Power of Rehabilitation: Best Hostpials and Recent Trends

Written by Richard Heap

Basic Tenet of Accountable Care

The term "Accountable Care Organization" (ACO) was first used by Elliott
Fisher, Director of the Center for Health Policy Research at the Geisel
School of Medicine at Dartmouth in Hanover, NH. In essence, ACO is based on
the concept of "provider-led organizations with a strong base of primary
care that are collectively accountable for quality and total per capita
costs across the full continuum of care for a population of patients."

One interesting aspect is the discussion involving "full continuum of care" and
how that affects hospital relations with physician groups, insurance
providers and other hospital networks. This has led to a particular concept
based around ensuring the patient receives the appropriate evaluation and
treatment at the appropriate time in their recovery process, commonly
referred to as a "Life Coach" or "Patient Concierge". In essence, once a
patient is admitted to a healthcare network, a representative is assigned to
be with the patient from initial testing completion through follow up and
therapy if required.

Position of Rehabilitation Hospitals

The goal for rehabilitative care is to ensure that patients are able to be
discharged to their homes instead of  an acute care or nursing facility. To
this end, rehabilitation hospitals are already on the cutting edge of what
healthcare reform is all about because their approach to patient care is
very much team-based care. "In rehab, you are putting the whole person back
together. It can't be just the physician; there is the need for the
therapist, the case manager, the whole team. It is part of the recovery
process", 2 says Charles Pu, MD, Chief Medical Officer for Spaulding
Hospital in Boston, MA. With the increasingly aging population and a focus
on full continuum of care, rehabilitative care will become a progressively
more important component to the healthcare delivery process.

Relationships between acute care facilities and rehab hospitals can result in improved
outcomes and reduced expenses through collaboration and cooperation. "An
interdisciplinary team approach is the foundation of the system. The team
consists of physical, respiratory, occupational and speech therapists, as
well as a neuropsychologist, physician, nurse, dietitian, infection control
nurse and clinical case manager, which allows patients to see a wide variety
of spinal cord specialists". 

Recent Trends in Rehabilitation Services
Rehabilitation hospitals occupy a unique position within the spectrum of
aging/patient care with connections both into acute care hospitals and into
senior living/skilled nursing facilities. In a recent white paper released
by RehabCare, "there are opportunities to proactively prepare for changes
and anticipate positive clinical and business outcomes. Rehabilitation
programs present an immediate opportunity to achieve increased operational
excellence in providing quality outcomes in a cost effective setting".

The paper goes on to suggest 10 steps to improve rehabilitation services:

1.      Build your program around quality people
2.      Invest in the professionalism of the Therapy Department
3.      Develop specialized programs that meet the needs of the facility and community
4.      Excellent therapy management
5.      Know the rules and follow them
6.      Know your customers and the market
7.      Strategically approach census development
8.      Make it easy for your customers
9.      Manage the rehab stay
10.     Keep your customers happy

In the ever-increasing consumer empowerment of healthcare selection, I would
propose that the order should start with #8, followed by #10. To achieve
those metrics, the facility must excel at all of the other steps. Having a
strategic design partner to assist with thought leadership and national best
practices and ensure that the facility design matches the forward thinking
of the operational process is the next logical step.

About the Author

Richard Heap, Associate AIA, IABC Director Arate Communications Consulting, Inc.
Market-focused Visibility.  Professional Integrity.  For 15 years.