March 2018 PULSE

MARCH 2018

-COMING UP THIS MONTH-

GATHER AND CELEBRATE: THE PTSMC WAY The PTSMC Leadership team had the opportunity to get together in late January for our annual year end wrap up and our look to the upcoming year. We celebrated an outstanding year for PTSMC. Statistics reflecting growth in New Patients, Visits and Cash were shared. Similar to the SAG Awards (Screen Actors Guild) that happened the weekend prior, we recognized the MAG Awards; Measures, Achievements and Growth. Clinics were honored for achievement in categories such as: 10,000 annual visits club, 1,000 new patients in a year club and 1,000 visits in a month club, highest average clinic New Promoter Score. Triple claps for all achievers!

programs, potential of 1 hour IEs for all, reforming the role of the PT Aide, paperless registration and value based care models. Great conversations with more to come.

Aligning with recent events, a review of PTSMC’s sexual harassment prevention plan as well as a plan to better train staff was accomplished. Payer updates were reviewed including Medicare 2018, Oxford & required flowsheets, UHC reimbursement issues and Yale’s Preferred Provider Network – how PTSMC may get in.

We covered a ton in a short period of time. Looking ahead, I In my opinion, PTSMC has a performance culture that is driven am excited about the capabilities of our people, our organization and our profession. As we head into spring, our to do better tomorrow than we did today. The look back is a great compliment to our people who help us realize such great people are wrapping up individual reviews of 2017 and looking ahead to 2018 through our Dialogue for Development achievements. CHEERS to a successful year and to the process. I hope everyone shares in the recognition of how relationships and lives we have impacted in a positive way. each of you embody the PT for Life experience.

The group also spent time in small groups discussing and Please spend thoughtful and mindful time on your goals for presenting important operational topics: personal and professional development. Imagine what could - Dry Needling Only Patients - Can we create an organization-wide uniformed definition be! of CANCEL? I look forward to seeing everyone at our Organization - Valuing the Clinical Certifications Inservice on Tuesday, May 15th, at a new venue in Branford!

- NPS Scores: has the Strive feedback helped PTSMC staff?

As always, I thank you for all you do.

We also took a VISION trip for 2018 including thoughts and discussion regarding the WebPT transition, outcomes, exercise

StriveHub Fab 5

The staff is awesome. They have been incredibly helpful to our family. I honestly do not know what we would do without them! - Avon

Physical therapists are kind, nice, friendly, welcoming and educated. They work together to listen to the patients and take the time to come up with a great recovery plan. - New London They understand the issues and know the right approach to a solution to solve the problem. - Guilford

It was a great experience. I feel better and improved a lot in my walking and movement. My therapist Danielle was wonderful and very understanding of my symptoms with Parkinson's Disease. I'm looking forward to continuing my exercise every day to stay as healthy as I can. - Wallingford Place is amazing! Everyone is professional, dedicated, and friendly! Services are top notch! - Waterbury

MARCH IS NATIONAL ATHLETIC TRAINING MONTH

We salute all of our athletic trainers who are delivering “compassionate care for all” every single day. PTSMC employs 10 Certified Athletic Trainers who provide outreach care to local secondary schools, as well as athletic trainers in other leadership roles within the company.

PTSMC Athletic Trainers provide an all-encompassing approach to healthcare and support the youth in our communities - just another way PTSMC is your PT for Life! To help celebrate, PTSMC will be featuring all of our high school athletic trainers on social media throughout the month of March.

Saturday, March 3 8:00 am Groton clinic at Kelley’s Pace Hare Hop 5K Tuesday, March 6 6:00 - 9:00 pm Newington clinic hosting multi-business Health & Wellness night Saturday, March 10 9:00 am - 1:00 pm Plainville and Southington clinics at Central CT Chambers Health Fair Saturday, March 10 10:00 am Waters region clinics at Shamrock Shuffle Tuesday, March 20 7:00 am Newington clinic at Newington HS career fair Saturday, March 24 9:00 am - 3:30 pm Westbrook clinic at Clinton Business Expo

Save The Date!

PTSMC Organizational Inservice

Tuesday, May 15

The WoodWinds in Branford 7:00 am Breakfast- 7:30 am Program start Watch your email for official event information!

#GetMoving

Challenge is back!

The 4th Annual PTSMC #getmoving challenge is starting Monday, April 2! This 6-week challenge is meant to help us beat the winter blues, focus on our own health rather than just on our patients, have fun as a company and highlight some of our healthy habits on social media!

The rules for #getmoving remain the same: complete at least 30 minutes of exercise, 3x per week & log your activity. That’s it! You will receive official challenge details, including exercise ideas and how to track your activity, once you’ve registered.

