November 15-16, 2013Chevy Chase Bank Conference Center

The Sheikh Zayed Tower The Johns Hopkins Hospital

Baltimore, Maryland

Critical Care Rehabilitation Conference:

UNDERSTANDING & IMPROVING

ICU Patient Outcomes

DIVISION OF PULMONARY AND CRITICAL CARE MEDICINE AND

DEPARTMENT OF PHYSICAL MEDICINE AND REHABILITATION

Present

C O N T I N U I N G M E D I C A L E D U C A T I O N

This conference has been endorsed by the American Thoracic Society

ACCREDITATION STATEMENTThe Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CREDIT DESIGNATION STATEMENT The Johns Hopkins University School of Medicine designates this live activity for a maximum of 10.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

OTHER CREDITAmerican Nurses Credentialing Center American Nurses Credentialing Center (ANCC) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

American Academy of Nurse PractitionersAmerican Academy of Nurse Practitioners (AANP) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

American Academy of Physician AssistantsAmerican Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME. Physician assistants may receive a maximum of 10.75 hours of Category 1 credits for completing this program.

American Occupational Therapy Association, Inc. (AOTA)The application for AOTA CEUs is currently pending approval.

American Speech-Language-Hearing Association The application for ASHA CEUs is currently pending approval.

Contact Hours for Non-PhysiciansThe Johns Hopkins University has approved this activity for 10.75 contact hours for non-physicians.

Physical TherapyThis course has been approved by the Maryland State Board of Physical Therapy Examiners for 1.0 CEUs. You will be issued a CEU certificate upon completion of the course. A record of CEUs earned will be retained by the sponsor.

Psychologists The Johns Hopkins University School of Medicine is authorized by the Maryland State Board of Examiners of Psychologists as a provider of continuing education. The Johns Hopkins University School of Medicine maintains responsibility for this program. A certificate for CEUs will be awarded upon completion of this live activity.

Professional Counselors and Therapists This Continuing Education activity is eligible for Category A CEUs for Professional Counselors and Therapists as a result of the sponsor, Johns Hopkins University, and its classification as an institute of higher education.

POLICY ON SPEAKER AND PROVIDER DISCLOSUREIt is the policy of the Johns Hopkins University School of Medicine that the speaker and provider disclose real or apparent conflicts of interest relating to the topics of this educational activity and also disclose discussions of unlabeled/unapproved uses of drugs or devices during their presentation(s). The Johns Hopkins University School of Medicine OCME has established policies in place that will identify and resolve all conflicts of interest prior to this educational activity. Detailed disclosure will be made in the activity handout materials.

COURSE DESCRIPTIONInterdisciplinary collaboration and coordination is vital to facilitate

early mobility and rehabilitation in the intensive care unit (ICU)

setting. A recent stakeholders’ conference aimed at improving long-

term outcomes for ICU survivors identified important ‘silos’ among

critical care and rehabilitation clinicians working in the ICU, with

these ‘silos’ acting as a barrier to collaboratively advancing the field

and improving patient outcomes. While clinical trials support the

benefits of early rehabilitation for mechanically ventilated patients,

implementing these interventions requires

creating a new ICU culture based

on proactive rehabilitation and

interdisciplinary collaboration

between all critical care

and rehabilitation clinicians.

This activity will bridge

the interdisciplinary gap

from research to clinical

implementation at the

bedside.

OBJECTIVESAfter attending this activity, the participant will demonstrate the ability to:

•Identify thechallengesassociatedwith ICUsurvivorshipaswellas risk factorsandprevention strategies.

•Appraise the latest evidence on long-term physical, cognitive, and psychiatricoutcomes.

•DescribethesafetyofearlyrehabilitationintheICU.

•RecognizethedetrimentaleffectsofICUdeliriumanddiscussstrategiestoimprovethe management of ICU sedation, delirium and sleep.

•Describe the typesofphysical therapy,occupational therapyand speech languagepathology interventions to improve ICU patient outcomes.

•Explain the inter-disciplinary roles of physicians, nurses, physical therapists,occupational therapists, speech language pathologists, psychologists, and respiratory therapists, as it relates to the day-to-day implementation of an early ICU rehabilitation program.

•Explaintheroleofastructuredqualityimprovementprocessfortheimplementationand evaluation of an early ICU rehabilitation program.

•DescribeanddiscusshowtochangeICUcultureandpracticetoimplementanearlyand sustained mobility program for critically ill patients along the continuum of care.

