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Inpatient rehab

Setting global standards in neurorehab

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With a global reputation for its work in brain and spinal cord injury rehabilitation, Craig Hospital has delivered life-changing outcomes for thousands of patients for 65 years. Deborah Johnson meets Jandel Allen-Davis, CEO of the pioneering US hospital, to learn more about its work 

 

With an unrelenting focus on rehabilitation, underpinned by world-leading technology and led by a team who pride themselves on being by their patients’ sides every step of the way, Craig Hospital has built a global reputation for its work. 

Having offered neurorehabilitation since 1956, supporting over 34,500 brain and spinal cord injury patients during that time, Craig is known the world over for its pioneering and brave programmes which empower patients and maximise their independence. 

From its base in Denver, Colorado, Craig attracts patients from across the United States – and often internationally, too – with its ‘Craig graduates’ routinely building a lifelong affection with the hospital and its team, forever indebted to the life-changing impact they have made. 

Led by Dr Jandel Allen-Davis, who became CEO of Craig in 2018, Craig’s reputation for pushing the boundaries of possibility for its patients through intensive rehabilitation is one she is committed to taking forward even further. 

“We work hard, we’re healing bodies, minds and spirits,” Jandel tells NR Times. 

“The people we care for woke up with one reality and went to bed with a very different one – but there is life after brain injury or spinal cord injury, and we will show them that is possible.

“The interesting thing about Craig is that typically in United States acute rehab, you’ll get two or three hours a day (of rehabilitation). Here at Craig, it’s between four and six, and it’s usually six. 

Dr Jandel Allen-Davis

“The day generally starts at 9 and ends at 4, and that hard work could be physical for brain injury and spinal cord injury patients, or cognitive for brain injury patients.

“We only have 93 beds, so it’s a precious resource and there is way more demand than we have beds.

“They have got to come here ready to work. On the first day here, we’ll get them fitted for a wheelchair if that’s needed, we start work on day one and work hard from there.” 

But the concept of hard work is something welcomed by Craig patients, with the outcomes of countless Craig graduates showing what can be possible for those living with brain and spinal cord injury. 

“We achieve stellar outcomes,” says Jandel. 

“In 2020, 82 per cent of our patients were discharged to their homes, and about 48 per cent of our SCI and BI patients returned to work or school within one year after discharge.

“Our patients require significantly fewer hours of daily attendant care than those who don’t come here – we strive for independence.

“I love it when I hear patients say ‘I do what I used to do, but now I do it differently’. Often they say they wouldn’t go back to their life before their injury – and often that’s because they have discovered new resilience and determination in themselves they had no idea existed. 

“It’s pretty remarkable and shows us every day there is life on the other side of spinal cord injury and brain injury, a good life.”

With therapy programmes devised around the exact needs of each patient, Craig’s use of technology and equipment – partly funded by the “magical generosity” of donors through its associated Craig Foundation – is genuinely world-leading. 

Its work in transcutaneous electrical stimulation for spinal cord patients in particular is globally significant, having begun in pilot in 2019, and is now helping people to regain the power of movement. 

“We are helping people to get their function and movement back, even years after injury, it is really amazing,” says Jandel. 

“But the physician in me totally believes and knows that technology is like a scalpel and pills, they are tools, enablers, not the be all and end all. 

“We start with the basics and then look at how technology can advance their rehab. It’s a holistic approach, of which technology is a part.” 

But the part technology plays is without doubt a key component in Craig’s offering – from exoskeletons to EyeGaze, VR to robotics, as well as gaming which proves especially popular in its Teen Rehab groups. 

And through its work in research and paving the way for new innovation, the potential for its patients – both current and future – is increasing all the time. 

“We have the most amazing equipment, there are some really cool things,” says Jandel. 

“It starts here at Craig where we have the most highly-skilled therapists who understand neuroscience and body mechanics, we’re learning more about neuroplasticity and the ability to regenerate. We have things being created on 3D printers by our therapists which can support people in living independently.

“Human ingenuity and the quest for innovation will never be complete, and that thirst will never be quenched, thank God.

“Neurorecovery is a big frontier in an exciting way, in the way that brain plasticity can recover, and neuroregeneration through spinal cord injury transplant of tissue – these things are super new, the data is not yet solid, but the cool thing is that as we have a research unit at Craig, we stay in the game all the way.”