There will be 3 winners of this year’s challenge: - most logged workouts within the 6-week period (>3x/week) - most posted workouts to social media - most creative social media posts Kristen Ludwig is also excited to offer her F.L.A.G. program to employees during these 6 weeks for only $50! This is a HUGE deal!

ALL challenge participants who complete the full 6 weeks will receive a *special* gift at the Organization Inservice on May 15. To register for #getmoving, send an e-mail to Ellen.Chatfield@ptsmc.com and say “I’m in!” by Monday, March 26!

CLINICIAN’S CORNER BY

ALI FILER, PT, DPT

Beyond the Joint: The Role of Central Nervous System Reorganizations in Chronic Musculoskeletal Disorders Management of musculoskeletal disorders is largely focused on structural dysfunctions found within the musculoskeletal system; however, this effectiveness is limited in those with recurrent or chronic musculoskeletal pain. According to Roy et. al. the central nervous system (CNS) can undergo plastic reorganizations that can be maladaptive, contributing to altered joint control and pain; therefore, these patients should be treated through a global view incorporating both central (neural) and peripheral (joint-level) changes.

Most individuals with musculoskeletal disorders perceive pain differently even when the structural disorders are similar. This could be explained by central sensitization, “amplification of neural signaling within the CNS eliciting pain hypersensitivity, “ (Woolf, 2011). CNS can rapidly adapt to changes occurring at the periphery. For example, there is an increase in sensorimotor cortex excitability following repeated use of new motor patterns, immobilization, or acute pain. These changes in cortical maps may disrupt the facilitation of the muscles needed to execute a motor task. For instance, individuals with recurrent LBP showed changes in spatial territory of the motor cortices that correlated with delayed onset of transverse abdominis (TrA) during rapid arm movements. i.e. impaired anticipatory activation of trunk muscles.

Since CNS reorganizations can affect motor and postural control, it is important for clinicians to evaluate how the joint is controlled. An example would be observing patients moving their limb during a motor task, changes in movement symmetry, compensations, and aberrant movements. It is also important to include emotional-cognitive assessment such as fear avoidance, pain catastrophizing and anxiety since these factors can contribute to central sensitization and joint control.

Studies have shown that changes in structural and functional brain organizations can be reversed in patients with chronic musculoskeletal disorders, and using sensorimotor training or skill training leads to improved motor function and decreased symptoms. For instance, chronic LBP rehabilitation with emphasis on somatosensory training, including voluntary contraction of muscles to improve TrA control led to normalization of motor cortices. Sensorimotor training begins with education on pain neuroscience, and on educating about the rehabilitation program to make sure the patients understand the goals. During the global approach, feedback is provided to elicit awareness of motor control deficits. Once the patient reaches pain free execution and adequate control then progression to re-education exercises according to work, sport and activities of daily living are initiated.

Maladaptive CNS reorganization associated with chronic musculoskeletal disorders may be involved in altered joint control and chronic pain. Therefore, it is important for clinicians to understand central neural mechanisms that lead to motor deficits and pain as well as using a global approach to optimize recovery and prevent recurrence.

Roy JS, Bouyer LJ, Langevin P, Mercier C. Beyond the Joint: The Role of the Central Nervous System Reorganizations in Chronic Musculoskeletal Disorders. JOSPT. 2017; 47: 817-821.

w o h s o t d , an s. e v r e s o t is er e h f t i l o n p l a e m h u f h d the will to o e s o p r u The p compassion an

Woolf CJ. Central sensitization: implications for the diagnosis and Treatment of Pain. 2011; 152:S2-S15.

STUDENT PROGRAM UPDATE

CONTINUING EDUCATION March 24 & 25 (1.5 days) Graston M1 at PTSMC Wallingford Instructor: Jackie Shakar May 8 from 4:00 - 8:00 pm Lower Extremity at PTSMC Newington Instructor: Joe Allen September 22 Examination and Treatment of the Foot & Ankle Location TBD Instructor: Rob Martin October 27 & 28 Mulligan Upper Quarter Location TBD Instructor: Russell Woodman Email ConEd@ptsmc.com to register for any of these courses!

Welcome to Sean Scully! Sean is a DPT student at the University of Scranton and will be completingPROGRAM his final STUDENT UPDATE affiliation with Joe Allen in Newington from March until May. Victoria Renner, SPT, will be completing her affiliation in Avon at the end of March. She’ll be presenting her inservice, “Cupping as Clinical Intervention,” on March 20.

Ashley Tighe, SPT, will be finishing up her affiliation in New Haven at the end of March. She’ll be presenting her inservice, “The Psychosocial Aspects of Physical Therapy,” on March 14 at 12:00pm.

