Success Story: Broda at Islands Skilled Nursing and Rehabilitation
Islands Skilled Nursing and Rehabilitation is a 42-bed facility that re-opened recently in October 2019 in Hawaii after extensive renovations. Centrally located in Honolulu, just a block away from Kapiolani Hospital, Islands is Hawaii’s leading respiratory and post-acute medical care community. Upon opening Steve Nawahine, center administrator and CEO, told Pacific Business News, “We’ll be working with patients from all hospitals on Oahu.” The facility’s mission is to enhance the lives of our associates, partners, residents and their ohana by promoting and practicing the aloha spirit as they provide the highest standard in excellence of care. In order to meet and exceed the same lofty standards of care that residents would receive in a hospital or intensive care unit, Islands needed to hire exceptional staff, provide training for intensive and complex medical care, and equip the facility with the best medical equipment available.
Gary Y. G. Wong, RRT, MBA Islands’ Director of Respiratory Services was tasked with his colleagues to discover and procure the medical equipment to achieve these goals. Gary and his team of colleagues that include physical, occupational, speech and respiratory therapists, a social worker, nutritionist, critical care nurses and nurse assistants, were excited about the tremendous opportunity to design a better long term and complex care facility from the ground up. With over 25 years of experience in healthcare services, Gary takes a holistic approach to designing an optimal care facility. “We designed our new facility with early mobility in mind. Bed rest is a common practice in ICUs especially for mechanically ventilated patients. ICU acquired weakness is due to a combination of critical illness and bed rest leading to decompensation in these patients. Mobilization and rehabilitation play an important role in our ventilator and tracheostomy rehab program”.
A 2009 study in the Journal of the American Geriatrics Society found for older patients (74 years old was the mean age of study participants) on average 95% of time during their hospital stays are sitting in a chair or confined in bed. Getting residents out of bed is critically important but only half the story because the seating must adequately accommodate each user’s condition and comfort requirements. Leaving patients in beds or uncomfortable furniture like basic recliners, sofas, or chairs was not a valid clinical seating choice for Islands. Gary further described their situation, “Our facility is a newly renovated SNF building that was built originally in the 60’s with dual occupancy rooms. Although we spent a lot of money in modernization, the footprint for the amount of medical equipment and furniture was limited.” Gary said, “We also are a no-lift program facility, so we needed an alternate solution from using a Hoyer lift for transferring bed bound patients out of bed.”
These limitations challenged Islands’ team unfamiliar with seating and positioning options:
- On one end of the spectrum there are Complex Rehab Technology (CRT) wheelchairs which are highly customized, specialized, and expensive equipment that are specified for each patient.
- On the other side there are geriatric chairs or ‘geri chairs’ which are outdated basic reclining and positioning devices notoriously unwieldy, uncomfortable, and dangerous for patients.
- The other general option end are basic cheap wheelchairs that provide limited positioning options, uncomfortable sling seats, and easily break or malfunction.
After confronting these limited options, the search continued and fortunately Gary and his team were able to discover Broda.
Islands tested Broda’s Synthesis Positioning Wheelchair, Encore Pedal Wheelchair, and Revive Shower Commode as a comprehensive solution for their mobility and hygiene equipment needs.
With Broda’s Synthesis Positioning Wheelchair, they were able to find found an immediate success. Gary described the situation, “Getting these patients into a wheelchair on day two is the first time for many that they got out of bed. Broda’s Synthesis Positioning Wheelchair with the adjustable seat tilt and back recline features helped these patients develop a tolerance for sitting, a feature unavailable in a standard bedside geriatric or reclining chair.”
Continuing to safely get patients out of bed and in line with their no-life program, “Broda’s Synthesis Positioning Wheelchair with its feature of a 90 degree recline to lay flat facilitated easy lateral transfer from the bed combined with the use of our blower mattress transfer systems. The Broda Synthesis Positioning Wheelchair for our bed bound patients allows them to get out of bed and increase engagement with activities in the facility.
“With the design of the Comfort Tension Seating system of the Broda line of wheelchairs, the patient experience and quality of life in our facility has improved with the tolerance of being able to sit for longer periods to enjoy getting rehab care and doing activities away from the bedside. We even have had requests from case managers who wanted to know how to purchase their own Broda wheelchairs for their clients returning home.”
