Wenyuan’s Story: Successful Long-Distance Discharge to Complex Home Care After COVID-19 and SCI

Challenge:


In March 2020, Wenyuan H. (32) sustained a work injury when he contracted COVID-19 working as an admissions coordinator in a New York City hospital. While hospitalized, Wenyuan sustained a C4-6 spinal cord infarction (stroke) due to COVID-19, which resulted in quadriplegia. Amid resource shortages, the closest rehabilitation hospital able to provide the necessary care was Shepherd Center in Atlanta, GA. His Paradigm network manager coordinated transport and admission to Shepherd, 800 miles from home.

Wenyuan’s condition was complex, requiring a tracheostomy and mechanical ventilation, a feeding tube, and a suprapubic catheter. At Shepherd, he received a diverting colostomy to allow a Stage 4 pressure injury to heal. While receiving inpatient rehab services, Wenyuan was successfully decannulated, and when the time came to plan his discharge to New York after a 6-month stay at Shepherd, BAYADA was engaged to provide the next level of care.

Wenyuan's Story

Solution:

With certified rehabilitation registered nurses (CRRNs) in multiple states BAYADA serves, BAYADAbility Rehab Solutions’ national program, along with the local BAYADA service offices, easily worked with Paradigm teams in Georgia and New York to safely transition Wenyuan from facility to home care. Despite pandemic travel restrictions, a BAYADAbility CRRN was able to attend family training, met with Wenyuan’s doctors, and worked closely with his NYC BAYADA Clinical Manager to educate nurses, reinforce family skills, and ensure that a safe home environment was prepared for Wenyuan’s continuity of care. BAYADA attended Wenyuan’s discharge meeting in GA and met him at home in NYC.

Wenyuan receives 12 hours/day of skilled nursing care at home, with a plan of care developed collaboratively by an RN supported by a BAYADAbility CRRN. Outcomes focus on regaining independence and the prevention and early detection of potential complications. In addition to attending outpatient therapy sessions with Wenyuan, nurses provide daily monitoring of vital signs and blood glucose levels and apply orthotic splints to enable continued progress toward reintegration into the community. Continuous assessment of skin integrity, maintenance of elimination routines, and assistance with his prescribed exercise regimen ensure optimal conditions to achieve desired outcomes.

Solution:

For six months and counting, BAYADAbility Rehab Solutions and his local BAYADA service teams have kept Wenyuan safe at home without rehospitalization. According to the National Spinal Cord Injury Statistical Center, 30 percent of individuals with a spinal cord injury (SCI) are rehospitalized one or more times per year, for an average length of stay of 18 days. Genitourinary and skin diseases are the most common causes of readmission. Wenyuan has had no serious complications nor adverse events related to his medication changes, saving thousands of dollars in health care spending by successfully managing his care at home.

With daily assisted PT and OT practice, Wenyuan is increasing his strength and range of motion to bilateral upper extremities and now can reach the top and back of his head. His feeding tube has been removed, and he now uses adaptive equipment to feed himself and to use the computer and phone. Wenyuan and his parents are in good spirits, feel hopeful for his continued recovery, and are happy with the care they are receiving

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