}

We wish you both all the best!

D4D GOALS & OBJECTIVES

All employees should be nearing or have completed 2017 D4D’s and 2018 Personal Goals and Objectives.

SANDRA BOCCIALETTI, HR COORDINATOR

HAPPY 1-YEAR ANNIVERSARY OF PAYCHEX FLEX!

Employees’ D4Ds and Goals and Objectives will be scanned into Human Resources. To view, login to Paychex Flex and click on Under Personal Information, click on:

It has been an interesting and a bit of a challenging year with the Paychex Flex migration. I am happy to say we ended the year with all going well!

I know employees continue to have questions or issues with the system. I have sent emails and put articles in the PULSE regarding the process, however I feel more one on one training is needed. My plan for Spring 2018 is to answer the following questions about the Paychex Flex system: • What is on the Dashboard?

• What is the orrect way to request time off?

• How can I identify how much time off is available to me and what is accrual?

• How do I correctly submit and approve timesheets?

My plan is to attend each clinic’s staff meeting between March and June and answer all of your questions!

The system is robust and I continue to learn what it has to offer PTSMC. I am looking forward to making sure all employees are 100% comfortable with using the system!

\

401(K) MATCH PTSMC 401(k) match for 2017 will be reflected in participant accounts on March 15, 2018.

CURRENT JOB OPPORTUNITIES AT PTSMC Patient Services Coordinator (part-time) Guilford Customer Experience Coordinator (30-40 hours) Admin

Physical Therapy Aide Windsor

Check PTSMC.com for our most up to date postings and feel free to share!

We’re always interested in connecting with referrals of colleagues and friends.

With so many insurance carriers and plans in the mix, it can be dizzying to keep them all straight! Here’s a tips list to help you out: Requires BOTH a script and Orthonet authorization after 1st visit: Requires ONLY script: All BCBS Exchange Plans (Platinum, Gold, Silver, Bronze) Cigna HMO “Disney Co.” plans State Bluecare Plus plans All Connecticare and Connecticare Medicare Auto Med Pay Requires script and authorization from adjuster prior to 1st visit: Workers Compensation

Daylight saving time begins Sunday, March 11!

Daylight saving time begins Sunday, March 11. Test your knowledge & send your answers to Christine.Rasile@ptsmc.com by March 16!

1. Which two states do not observe daylight saving time?

2. Which U.S. President signed the Energy Policy Act of 2005?

3. What month does daylight saving end?

MARCH IS

NATIONAL LYMPHEDEMA

AWARENESS MONTH

SAMANTHA HUEBNER, PT, DPT, CLT Lymphedema is a condition in which the lymphatic system becomes inefficient at draining our normal production of lymphatic fluid in the body. This happens for one of two reasons: 1) Primary (or hereditary) lymphedema- A person is born with fewer or smaller lymphatic vessels or fewer lymph nodes.

2) Secondary lymphedema- This is due to an acquired mechanical insufficiency of the lymphatic system. Most often it is seen after removal of or radiation to regional lymph nodes in an area of cancer. However, secondary lymphedema can also be caused by an injury or surgery in which the lymphatic vessels are severely damaged or it can be a progression of chronic venous insufficiency when seen in the lower extremities.

In the US, breast cancer is the #1 cause of secondary lymphedema. Because of the increasing prevalence of breast cancer, we are seeing an increase in people with lymphedema and more research is starting to take place because of it. Recent studies are looking at various drugs to help reverse lymphedema as well as low-level laser therapy as a means to treat lymphedema. There are only very few surgical trials that are showing success at this time and therefore, Complete Decongestive Therapy (CDT) is currently the gold standard of treatment. CDT consists of the following 4 components: Compression- Gradient compression used to approximate valves and maintain volume reduction achieved with manual lymphatic drainage Manual Lymphatic Drainage- Gentle manipulation of the skin to reroute lymphatic fluid to an alternative pathway, which is better able to process fluid Exercise- Decongestive exercises are very important in management of lymphedema. Since the lymphatic system does not have a central pump like the cardiovascular system, it relies on muscle pump activity to help the movement of fluid as well as external tissue pressure from the skin and compression garments Skin Care- With a build up of protein-rich lymphatic fluid in the tissue, it becomes harder for the skin to receive adequate nutrients from the tissue, and therefore we often see tissue changes and fibrosis of the skin as stages of lymphedema progress. Those with lymphedema are also at a greater risk for developing cellulitis due to the build up of protein rich lymphatic fluid. Patient education is very important in regards to skin care to assist with preventing infection.