•Describetheuseofnewinterventionstoimprovetheneuro-psychologicaloutcomesof ICU patients.

•Describe and discuss best practices for implementing and maintaining aninterdisciplinary early mobility program in the ICU.

WHO SHOULD ATTENDThis activity is intended for physicians (critical care, pulmonologists, physiatrists, psychiatrists), physical therapists, occupational therapists, rehabilitation assistants, speech language pathologists, respiratory therapists, nurses, nurse practitioners, psychologists, physician assistants, and hospital administrators.

RegistrationFriday, November 15, 2013, 12:00 p.m.

Location Chevy Chase Bank Conference Center The Sheikh Zayed Tower The Johns Hopkins Hospital 1800 Orleans Street, Main Level Baltimore, Maryland, 21287

The Sheikh Zayed Tower is located on Orleans Street between Broadway and Wolfe Streets. Directions and campus parking information are available on our website under the contact and travel section at www.HopkinsCME.edu. The closest garage is the McElderry Street Garage, which is located off Caroline Street betweenMonumentStreetandOrleansStreet(Route40).Handicappedparkingisalso available in the McElderry Street Garage. Johns Hopkins is smoke free.

FEESREGISTRATION CUT-OFF DATE - NOVEMBER 8, 2013

Methods of Payment: Payment by check or credit card must accompany the registration form prior to the activity. On-site payments by credit card only. Foreign payments must be by credit card or with a U.S. Dollar World Money Order. The registration fee includes refreshment breaks and lunch.

Physicians ........................................................................................................................................................ $495

Non-physicianProviders/Residents*/Fellows* .......................................................................$375*withverificationofstatus

You will receive a confirmation by e-mail if you have provided your e-mail address, otherwise confirmation will be sent by mail. If you have not received it by November 8, 2013, call (410) 502-9636 to confirm that you are registered. AcertificateofattendancewillbesentbyJanuary6,2014tothee-mailaddressyouprovide on the registration form.

The Johns Hopkins University reserves the right to cancel or postpone any activity due to unforeseen circumstances. In this event, the University will refund the registration fee but is not responsible for travel expenses. Additionally, we reserve the right to change the venue to a comparable venue. Under such circumstances, registrants will be notified as soon as possible.

LATE FEE AND REFUND POLICYA $50 late fee applies to registrations received after 5:00 p.m. EST on November8,2013.Ahandlingfeeof$50willbedeductedforcancellation.Refundrequests must be received by fax or mail by November 8, 2013. No refunds will be made thereafter. Transfer of registration to another Johns Hopkins conference in lieu of cancellation is not possible.

SYLLABUSAll registrants will receive a folder with general information and paper for note-taking. This is included in the cost of your registration. A link to the syllabus will be provided via email shortly before the activity begins if you prefer to print the syllabus. A printed copy may be ordered at the time of registration for an additional fee of $35 forblackandwhiteor$95forcolor.Theprintedcopywillbeprovidedduringactivityregistration. Cancellations or refunds for the printed copy will not be permitted.

HOTEL AND TRAVEL INFORMATION We strongly encourage you to book your accommodations at one of the following three hotels. The Johns Hopkins Office of CME makes every effort to secure the best rate for overnight accommodations. The rate is part of a negotiated conference package that incorporates many services. By staying at the host hotel and booking within the room block, you help us maintain current conference benefits and keep future registration fees reasonable. Please consider this when making your overnight accommodations decision.

Hilton Garden Inn Baltimore (888)429-7482 HarborEast (410)234-0065 625SouthPresidentStreet FAX:(410)234-0299 Baltimore, Maryland 21202 Web Site: www.baltimoreinnerharbor.stayhgi.com

HOTEL RESERVATION CUT-OFF DATE: OCTOBER 1, 2013A limited block of sleeping rooms has been reserved for your convenience and will be available on a first come, first served basis.

The Hilton Garden Inn Baltimore Inner Harbor, pleasantly situated in Harbor East, blends well with its fashionable surroundings and offers excellent accommodations

within walking distance of downtown Baltimore. Make your reservation online at www.baltimoreinnerharbor.hgi.com or call the hotel directly and specify that you are attending the Johns Hopkins Critical Care Rehabilitation Conference to receivethespecialgrouprateof$149,singleordouble,plustax.Thisrateincludesbreakfast daily (maximum of 2 people per room) and one roundtrip taxi voucher to the main hospital daily. Complimentary wireless high speed internet access is also included with this rate. On-site parking is available at an additional charge. Check-in time is 3:00 p.m. Check-out time is 12:00 p.m.

