Rehabilitation services within home health have long lacked consistency, but more recently certain agencies are seeing the benefits of emphasizing and properly training physical therapists.
“Before, companies were concerned about quality of the services but had no way to measure them, and physical therapists were very independent and had little supervision,” Joyce Boin, principal consultant at Strategic Healthcare Solutions, explained at the Illinois Home Care and Hospice Council annual conference outside Chicago last week.
By finding what works best for each agency, home health providers can boost their rehab services to better serve patients and keep physical therapists motivated, said Boin. Prior to becoming a consultant, she was the co-founder and COO of Verve Rehab Inc., and she also was a director for Advocate at Home for three years.
Over the last decade, the role and view of rehab services within home health began to change due to sicker patients and increased rules and regulations, Boin explained.
“The acuity of patients started to change—they became sicker and more compromised,” she said. “Documentation requirements started to increase, and it wasn’t appropriate anymore for a physical therapist to see a patient and drop off notes three weeks later.”
There was also a switch to more in-house physical therapists. In the past, the majority of rehab service providers were outsourced and could have been working for various sectors within health care. Now, agencies are starting to see the benefits of having physical therapists fully trained and committed to home care patients.
“Agencies started to find therapists who are willing to go the extra mile and who are committed to learning how to use OASIS and different EMR systems,” Boin said. “Though therapists may be committed to learning, agencies need to be the ones to provide proper comprehensive orientation and ongoing training to employees.”
Once agencies have a comprehensive rehabilitation program and committed therapists, focusing on patient experience and not only patient satisfaction is vital.
“It’s no longer just about providing great care. Agencies need to ask themselves, what are our patients getting from us that’s different from down the street,” Boin said. “There needs to be a focus not just on clinical care but the patient experience at large.”
One way to enhance the patient experience is to recognize that therapists won’t always have all of the answers to patients’ questions, but they should be informed enough to be able to direct the patients to the right place in order to get the answers they’re looking for.
Another way to keep therapists engaged and up-to-date in the home care world is to encourage communication between nurses and therapists.
“Good therapists are not just good when they are giving services to patients in their homes, they’re good when there is sufficient communication before and after each visit and they are educated on what is happening on the regulatory side of the industry,” explained Boin.
There’s no telling what may or may not happen as reimbursement changes continue, but having a solid team that feels supported and educated can help alleviate some pressure when and if changes come about, she added.
Written by Alana Stramowski