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Raise Expectations: Therapists Working at the Top of License

Have you heard the expression “Therapists working at the top of their license?” For those of you who are part of the HealthPRO® Heritage family, either associate or partner, then the answer is surely “Yes.”  But what specifically does this phrase mean?

At HealthPRO® Heritage, we have great respect for the Patient-Driven Payment Model. Our perspective: PDPM is well thought out, fair, and a positive change for the PAC industry as a whole. But we recognized that succeeding under this new model would require providers to take an innovative approach that included a heavy dose of education, strategy, and redesign of current systems and processes. We focused on how we could help best position our staff, patients, and partners. Our task: demonstrating that specialized, functional therapeutic interventions – delivered through individualized care plans – are higher determinants of positive patient outcomes than quantity of therapy delivered.    

The solution was obvious to us: the key to success would be in the hands of our clinicians. PDPM would be an opportunity to hit the Refresh button and make sure that we were not just counting minutes, but instead making the minutes count!  We would need to ensure our frontline clinicians had the resources and tools to drive positive outcomes and enable patients to thrive.  In short, we needed to empower our clinicians to “work at the top of their license.”

“To work at the top of your license” means to challenge clinicians to get outside their comfort zone and treat higher acuity residents.  It also means to focus on highly individualized, progressive treatment interventions. HealthPRO® Heritage worked with our teams to ensure they understood this concept in the context of several important success drivers and the following proprietary initiatives.

With reimbursement drivers shifting from Therapy to Nursing, HealthPRO® Heritage thought about how therapists could support Nursing programmatically and through documentation to capture appropriate reimbursement. In some instances, it would mean developing a formal specialty niche program or having our therapists perform wound care. In other instances, it may be ensuring therapists are comfortable treating residents with acute cardiopulmonary conditions that require a collaborative medical model approach. Also, we focused on educating therapists about how documentation can help support the MDS. Basically, we knew our clinicians could contribute positively to an enhanced case management model and that our programs and documentation could be redesigned to better support our Nursing colleagues.  This approach is critical to assuring patient outcomes for patients with varying acuity levels and also incorporates risk measures to address VBP success drivers, such as rehospitalization.

We are proud of our clinicians who have truly embraced our proprietary “Safe Transitions” clinical framework, which initiates discharge planning from Day 1 and focuses on initiatives to reduce hospital readmissions. "Safe Transitions" is well aligned with necessary care management philosophy under PDPM. This signature program features specialized risk assessments, home evaluations, health literacy, and functional treatment approaches. From evaluation thru discharge, patients can expect clear communication RE: expectations, progress, and joint goal setting.  Treatment approaches include highly functional tasks and interventions that truly require the “skill of a therapist,” such as disease management through use of health literacy, educational groups (not group for the sake of group or staffing!) or sessions throughout their stay, home management, medication management, indoor and outdoor functional mobility, home evaluations and modifications, and so much more. “Safe Transitions” is not only a rehab-driven program, but an interdisciplinary approach to discharge planning through use of discharge readiness checklists that ensure each department (nursing, dietary, social services) works closely with the individual to ensure success at the next level of care post-discharge. 

Our teams emphasize how critical it is that we make every minute with our patients the most impactful, purposeful, and functional they can be. Patients should not only walk away from a treatment session feeling physically challenged, but also mentally stimulated and empowered with knowledge that will carry on far after their rehab stay has ended. 

The same sense of purpose is important for our clinicians. We want them to be equally as stimulated and challenged and to feel as though they work in an environment that fosters patients' growth, and their own professional/personal growth too.  We never want them to feel stagnant or complacent, so the concept of our teams “working at the top of their license” is critical. We provide educational series to support all levels of our team and our partners, because we know that, ultimately, is what will enable residents to achieve optimal outcomes. 

HealthPRO® Heritage looks forward to raising the bar in response to our changing industry with an emphasis on the quality outcomes from well-designed therapy programs. Ultimately, we hope to see – as an industry –  there is less focus on counting minutes and a greater focus on making the minutes count.