But for Jandel, while technology and therapy are of course fundamental in Craig’s offering, the factor that underpins its reputation, outcomes and work is the dedication of its team. 

“This place is so unique. I’ve never worked in a place which lives and breathes patient and family-centred care like this. A lot of places talk about it, but this is truly standout – and I can say this with 40-plus years in healthcare,” says Jandel, whose background is in obstetrics and gynaecology, and admits a move into neurorehabilitation was “completely off the beaten path”.  

“It’s team-based care. We have psychologists, PT, OT, speech and language and the ‘angels’ who are the clinical care managers.

“I’ll have been at Craig for three years in October and it still feels new. I think that speaks volumes about what a difference it makes to bring your whole self to work, with team mates who bring their whole selves to work. It is a privilege and an honour to serve at Craig.

“From the folks in the environmental services team, through to the frontline caregivers, everyone gives their all. Some of the leadership team have been here for 30-plus years, they are Craig veterans, and everyone plays their role.”

Leading from the front, Jandel is often to be found walking the floors at Craig, getting to know patients and their families and discovering the impact her team’s work is having on their lives. 

“I love walking the floors and talking to patients, they gush about this place and the relief that washes over them when they come here,” says Jandel. 

“We hear from families what a wonderful place this is, and I say ‘It was like this when I got here’. 

“It’s not just about the patient; as with brain injury and spinal cord injury, they are probably going to need an attendant to help them. So we deliver family-centred care. 

“The patient and family are at the centre of a myriad of services and people that surround that patient, and we customise a care delivery programme.

“When I’m walking around, I joke to patients ‘Did we beat you up today?’ They say we have and I say ‘Well, our work is done’.

“Craig graduates always come back, many come to get their ‘tune ups’, get their wheelchair checked, and so on. But we offer lifelong care and support for patients and their families, so we do hope they will come back.” 

As a hospital working at the forefront of neurorehabilitation, but with only 93 beds, Craig is a great believer in the power of empowering people in their own homes and communities, with the COVID-19 pandemic highlighting the importance of enabling that. 

“I’m interested in what potential lies ahead for distanced medicine,” says Jandel. 

“With people living longer, we have to think about delivering care for everyone, it’s less about the ages and stages. As an example, spinal cord injury patients do age more quickly, and there are parts that telehealth can enable. 

“Home health needs a huge lift, people live in tiny communities – how do they access the support and neurorehabilitation they need? This is where their life happens so it’s more natural for people if they can do this where they live. 

“If we can figure out how that works, then do we need to add a whole ton of new beds? We have to think about these sorts of things. The economics of it would enable us to lessen the burden on resources, while enabling people to be more independent.

“Rehab is always going to be part of the deal, so we need to do the right things.”

While Craig’s work continues to develop, with ongoing innovation and progress for its patients made by the day, it will continue to hold its place as one of the world’s leading neurorehab centres. 

But for Jandel, the ultimate dream is that no patients would need to access such a place, and that prevention could get to such a stage that such intensive neurorehabilitation would not be needed. 

“The big dream is that we wouldn’t need a place like this,” she says. 

“Nobody wakes up in a morning and says ‘I want to go to Craig’. 

“We’re in a space now where we’re thinking more about prevention, how to prevent sports injuries, workplace injuries. I think it’s so important to use our voice in the prevention space, alongside the work we’re doing now in treating.” 

Inpatient rehab

New brain injury hospital given go-ahead

The Disabilities Trust retains its 20-year presence in York through its new development

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Plans for a new brain injury hospital are to become reality after The Disabilities Trust secured approval for the project, which will maintain a vital service in Yorkshire. 

For over 20 years, the charity has operated York House in the city of York, but was forced to look elsewhere due to the closure of the site. 

After a lengthy search, The Disabilities Trust has chosen its new site, south of The Residence at the city’s Chocolate Works development, and construction is now able to begin to create the 36-bed purpose-built facility. 

The four-ward hospital, which retains around 145 healthcare jobs in the city, will be dedicated to acquired brain injury rehabilitation and will also include four assessment flats and a therapeutic garden. 