The above components are necessary in management of lymphedema and due to the chronic nature of this condition; it is a population that we may see in PT for multiple episodes of care throughout their lifetime.

If you have a patient in need of quality compression garments or a more complicated lymphedema case, please email Samantha.Huebner@ptsmc.com.

Life Beat

BUFFALO CHICKEN

BOMBS

Are you in need of a new, easy and delicious appetizer to bring to your next pot luck or dinner party? This Delish.com recipe is the “BOMB”!

INGREDIENTS: Cooking spray, for pan 3/4 c. shredded cooked chicken 2 Tbsp buffalo hot sauce 1 Tbsp sour cream or plain greek yogurt 1 tube refrigerated biscuit dough (8) 1-inch cubes white cheddar cheese, well chilled 3 Tbsp melted butter 1 Tbsp chopped parsley 1 Tsp chopped chives Ranch dressing, for garnish DIRECTIONS: 1. Preheat oven to 375°. Spray an 8" round baking pan or pie dish with cooking spray. In a medium bowl, combine the chicken, buffalo sauce, and sour cream (or yogurt).

2. Flatten each biscuit round to about ¼” thickness. Top each round of dough with a scoop of the chicken mixture and a cube of cheese.

Bring the edges of the dough together and pinch to seal. Place in pan seam side-down.

3. In a small bowl, mix the butter, parsley, and chives. Brush the tops of the dough balls with the butter mixture.

4. Bake until the biscuits are golden and cooked through, about 20 to 25 minutes.

5. Drizzle with ranch dressing and serve warm.

EMPLOYEE RECOGNITION

MARCH BIRTHDAYS Donna Baribault Lindsey Scianna Dan Delgado Cathryn Davenport Renee Gallant Shanan Pineiro Alison Pearce Cindy Gallagher Joanna Fisher Tommy Kirsch Sylvia Yanez - Carlson Katie Newton Kevin Howard Danielle Jaffer Nancy Chilson Mikayla Raffone Jani Kaszeta Jenna Bouffard Mary Wojtowicz Heather Feiner Max Erwin Ted Raczka Dominique Riley Brooke Uliano Gabby Didiano Linda Easterling Bill Chapin Gabby Verrilli

March 1 March 1 March 1 March 2 March 3 March 3 March 4 March 7 March 7 March 8 March 8 March 14 March 14 March 15 March 16 March 17 March18 March 21 March 22 March 24 March 25 March 26 March 26 March 26 March 27 March 29 March 30 March 31

Watertown Watertown Windsor Guilford Branford New Haven Groton Southbury Waterbury Avon Watertown Newington Orange Southington Avon New Haven Guilford Watertown Windsor Admin Plainville New Haven Orange Wallingford Wallingford New London Branford Naugatuck

ANNIVERSARIES CHEERS TO 15 YEARS!

Scott Cameron, Westbrook Partner & Director HAPPY 5 YEARS! Abbey Roderick, New London PSC HAPPY 1 YEAR! Peter Decoteau, Admin, Director of Marketing Chris DeLillo, Groton PT Aide Dominique Riley, Orange PT Aide Sue Mantz, Watertown PSC

Congratulations

to Wanda Figueroa, PTSMC’s Accounts Payable Representative, for completing her Advanced Accounting Certificate from Capital Community College.

Congratulations to Rick Purdy, PT and Erin Walsh, PT, DPT! Both Rick and Erin were named one of the “Top 3” best PTs in the cities in which they treat.

ThreeBestRated.com is a third-party website that used their own 50-point inspection to name their “bests” for the cities highlighted.

NEW EMPLOYEES

This March marks the 15 year anniversary of PTSMC Westbrook.

Welcome to PTSMC. We’re so happy to have you!

Congratulations to Scott Cameron and the entire Westbrook team!

Lori Dietz Naugatuck PT Aide

Elizabeth Ramsey Branford PT Aide

Brooke Uliano Mary Wojtowicz Wallingford PT Aide Windsor Physical Therapist

PTSMC Happenings

Our love for you runs deep!

We’re still in shock! Brian Vo and Jason Smutnick were both tasered at the Windsor Police Department’s community forum on “Traffic Stops, Motor Vehicle Law and Use of Force”. Talk about dedication to their community!!

Social Media Sensation

Congratulations to Ashley Figueiredo, New Milford PSC, for being chosen as this month’s Social Media Sensation! The Olympics were a HUGE part of last month’s events in many of our clinics and she was able to capture Bryan O’Neill’s fantastic impression of USA Curling star, Matt Hamilton.

Thanks for sharing, Ashley! Enjoy your gift card!

The Branford and New Haven teams love a good team happy hour! Check out this good lookin’ crew at Woodbridge Social.