Customer Service Driven Therapy
What do you believe creates a great healing experience for someone who needs short-term care? Is it providing a hotel-like atmosphere with caregivers who have customer service training? Is it the rigorous therapy schedule? Is it the Wi-Fi access? Is it about moving people in and out as quickly as possible so they can get home? Is it just about meeting the physical needs of the individual?
Providers tell me that those who are coming into short stay rehab tell them it is about being treated as a patient; in fact they ask for that language to be used. There are some individuals receiving this care who choose to fully commit to the rigorous therapy schedule and then spend time alone in their room, exhausted and eating their meals in bed. Providers are left with the impression that the best healing environment is being in a hospital-like environment. In fact, it is not unusual to hear providers talk about their sub-acute care units now. From the perspective of the individuals, they are in the hospital or they are home, and they certainly don’t want to be “at home” in a long-term care setting that is now taking on short stay rehab care.
The oversight of short stay rehab is supporting the efforts of these individuals to see this interim stop on their way home as another form of hospital. The regulatory focus is on billable minutes, risk of pressure ulcers, improvements in timed get-up-and-go scores, keeping the individuals out of the hospital and whether best practice therapy goals were met. Improving these measurable aspects of treatment is important, and it creates quality, but is that the only place where providers should focus their improvement efforts?
From the perspective of a family member, who had someone spend three weeks in short stay rehab, I believe there is much more to creating a true, healing environment. If we fall prey to the societal perceptions of what this approach to care is about, we will continue to have individuals fail and find themselves placed in long-term care; we will continue to have people struggle and bounce back into the hospital; and we will never be successful with changing the culture of care for the young and old alike. My family member would have experienced a crisis of identity, loss of autonomy, loneliness, helplessness and boredom had we (the family) not been paying attention to those needs. Certainly the caregivers did not have time to ask him about these issues, or attend to them.
Improving quality, and the lives of the individuals being served, rests on the strength of relationships that the care partner team (individual, their family, healthcare professionals, caregivers) forms with one another both during the period of treatment and afterward. Being well-known, having the therapists and nurses understand what the individual wants to accomplish, and then tailoring the short stay rehab experience to meet those goals is what will improve performance and ensure quality. This individual has been through a significant life-changing experience. If their well-being and the risk of loneliness, helplessness, and boredom are not talked about, and addressed, then it is much more likely they will struggle, and possible fail, in their rehab. Person-directed care is the key to success!
What do you believe? Is your approach to short stay rehab meeting the spiritual as well as physical aspects of the individual? Have you fallen prey to the paradigm of creating a sub-acute care unit rather than a transitional home that will help the individual successfully move into their next phase of life? What are you doing to set your organization apart from those who have yet to fully embrace person-directed care, while providing short term support services? Learn more about how to use person-directed care to improve quality and create a meaningful, healing experience by registering for “Reframing Rehabilitation and Therapeutic Support,” the third webinar event in the 3-part series, Person-Directed Clinical Practices – A QAPI Strategy scheduled for June 11, 2014, from 3-4:00 pm ET.