Lord Baltimore Hotel (800)395-7046 20WestBaltimoreStreet (410)539-8400 Baltimore,Maryland21201 FAX:(410)625-1060 Web Site: www.radisson.com/lordbaltimore

HOTEL RESERVATION CUT-OFF DATE: OCTOBER 18, 2013

A limited block of sleeping rooms has been reserved for your convenience and will be available on a first come, first served basis.

The Lord Baltimore Hotel, a newly renovated historic hotel in the heart of Baltimore’s business district, is connected to the Inner Harbor and Convention Center via skywalks just two blocks from 1st Mariner Arena and Oriole Park. Make your reservation online at www.radisson.com/lordbaltimore or call the hotel directly and specify that you are attending the Johns Hopkins Critical Care Rehabilitation Conferencetoreceivethespecialgrouprateof$99,singleordouble,plustax.Thisrate includes breakfast for up to two guests per room, per night.

Complimentary self-parking is available along with transportation to and from the Johns Hopkins Hospital. Complimentary wireless high speed internet access is also included with this rate. Check-in time is 3:00 p.m. Check-out time is 12:00 noon.

Sheraton Inner Harbor Hotel (888)962-8300 300SouthCharlesStreet (410)962-8300 Baltimore,Maryland21201 FAX:(410)962-8211 Web Site: www.sheraton.com/innerharbor

HOTEL RESERVATION CUT-OFF DATE: OCTOBER 18, 2013A limited block of sleeping rooms has been reserved for your convenience and will be available on a first come, first served basis.

The Sheraton Inner Harbor Hotel is centrally located in the heart of Baltimore’s Inner Harbor. The official hotel of the Baltimore Orioles is just one block from the Convention Center, Harborplace and sport complexes. Make your reservation online at www.sheraton.com/innerharbor or call the hotel directly and specify that you are attending the Johns Hopkins Critical Care Rehabilitation Conference toreceive thespecialgrouprateof$149, single,double, tripleorquad,plus tax.This rate includes one complimentary taxi voucher to and from The Johns Hopkins Hospital per guest, per night. Complimentary internet is also included with this rate. On-site parking is available at an additional charge. Check-in time is 3:00 p.m. Check out time is 12:00 noon.

EVALUATIONA form will be available to attendees to evaluate each session and each speaker’s presentation as well as to identify future educational needs.

OUTCOMES SURVEYA survey will be sent to all physician attendees within three months post activity to assist us in determining what impact this activity had on the attendee’s practice.

EMERGENCY CALLSOnNovember15-16,2013,directallemergencycallstotheHopkinsregistrationdeskat(443)-287-5426.Messageswillbepostedforparticipants.

AMERICANS WITH DISABILITIES ACTThe Johns Hopkins University School of Medicine fully complies with the legal requirements of the ADA and the rules and regulations thereof. Please notify us if you have any special needs.

TO REGISTER or FOR FURTHER INFORMATIONRegisterOnline(creditcardandeCheck) www.HopkinsCME.eduRegisterbyPhone(creditcardonly) (410)502-9636RegisterbyFax (866)510-7088Confirmation/Certificates (410)502-9636GeneralInformation (410)955-2959E-mail the Office of CME cmenet@jhmi.eduFollow us on Twitter: http://twitter.com/HopkinsCMEFacebook: http://www.facebook.com/HopkinsCMESponsoring Department Website: www.hopkinsmedicine.org/OACIS For general information, the direct link for this CME activity web page is: http://www.hopkinscme.edu/CourseDetail.aspx/80032299.

General InformatIon

Friday, November 15, 2013Afternoon 12:00 – 1:00 Registration 1:00 – 1:05 Welcome and Conference Goals

Dale Needham, MD, PhD

Session 1 - Survivorship Chair: Dale Needham, MD, PhD 1:05 – 1:30 The Patient Perspective on ICU Survivorship

Moderator: Jennifer Zanni, PT, DScPT 1:30 – 1:50 Survivorship: Learning from Oncology VIDEO LECTURE

LillianShockney,RN,MAS 1:50 – 2:10 Post-Intensive Care Syndrome: What is it?