The new centre will add further to the charity’s brain injury inpatient portfolio, which extends across England, Scotland and Wales, in addition to its community and supported living services. 

“We are delighted to have received planning permission which will allow us to continue our presence in York after more than 20 years of service,” said Bill Chidgey, director of corporate services at The Disabilities Trust.

“This development will enable us to provide the people we support with the highest quality of facilities, to aid and support them in their treatment and rehabilitation.   

“We’re proud to call York our home and are looking forward to building strong ties with local residents and our new neighbours. Throughout this process our priority has been to retain our workforce and provide long-term assurances to the people we support and their families. 

“Now our plans have been approved we can look forward to our future in York.”

Tom Wheldon, director and head of region at HBD, said: “We’re pleased to have been able to partner with The Disabilities Trust to bring forward this new facility – it will bring huge benefit to so many people and retains a vital mental health service for York.

“We’ve worked closely with the local community to create a scheme that is both considerate of its surroundings and incorporates high quality facilities for the benefit of service users and staff.”

The planning application to City of York Council was submitted in July following a public consultation, and the project will be completed in partnership with development company HBD. 

The project team supporting the scheme includes planning and heritage consultant JLL, principle architect Jefferson Sheard, and specialist landscape architect, re-form landscape architecture.

The development will also include 50 car parking spaces, bicycle racks and additional landscaping adjacent to the Peace Garden. The building will aim to achieve BREEAM Excellent rating, a 28 per cent reduction in carbon emissions in line with Council objectives, and include a green sedum roof.

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Inpatient rehab

‘The challenges are ongoing, but our resilience is getting us through’

Chase Park Neuro Centre discusses the challenges faced by care providers and how ongoing investment is enabling it to look forward with confidence

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A specialist neurological care centre has highlighted the impact of the compulsory COVID-19 vaccination policy for staff as the latest in a series of major challenges for the sector to deal with during the pandemic. 

During one of the most challenging periods for healthcare in living memory, care has been particularly adversely affected, with the loss of staff through the introduction of rules around vaccination being the latest storm for providers to weather. 

Chase Park Neuro Centre has said it, like many other specialist care centres, has lost staff as a result of the new Government-led policy – exacerbating the social care recruitment crisis further – but its team has pulled more tightly together as a result, to continue to deliver the best possible care to its residents. 

“Much of the industry is reacting quite furiously to the Government making COVID vaccination among care homes staff compulsory, because we are the only industry that has been mandated to have all staff double vaccinated by November 11, otherwise, staff will lose their jobs,” says Paul Smith, director of operations at Chase Park, in Whickham, Gateshead. 

“Whatever the rights and wrongs of such policy, we are in a situation whereby people who may have been with a company for many, many years are going to have to be let go, or redeployed to an off-site service, and most care homes simply can’t do that.

“Luckily, across our dedicated staff group, there is only one person who has declined the vaccine.

“Of course, in tandem, what we’ve also got is a population that is tired, a population that is concerned about facing a fourth wave and future restrictions, but as a positive we have a workforce who has come through all of that. 

“At the end of the day, as tiring and as stressful as it has been, we have more resilient and committed staff at the end of it and that’s a strong position to hold.”

Chase Park, a 60-bed care home which provides rehabilitation services to people with neurological and long-term nursing conditions and more recently opened a villa for people living with dementia, has been running at 50 per cent capacity throughout the whole of the pandemic. 

A voluntary decision was made in March 2020 to close one of the two main buildings as some of the residents were highly vulnerable. They have since begun to safely reopen the closed unit with four residents already in situ at the site. 

For operators such as Chase Park and the teams working within the businesses, the impact of the pandemic physically, mentally and financially has also been significant, says Paul. 

“Although there has been some Government support in terms of COVID funding, that has mainly only been for PPE and testing,” he says.

“The testing regime itself has been a huge strain on managers and care, combined with the quarantine of up to 14 days. 

“I don’t think any care home, or any provider, is coming out of this in a healthy state, either the kind of physical and mental health of the teams and the managers in particular, but also on the financial side. 

“We are all trying to dig ourselves out of a very large COVID hole at the moment, but we have chosen a particularly proactive means to do this.”

