of those numbers matter. ————————————————————— To learn more about faculty who are including women’s and maternal health into rehab curriculum, join the discussion on Wednesday, October 16th at 6 PM ET. Live or replay: https://lnkd.in/giTeuqZ7

“Rehab education at its core intended for therapists to teach. Although noble, it was not intended for the sole provision of patient care.” We received an email last week from a NICU-trained OT that I must have re-read at least 5 times. In early 2023, she enrolled in the 15-hr ERAD course that was recorded and self-paced. By the summer, she facilitated an in-person training at her hospital where Dr. Jenna Segraves, PT, DPT, NCS and I taught the 15-hr ERAD course to her team: 10 OTs and 10 PTs. Her email this week: she created a presentation from what she learned last year that she used to train therapists among 12 hospitals in her region. That’s what I kept re-reading. It helped me to understand what she wrote next. “Our system is now live for automatic PT/OT evaluation orders following a cesarean.” Once she agrees, we will open a public Q/A with her team to communicate exactly what they did. I have heard of programs spreading this fast with other patient populations - I just personally have not experienced it in acute care women’s health or inpatient pelvic health. On October 15th, we will introduce the approach we are taking with the 15-hr ERAD course to train more rehab educators. Of note: this OT did not take the formal 30-hr Perinatal Health Specialist Certification. She obtained the 30 hours she needed by taking the 15-hr ERAD course on her own, and then she took the same 15-hr course again with her team when it was offered in-person at her hospital. Furthermore, she did something that I find completely remarkable: she went around to other hospitals in her system and taught acute care therapists from a presentation that she created to reinforce what they needed to know to offer rehab to patients in the hospital after c-section. As a pelvic health therapist who practiced in acute care, I used to think of rehab across any setting as a pie, wondering: will there be enough slices for everyone? I now think of rehab as a seed: how many trees will each therapist plant in their community? October 15th from 7:00-7:10 PM ET 10-minute rehab educator info session: “Grow Your Reach”: please check your emails for the link or DM me. Q: Why 10 minutes? A: Current participants are taking the PHS certification exam in November and we will open the remaining session for members to join our discussion on cases and course content. Thank you! Dr. Rebeca Segraves https://lnkd.in/gP6aPMnF

Fathers save lives. A hospital rehab case: You get an order to evaluate and treat a patient who lost 1200 mL of blood s/p vaginal delivery. With the emerging guidelines, you think: 1) this is only 200 mL of blood loss above normal 2) how impaired can the patient be? 3) is this eval a priority for OT and PT? You decide to make room on your schedule to complete the eval. You hear confirmation that you can enter the room when you knock. The patient is up and walking while holding her baby. You sigh...not from relief. You think of the patients you could have seen instead. Postpartum Readmission: 3 days later, you learn that your patient has been readmitted to the hospital. She went to the ED twice in a 36-hour period following her discharge. Her blood pressure was dangerously high on both occasions yet the 2nd time, her husband demanded that an OB/GYN exam her. Her diagnosis when you come into her room this time: postpartum preeclampsia and acute heart failure. She looks you in the eye and says, "my husband saved my life." Case Reflection: There are 3.6 million births in the U.S. annually. How are OT and PT faculty preparing students to screen families in the hospital after birth and the first 2 weeks at home where most maternal health complications occur? Most importantly, are entry level therapists prepared to screen for complications in the hospital after any birth experience? Q/A: Are fathers supported during the maternal rehab session? A: In the hospital, rehab therapists rarely skip a beat: everyone in the room is included in a high-risk pregnancy and postpartum eval. However, patient education is usually postpartum-focused when more of it should cover paternal and familial health in more depth - training families to spot concerns earlier and advocate for mothers at the time of birth. Q/A: Do OT and PT faculty teach students about paternal health? A: We're actually not sure many OT and PT faculty include maternal health in their curriculum at baseline. Yet, we plan to ask this and so many more questions at our upcoming interview with rehab faculty around the nation: Maternal Health Rehab in OT and PT Education on Wednesday, October 16th at 6 PM ET. 🎙️Let us know what other questions you want OT and PT faculty to answer regarding maternal and paternal health in rehab curriculum. Dr. Jasmine Edwards, PT, DPT, NCS | University of Pittsburgh Dr. Pamela Hess, OTD, OTR, PMH-C | University of Florida Dr. Becky Parr, PT, DPT, DHSc, OCS, Cert. DN, CAPP-OB, Hanover College Dr. Carlin Reaume, OTD, OTR/L, MAEd | University of the Pacific Dr. Sarah Sidar, OTD, OTR/L | Shenandoah University Learn more: https://lnkd.in/giTeuqZ7