Dale Needham, MD, PhD 2:10 – 2:20 Question and Answer Session 2:20 – 2:30 Break

Session 2 - Recent Literature on ICU Patient Outcomes Chair: Dale Needham, MD, PhD 2:30 –2:45 Update on Long Term Physical Outcomes

Dale Needham, MD, PhD 2:45 –3:00 Update on Safety of Early Rehabilitation Interventions

Dale Needham, MD, PhD 3:00 – 3:20 Update on Long Term Neuropsychological Outcomes

O. Joseph Bienvenu, MD, PhD 3:20 – 3:30 Question and Answer Session 3:30 –3:50 RefreshmentBreak

Session 3 - Interventions to Improve Patient Outcomes Chair: Dale Needham, MD, PhD 3:50 – 4:15 Sedation, Delirium and Sleep Interventions

KathleenBailey,RN,BSN;DaleNeedham,MD,PhD 4:15 –4:35 Early Mobility and Physical Therapy

Jennifer Zanni, PT, DScPT 4:35 –4:55 Early Occupational Therapy

AngelaRegensburg,MS,OTR/L 4:55 – 5:15 Communication and Swallowing

Therese Kling-Cole, MA, CCC-SLP 5:15 – 5:30 Question and Answer SessionSession 4 - “A Day in the ICU”: Practical Issues in Organizing Early Rehabilitation Chair: Michael Friedman, PT, MBA 5:30 – 6:15 Multi-disciplinary Panel Discussion

KathleenBailey,RN,BSN;O.JosephBienvenu,MD,PhD; ThereseKling-Cole,MA,CCC-SLP;DaleNeedham,MD,PhD;AngelaRegensburg,MS,OTR/L;JenniferZanni,PT,DScPT

Saturday, November 16th, 2013Morning 8:00 – 8:25 Continental Breakfast 8:25 – 8:30 Welcome and Opening Remarks

Dale Needham, MD, PhD

Session 1 - Practical Ideas for Changing Culture for Early Activity Chair: Dale Needham, MD, PhD 8:30 –8:45 Quality Improvement Methods for Changing Practice

Dale Needham, MD, PhD 8:45 –9:00 Providers’ Perspectives on Implementing an ICU Rehab

Program Michelle Eakin, PhD

9:00 – 9:15 How to Change Culture Jennifer Zanni, PT, DScPT

9:15 – 9:30 A Nursing Tool-Kit for Implementing ICU Mobility SamanthaYoung,MS,RN

9:30 –9:45 Activity and Mobility Promotion Outside the ICU Michael Friedman, PT, MBA and Erik Hoyer, MD

9:45 –10:00 Question and Answer Session 10:00 – 10:15 BreakSession 2 - New Ideas for Interventions in the ICU Chair: Michael Friedman, PT, MBA 10:15 – 10:35 Anxiety Management and Improving Psychological Outcomes

Jennifer Stevenson, MPH, PhD 10:35 – 10:50 ICU Diaries

O. Joseph Bienvenu, MD, PhD 10:50 – 11:05 Engaging Patients to Participate in Early Mobility

Jennifer Stevenson, MPH, PhD 11:05 – 11:25 Cognitive Rehabilitation: Ideas for the ICU

KathleenKortte,PhD,ABPP-CNRP 11:25 –11:45 Future Directions

Michael Friedman, PT, MBA 11:45 –12:00 Question and Answer Session 12:00 – 1:00 Lunch

AfternoonSession 3 – Workshops 1:00 – 2:30 Mobility, Activity and Rehabilitation Interventions

Facilitator: Jennifer Zanni, PT, DScPT Business Case, Operations, Logistics and Management

Facilitator: Michael Friedman, PT, MBA Changing ICU Practices and Managing Sedation and Delirium

Facilitator: Dale Needham, MD, PhD 2:30 – 2:50 BreakSession 4 - Best Practice Summary Chair: Dale Needham, MD, PhD 2:50 – 3:50 Sharing Best Practices Summary from Workshops

MichaelFriedman,PT,MBA;DaleNeedham,MD,PhD; Jennifer Zanni, PT, DScPT

3:50 –4:00 Conference Wrap-up Dale Needham, MD, PhD PleasecompleteandreturntheEvaluationandCreditReportForms.TheRegistrationDeskwillremainopenduringconference hours.

The Johns Hopkins University School of Medicine takes responsibility for the content, quality and scientific integrity of this CME activity.This schedule is subject to change.

