nancy A. Flinn, OTR/L

Sr. Scientific Advisor
Courage Kenny Rehabilitation Institute
Minneapolis, Minnesota

The focus of my career has been on minimizing the consequences of chronic disability. This focus has related to both minimizing physical limitations as well as exploring what it takes to improve performance of meaningful activities, answering the “So what?” question. My graduate work on Constraint Induced Movement Treatment for individuals with chronic stroke found that participants made significant improvements in movement of their involved upper extremity, but did not significantly improve either performance or satisfaction with meaningful tasks. This finding was in contrast to much of my previous training, and focused me more specifically on interventions that would affect a more traditional definition of disabling conditions, while at the same time improving the quality of life or level of social participation for participants. While employed as the Director of Outcomes and Research at Courage Center, I became the Outcomes Manager on a 4-year $1.7 million Centers for Medicare and Medicaid cooperative agreement to create a primary care medical home for individuals with chronic disabilities, which combined intensive care coordination, extended primary care visits, accessible clinic, and county social services. This clinic resulted in significantly reducing health care costs, while improving patient reported health. The amount of change in health that needed to occur before there was any significant improvement in reported health focused my attention on the client’s report of outcome.