Throughout the pandemic, Chase Park has continued to invest heavily into its facilities and offering. 

Under the ownership of Dr Niraj Brahmabhatt, Chase Park – a nurse-run service owned by medical practitioners, with management from clinical backgrounds – has strengthened its management team and appointed two non-clinical deputies through internal promotions to support the centre manager, Jane Webber. 

As well as refreshing its therapy team, it also has a new physiotherapist joining and will have both a physiotherapist and an occupational therapist on-site.

Chase Park has also invested heavily in digital technology and rehabilitation technology, including the implementation of a Tyrostation. It has introduced PCS, a person-centered software e-care plan system, as well as the Croner-I governance support system. It has also taken out a subscription with the Royal Marsden for staff to access vital clinical resource support anytime. 

Reflecting on the development of the centre and its team, director Dr Brahmabhatt says: “We continue to invest in Chase Park and our staff. We focus heavily on our culture and progression. 

“We want our staff to feel supported and confident in what they do. We run a staff satisfaction survey every six months as well as a service user satisfaction survey and incentives such as ‘employee of the month’. 

“With several staff starting their careers with us as carers and progressing to team lead and non-clinical deputies, we are committed to creating a culture of continuous learning.”  

Centre manager Jane adds: “Chase Park is very special and one big family. We believe in developing people, and they really do count every single day. 

“We currently have seven new recruits coming on board, we’ve also had an influx of nurses and we are now looking at tier two applications. If anyone is considering a career in care, we would encourage them to give us a call to find out more, our door is always open.”

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Inpatient rehab

QEF appeal hits £1million milestone

The disability charity’s £2.7million fundraising drive is to complete and fully fund its Care and Rehabilitation Centre

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A charity has reached the £1million milestone in its three-year fundraising appeal to complete and fully fund its state-of-the-art Care and Rehabilitation Centre. 

Queen Elizabeth’s Foundation for Disabled People (QEF) launched its Edward Guinness Appeal to raise the final £2.7 million needed for its centre of neuro rehabilitation expertise, supporting people to rebuild their lives after a stroke, acquired brain injury, incomplete spinal injury or neurological illness.

Over the last 22 months the charity, based in Leatherhead, has had support from individuals and the local community who responded to the appeal and took part in a variety of fundraising activities. 

Marisa Goldsborough, head of philanthropy at Queen Elizabeth’s Foundation for Disabled People, said: “This is such wonderful news to be able to share with everyone. The last 18 months have been tough for many charities including QEF, so we are delighted to have achieved this milestone and are so grateful for the generosity of everyone who has supported us so far.

“We still have a long way to go to reach the final £2.7m needed but this has given us a real boost. 

“The funds raised through The Edward Guinness Appeal are vital to fully funding the Care and Rehabilitation Centre and supporting people when they need our expertise most to rebuild their lives after a traumatic event such as a stroke. 

“We also want to ensure items like additional lifts and automatic doors can be added to the building and we can install accessible technology throughout such as eye gaze technology, sensory zones in the gardens and provide additional therapy equipment.”

The Care and Rehabilitation Centre is a £15million development that was opened by HRH The Countess of Wessex in June and has played an important role in supporting the NHS in South East England throughout the pandemic. 

The charity launched the Appeal in November 2019 to raise the final £2.7m needed to complete and fully fund this landmark development, which puts QEF at the forefront of neurorehabilitation. 

The centre, recently rated as ‘Good’ by the CQC, can support up to 48 people at a time, providing integrated and person-centred neurorehabilitation and nursing care under one roof. 

The facilities have been designed to meet the needs of clients, including large ensuite bedrooms each with tracking hoists, a state-of-the-art therapy gym and adaptable therapy rooms, multi-purpose recreational rooms and informal social areas and large, spacious dining rooms.

The charity has a series of unique fundraising events planned over the next 12 months to raise the final total needed, including:
– The Guinness and Oyster Luncheon on November 25 at Mansion House,
– Magical Christmas at Lambeth Palace on December 2
– The ‘Best of British Wine’ tasting event on February 1, 2022
– Rugby Legends Gala Dinner on March 3, 2022.

Find out more about the appeal and how you can get involved at qef.org.uk/edwardguinnessappeal

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