SPEAKERSACTIVITY DIRECTORDale Needham, MD, PhDAssociate ProfessorDivision of Pulmonary and Critical Care MedicineDepartmentofPhysicalMedicineandRehabilitationMedical Director, Critical Care Physical Medicine and RehabilitationProgramJohns Hopkins University School of Medicine

PLANNING COMMITTEEMichael Friedman, PT, MBADirectorofRehabilitationTherapyServicesThe Johns Hopkins Hospital

Jennifer Zanni, PT, DScPTPhysical TherapistThe Johns Hopkins Hospital

JOHNS HOPKINS SPEAKERSKathleen Bailey, RN, BSNNurse Clinician

O. Joseph Bienvenu, MD, PhDAssociate Professor of Psychiatry and Behavioral Sciences

Therese Kling Cole, MA, CCC-SLPSpeech Language Pathologist

Michelle Eakin, PhDAssistant ProfessorDivision of Pulmonary and Critical Care Medicine

Erik Hoyer, MDAssistantProfessorofPhysicalMedicineandRehabilitation

Kathleen Kortte, PhD, ABPP-CNRPAssistantProfessorofPhysicalMedicineandRehabilitation

Angela Regensburg, MS, OTR/LOccupational Therapist

Lillian Shockney, RN, MASUniversity Distinguished Service Associate Professor of Breast CancerAssociate Professor of Surgery, Gynecology and Obstetrics and OncologyJohns Hopkins University School of MedicineAssociate Professor, Johns Hopkins University School of Nursing

Jennifer Stevenson, MPH, PhDAssistantProfessorofPhysicalMedicineandRehabilitation

Samantha Young, MS, RNClinical Nurse Specialist

ProGram

Understanding & Improving ICU Patient OutcomesNovember15–16,2013

ToRegisterOnline:(creditcardandeCheck):www.HopkinsCME.eduByfax:(866)510-7088 Byphone(creditcardonly):(410)502-9636

OrmailthisformtotheJohnsHopkinsUniversity,OfficeofContinuingMedicalEducation,P.O.Box64128,Baltimore,Maryland21264-4128.Includecheckpayable to HOPKINS/80032299, or include credit card information below.

PAYMENTMUSTACCOMPANYFORMTOCONFIRMYOURREGISTRATION.

I am a Johns Hopkins speaker for this activity.Please type or print clearly:

Primary Specialty:

Nurse Physician Speech Language Pathology

Occupational Therapy Psychology Other: (Please Specify) ______________________

Physical Therapy RespiratoryTherapy

You will receive a confirmation notice and your attendance certificate by e-mail if you provide your e-mail address.

Check here if you wish to receive e-mail notices about upcoming CME activities.

What do you hope to learn by attending this activity?

________________________________________________________________________________________________________________________________

Please notify us if you have any special needs. ___________________________________________________________________________________________

Registration Fees:

Physicians ............................................................................................................................................................................................................................................................................................................................ $495

Residents*/Fellows*/Nurses/AlliedHealthProfessionals..................................................................................................................................................................................................................... $375 *withverificationofstatus

Syllabus Binder - Color ................................................................................................................................................................................................................................................................................................. $95

Syllabus Binder - Black and White .......................................................................................................................................................................................................................................................................... $35

For registrations received after 5:00 p.m. EST on November 8, 2013, include a $50 late fee. On-site registrations are payable only by credit card.

Workshop1:Mobility,ActivityandRehabilitationInterventions Workshop 3: Changing ICU Practices and Managing Sedation and Delirium

Workshop 2: Business Case, Operations, and Logistics and Management

Total amount enclosed $ ____________.Payment Type:

JHUFaculty/StaffOnly:IfyouareusingyourTuitionRemissionBenefitoranIONbudget,pleasecompletethisregistrationformandreturnwithappropriate payment processing form to OCME, Turner 20. Forms can be found on-line at http://www.hopkinscme.edu/Resources/resources.aspx.

Check (See instructions on top of form.)

Credit Card: VISA MASTERCARDDISCOVERAMEX

Card # _________________ - _________________- _________________ - __________________ Exp. Date _____________________________________

Name on Card _______________________________________ Signature and Date ___________________________________________________________

last name first name m.i.

highest degree Hopkins Faculty/Staff Only/JHED ID Number:

mailing address

city state ZIP + 4 code country

daytime telephone fax number

e-mail / / / / / / / / / / / / / / / / / / / /

REGISTRATION FORM Course Number 80032299

JOHNS HOPKINS CRITICAL CARE REHABILITATION CONFERENCE: