Marsha Lommel tells Amanda Barber how focusing on the philosophy of rehabilitation diversified her hospital’s services.

In 2006, Madonna Rehabilitation Hospital opened ProActive, a 60,000-square-foot medical wellness center, to enhance its focus on rehabilitation. Madonna is the only rehabilitation hospital in Nebraska and also serves the five surrounding states of Kansas, Missouri, Iowa, South Dakota, and Colorado. Although the hospital’s geographic service area differentiates it from others in the industry, comprehensive services make this 143-bed facility unique.

Marsha Lommel, President and CEO

“Rehabilitation is about participation in life,” said Marsha Lommel, president and CEO. “The fundamental philosophy of rehabilitation is to give people the tools to help themselves; they are in the driver’s seat.”

When Lommel and her administration looked at the path their patients took after graduating from rehabilitation, they realized there was no place for patients to go to continue the healing process. Healthcare therapy is often limited to six or eight sessions, after which patients are handed a piece of paper with instructions on continuing therapy at home. That information, coupled with the nationwide increase in obesity and chronic illness, made opening ProActive an obvious choice. At ProActive, fitness is seen as a component of wellness, and providing wellness services supports Madonna’s holistic approach.

“In rehabilitation, you have to take control and do it yourself but with professional support,” said Lommel. “We felt a medical wellness center focused on that philosophy could make a dent in some of these problems.”

ProActive houses five physical therapists, a PhD health psychologist, full-time integrative medical nurse, two cardiac rehabilitation nurses, a dietitian, and exercise physiologists who specialize in working with patients with disabilities or impairments. Patients who leave Madonna’s care are given a one-month free membership to the center in a program called Structured Independence. ProActive is also open to the public.

“About 40% of those who are given the free one-month membership join the wellness center,” said Lommel. “The remaining patients have had a month of medically supported rehabilitation rather than simply receiving written instructions for a home program. Since we opened the doors, our ProActive membership has grown to 2,800.”

Cause and effect
The basis of everything at Madonna Rehabilita-tion Hospital comes from the research efforts of its Institute for Rehabilitation Science and Engineering. An enormous part of the work conducted at ProActive includes a research component that analyzes what works for people and what could be improved. Although research in the fields of physical, occupational, and speech therapy is common, funding for research pertaining to rehabilitation is not.

“Madonna Rehabilitation Hospital has a high success rate with its patients, particularly in the area of traumatic brain injury,” Lommel said. “A body of research showing other rehabilitation hospitals how to replicate the programs was a missing component. Healthcare technology research was occurring at the universities, but the patients were here. We needed to connect the technology researchers in the university setting with the rehabilitation practitioners who are actually working with patients.”

The Institute for Rehabilitation Science and Engineering has two main goals. One is to identify best practices, and the other is to apply emerging technology to the problems of people with activity limitations. The institute is comprised of centers for movement sciences, for communications, and for outcomes and informatics. Madonna partners with close to 40 universities across the country and is currently working with the national fitness equipment maker, Life Fitness.

“Life Fitness provided a set of equipment for ProActive that mirrors the exercise equipment being used in the Institute’s Movement Sciences Center,” said Lommel. “The research underway in the Movement Sciences Center was funded, in part, by a grant we received from the Daniels Fund. Our intent is to increase opportunities for people of all physical abilities to participate in safe and meaningful exercises.”

Design modifications have been made and presented to Life Fitness with hopes that former patients as well as “traditional” users can ultimately use equipment. Results from this work are also being presented at national conferences, including the American Society of Biomechanics in Virginia, the American Physical Therapy Association’s Combined Sections Meeting in Boston, the World Confederation for Physical Therapy in Vancouver, British Columbia, the American College of Sports Medicine in New Orleans, and the CDC’s conference on diabetes in Atlanta.

The culture at Madonna is one of growth, education, and innovation, and the developments of the past few years have only strengthened those qualities. Madonna recruited leading researchers, such as Dr. Judy Burnfield, to enhance the Institute’s understanding of research in movement and walking.

“Our institute is our living lab,” said Lommel. “All of our researchers know so much about the technology and love trying it and applying it. Our greatest successes come from seeing those who could not take care of themselves, but have learned and grown and can now walk away from Madonna with a renewed vision of their future.”