Rehab Hospitals Retooling
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“We have aggressive treatment before the sign of complications, and then you end up shortening that length of stay,” Rohlik adds. With the presence of nearby rehabilitation hospitals, patients can have reduced LOS in acute care facilities for multiple ailments ranging from spinal cord injuries to ulcers. “When you end up shortening that length of stay, it is a healthier person recovering,” she says.
“The term ‘multidisciplinary’ refers to everything coming and going, but in rehabilitative care it’s really based on an interdisciplinary approach. There are no silos, no walls; all [are] focusing on taking care of patients and their needs,” she adds.
A major goal for rehabilitative care centers is to improve outcomes so patients can be discharged to their homes, instead of nursing facilities. Craig Hospital in Englewood, CO, has been able to accomplish a 91% home discharge rate, which far exceeds the 71% national average, says Kenneth R. Hosack, MA, director of provider relations for the 93-licensed-bed rehab hospital for spinal cord and brain injury patients. Essentially, home placement results in superior long-term functional patient outcomes and cost savings, he says. Craig’s rehabilitation program enables 50% of patients to return to work one year after injury following their rehabilitation, exceeding the national average of 17%, Hosack says.
“Craig Hospital understands that evolving federal and state healthcare initiatives and marketplace dynamics will require our continual adaptation and flexibility,” says Hosack.
Rehabilitation care is on the cutting edge of what healthcare reform is all about, however, because it is “very much based on team-based care,” says Charles Pu, MD, chief medical officer for the 160-licensed-bed Spaulding Hospital for Continuing Medical Care North Shore in Salem, MA, which also maintains an additional 36-bed skilled, transitional unit.
“In rehab you are putting the whole person back together. It can’t be just the doctor; there is the need for the therapist, the case manager, the whole team. It is part of the recovery process,” Pu says. “One of the beautiful things is that it is inherently much more team-based care. An important factor is: How strong is this team?”
Success Key No. 1: Exchanging data
To improve patient outcomes, Carolinas Rehabilitation in Charlotte, NC, created a data exchange network with other inpatient rehabilitation hospitals. The Exchanged Quality Data for Rehabilitation (EQUADR) network is one of the first rehab-specific outcome databases in the nation, designed to help rehabilitation hospitals share information to drive best practices in quality improvement.
Carolinas Rehabilitation, which has 182 licensed beds across three sites, began the collaborative program to establish industry benchmarks and drive quality and patient safety improvements, says Shelby Harrington, RN, BSN, MS, outcomes specialist for the Carolinas HealthCare System.
In addition, the Patient Protection and Affordable Care Act requires the Department of Health and Human Services to specify quality measures for inpatient rehabilitation facilities and publish the data no later than Oct. 1, 2012. Inpatient rehab facilities must submit such quality data to HHS or face having federal reimbursements reduced by 2%.
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