Partnership allows rehab to offer off-site services

Staff use equipment at local YMCA

A partnership between the Sewickley Valley (PA) YMCA and D.T. Watson Rehabilitation Center allows the hospital to provide outpatient physical therapy services in the community without an expensive capital outlay.

In a 1,000-square-foot area at the YMCA, the hospital has installed some of its physical therapy equipment, such as ultrasound, an upper body exercise machine, and an exercise bicycle.

The hospital staff can use any YMCA fitness equipment not available at the hospital, including an indoor track, an extensive array of weight-resistance equipment, free weights, rowing machines, treadmills, an Olympic-size pool, and a hydrotherapy pool, heated to 90 degrees.

Located in the village of Sewickley, within walking distance for most patients, the YMCA physical therapy center helps patients make the transition from acute rehab and the hospital’s regular outpatient program to exercising on their own, says Julie Bodnar, PT, lead physical therapist for the hospital and the YMCA clinic.

"It’s a wonderful continuum," Bodnar says. "Once patients reach a certain level at the hospital’s outpatient program, they can progress to the YMCA, where we train them on the weight resistance equipment and set them up on a regular fitness program that they can continue independently. When they are discharged from our program, they can purchase a membership and continue independently with the same program our therapists set them up on."

One young man, who was admitted to the acute care hospital as a paraplegic, progressed to the hospital’s outpatient program then was transferred to the YMCA program. He now is in an independent program, using the YMCA’s handicapped-accessible equipment, onto which he can transfer from his wheelchair. The physical therapy staff taught his family members to help him with the equipment.

A Parkinson’s disease patient went through the D.T. Watson inpatient program following surgery. He continued through the rehab center’s comprehensive outpatient program, and when he reached the point where he needed only physical therapy, he transferred to the YMCA’s physical therapy program. Now that he has been discharged from rehab, he has a personal trainer on the YMCA staff working with him on the weight-resistance equipment.

Patients in the hospital’s outpatient program are usually more debilitated than patients in the YMCA program. They also may need occupational and speech therapy and often need to receive it at one time and place.

Currently the YMCA program offers only physical therapy. When needed, occupational therapists or social workers can meet with patients at the YMCA.

Most people referred to the YMCA therapy center are orthopedic patients with neck, shoulder, or back problems. In recent months, though, the caseload of geriatric and stroke patients has increased, Bodnar says.

Upon referral to the center, patients are evaluated by a physical therapist to determine what programs they need. They may start with massage, stretching, or ultrasound — traditional physical therapy modalities — then use the nautilus equipment, indoor track, or treadmill.

The contract allows the therapy staff to use the YMCA’s track and workout equipment at any time during the day, even when it is being used by the public. However, the weight-resistance equipment is so heavily used in the evening hours that it isn’t practical for patients to try to use it for therapy during that time, Bodnar says.

There are set hours during each day when the therapy pool is reserved for the rehab staff.

Charges are the same for an hour of physical therapy in both facilities. The only difference is that the YMCA offers group aquatic therapy at a discount.

The YMCA program also helps mainstream rehab patients into the community.

"The center offers a wellness environment vs. the hospital environment. In the hospital, they are surrounded by sick people. Here they see people doing aerobics. It boosts patients’ morale and gives them a sense of reintegration into the community," says Karen Bricker, MS, OTR/L, director of rehabilitation services.

Patients who won’t come to the hospital for therapy often do come to the YMCA because of the atmosphere of wellness, she adds.

YMCA center therapists treat a wide range of age groups, from young children to active older adults. The average length of stay is four weeks, depending on the diagnosis and condition.

The center is staffed by two physical therapists, who share one full-time physical therapy position; a full-time physical therapy assistant; and a therapy aide and admissions coordinator who admits patients, verifies insurance, and handles billing.

YMCA center staff may rotate to the hospital’s outpatient program when the census changes. Staff at both facilities are trained to use the equipment at both places.

The YMCA program is open from 11 a.m. to 4:30 p.m. Monday through Thursday and 8 a.m. to 4:30 p.m. on Friday. The late hours accommodate people who work and children who need to come after school. The hospital’s on-site outpatient physical therapy program is staffed from 8 a.m. to 4:30 p.m. weekdays.

"Our hours give another option to patients," Bodnar explains.

When the partnership was formed 12 years ago, the hospital paid the YMCA a percentage of funds collected from patients, says Linda Wetsell, the hospital’s chief financial officer.

As the rehab program grew and revenue increased, the hospital began renting the space, she says.