Specifically talking about a particular patient who benefited from the Synthesis: “We developed a rehab care plan for an ALS patient that was admitted for post-acute medical care who wanted to be able to use her electric wheelchair again. She was hospitalized for months and not been able to get out of bed into a geriatric reclining chair. Using the Broda Synthesis Positioning Wheelchair, we are not only able to get her out of bed every day but could attach our VOCSN ventilator securely on the back of the Broda. The lateral support and comfort seating system increased the tolerance for sitting and motivation to get out of bed. After a month of dependent mobility in the Broda with Physical Therapy, she was able to use her electric wheelchair with supervision.”
Gary and his team also found get great benefits with Broda’s line of pedal wheelchairs: “Broda’s Encore Pedal Wheelchair gives our therapists and staff the ability to have a multi-use wheelchair compared to a standard wheelchair. This Broda product is designed so that it can function for those that can self-propel using their feet or use the front mounted mag wheels. For those patients that require supervision away from the bedside, the seat tilt and rocker feature provide comfort and enjoyment.”
The Encore Pedal specifically helped improve the quality of life for one Islands’ patient: “We developed a rehab care plan for a patient who is blind with an history of extensive electrocution burns and was hospitalized for a year. Physical Therapy used Broda’s Encore Pedal Wheelchair to develop sitting balance and tolerance, trunk mobility for the patient to have lunch while seated in the Broda, and increase sitting time out of bed. The patient demonstrated appropriate and safe seating position to complete lunch while seated in the Encore Pedal.”
Adding to the benefit of these wheelchairs at the facility, both the Encore Pedal and Synthesis Positioning have WC19 Transportation Options, which are crash-tested configurations for safe vehicle transport via tie downs. This allowed Islands to “We routinely send our outpatient kidney dialysis patients with a Broda wheelchair for a safe transport. Prior to COVID, we had even planned on an outing to a mall using the Broda Synthesis Positioning Wheelchair and Encore Pedal Wheelchairs and will return to these outings when safe.”
Gary elaborated on this option, “compared to EMT transport with a gurney with caregiver dependent patients, Broda’s wheelchairs are easier to maneuver and allow for NEMT [Non-Emergency Medical Transportation] transport which is a cost savings of at least $2,850 per round trip.”
Hygiene care is also important for Islands and Broda’s solution helped improve this aspect of care for their patients: “The Revive Shower Commode allows the staff to safely transport and position the patient during bathing with tilt and recline. Broda’s seating system and design allows the patient to tolerate sitting compared to the standard PVP shower chairs.”
Gary summed it all up, “We have been using the Broda’s wheelchairs and chairs since opening our facility to admissions 8 months ago with no incidence of falls or pressure injuries from the wheelchairs. As Hawaii’s leading post-acute and respiratory care community specializing in short term rehabilitation, ventilator, and tracheostomy care we utilize medical technology and the best rehabilitation equipment. Broda’s wheelchairs are an integral part of our mobility and rehabilitation program. Broda is our premier provider of solutions for wheelchair mobility promoting safe rehab opportunities for patients and caregivers.”
ABOUT ISLANDS SKILLED NURSING AND REHABILITATION
Our mission at Islands Skilled Nursing and Rehabilitation is to exceed expectations and enhance the lives of our associates, partners, residents and their ‘ohana by promoting and practicing the aloha spirit as we provide the highest standard in excellence of care.
We’re Hawaii’s leading respiratory and post-acute medical care community equipped to provide the same kind of care that you would receive in a hospital or intensive care unit. Partnering with your physician, we put together a personalized critical care team for you. This team can include physical, occupational, speech and respiratory therapists, a social worker, nutritionist, critical care nurses, and nurse assistants.
Your staff members at Islands Skilled Nursing and Rehabilitation are trained and equipped with the skills and expertise to treat residents needing intensive and complex medical care. We pride ourselves on being Hawaii’s leader in caring for those needing ventilator or tracheostomy bedside assistance.
Our community design and specialty therapeutic equipment enables us to provide the first-class quality care needed to support your needs. The goal is to help transition you to as normal a life as possible.
Whether it’s a short stay to help with rehabilitation from a bone fracture, heart attack or stroke, or a long term stay to assist with daily ventilator or tracheostomy care,. Islands Skilled Nursing and Rehabilitation has you covered.