S180 S290
competitive in coming years by closing gaps with the most competitive
residencies.
Level of Evidence:
Level IV
Poster 146:
Rehabilitation Medicine: A Global Health Concern
Manoj K. Poudel, MBBS (Nepalese Academy of Physical Medicine and
Rehabilitation, Clovis, California, United States)
Disclosures:
Manoj Poudel: I Have No Relevant Financial Relationships
To Disclose
Objective:
To figure out the pattern of distribution of rehabilitation
medicine specialty in the world map.
Design:
Descriptive study.
Setting:
Countries in the world.
Participants:
None.
Interventions:
None.
Main Outcome Measures:
None.
Results:
According to WHO/World Bank data, around 15-20% of world
population is believed to have some form of disability. The number of
adults with significant disability has increased from about 92 million in
2004 to nearly 190 million in 2016. However, analysis of the data of
International Society of Physical and Rehabilitation Medicine revealed
that only about 40% of the total number of countries in the world have
their existing national society of rehab medicine physicians. Hence,
more than 60% of countries may not have existing rehabilitation
medicine journal publication, Physical Medicine and Rehabilitation
(PM&R) residency training facilities, separate physiatry specialty
board requirements and national rehab medicine conference orga-
nized in their countries. Only about 8.5% of African, 14% of Oceanian,
23% of North American, 48% of Asian, 75% of South American and 76% of
European countries have existing national societies of physiatrists. And
30% of high-income, 59% of upper-middle, 75% of low-middle and 95%
of low-income countries do not have their national society of rehab
doctors. Above 90% of least developed countries either have extremely
few number or no physiatrists at all. Average percentage of national
health expenditure with respect to Gross Domestic Product, in coun-
tries with and without national physiatrists’ organization, are found to
be 7.5 and 6.5, respectively, in the year 2014.
Conclusions:
The number of rehab physician is not sufficient for the
increasing number of population with disability around the world. The
PM&R specialty is not distributed homogeneously in the world map.
The reason could be directly related to the economic status of the
region. Hence, it is important to develop physiatry/rehab medicine
and its training as a global health concern.
Level of Evidence:
Level V
Poster 147:
Rehabilitation Student Run Interest Group Increases
Medical Student Interest in PM&R
Annamaria L. Dunn, MD (JFK Med Cntr), Alessandra Dunn, N/A
Disclosures:
Annamaria Dunn: I Have No Relevant Financial Relation-
ships To Disclose
Objective:
To determine if a student run interest group would in-
crease electives in PM&R and generate interest in the specialty.
Design:
A student run interest group was initiated by an attending
physician in the PM&R department. The faculty member sent out a
general email to the medical students seeking officers. Three officers
were chosen in the second-year class. The interest group met monthly.
Emails were sent by the officers to the student body prior to the
meeting. The meetings were informal. Each month a different
attending in the group with a different subspecialty spoke to the
students about why he chose the specialty, what his day is like,
interesting patients, etc. The students were able to ask the attending
multiple questions during the session. Example of topics were
prosthetics and orthotics, brain injury, pain, spasticity, musculoskel-
etal, stroke and electromyography. Lunch was provided. Students
paired up with various attendings for research projects and a shad-
owing program was initiated at the students request. The shadowing
program provides students the opportunity to spend a few hours with
an attending in a specialty of interest.
Setting:
A medical school in the Northeast.
Participants:
First, Second and Third year medical students and the
faculty of the PM&R department.
Interventions:
Not applicable.
Main Outcome Measures:
Number of students seeking an elective in
PM&R.
Results:
The number of students performing an elective in PM&R
doubled over a two year period. The shadowing program also added
students, and research projects were generated.
Conclusions:
A monthly student interest group run at the medical by
the students generates interest and knowledge in the field of PM&R.
Level of Evidence:
Level V
QUALITY IMPROVEMENT POSTER HALL: ORIGINAL RESEARCH
Poster 149:
Risk Factors for Acute Care Transfers in the Inpatient
Rehabilitation Setting and Early Warning Systems: A
Review of the Literature
Andrew Y. Chang, MD (WA Univ/BJH/SLCH Consortium),
Michael Bonnette, MD, David Carr, MD
Disclosures:
Andrew Chang: I Have No Relevant Financial Relation-
ships To Disclose
Objective:
Acute care transfers (ACTs) are common in inpatient
rehabilitation settings. Our aim was to analyze the current literature
to identify common characteristics and risk factors that lead to ACTs
and appraise the Early Warning Systems (EWS) literature with the
eventual goal of constructing a risk assessment tool for Acute Care
Transfer clinicians.
Design:
We reviewed published literature using Google Scholar and
PubMed using the search term “acute care transfers”, “unplanned
transfers”, “inpatient rehabilitation”, “risk assessment tools” and
“early warning systems.” We came across a total 108 articles of which
17 articles fit our inclusion criteria.
Setting:
Inpatient rehabilitation facilities throughout the United
States.
Participants:
Not applicable.
Interventions:
Not applicable.
Main Outcome Measures:
ACT rates, risk factors for acute transfers,
use of risk assessment tools and early warning systems.
Results:
Most common reasons for ACTs identified in the literature
were UTIs, pneumonias, dehydration, and neurological changes (e.g.
mental status changes). Overall ACT rates, ranged from 8%-17.4%. Most
common risk factors associated with ACTs were low FIM scores, older
age (
>
65 years), male sex, and polypharmacy. None of the articles
reviewed utilized a risk assessment tool, although several articles
supported the implementation of one. Early warning systems have
been studied in acute care hospitals but we are unaware of any studies
in the inpatient rehabilitation setting that have published on early
warning systems and preventing ACTs.
Conclusions:
Through this analysis of current literature, we are
confident that the set of risk factors identified can be used in the
implementation of a risk assessment tool for patients admitted to the
inpatient rehabilitation setting. EWS should be considered in the
inpatient rehabilitation setting given the acuity and complexity of
patients admitted in these settings.
Level of Evidence:
Level III
S180
Abstracts / PM R 9 (2017) S131-S290