SLIDE 1
The Goal of Rehab
- Generally, the goal of the Inpatient
Rehabilitation Facility should be the patient safely returning home or to a community based environment.
12/13/2011
Judith Ann Tinelli MSN, RN, ONC, CNL, CRRN Rehabilitation Nurse - - PowerPoint PPT Presentation
Judith Ann Tinelli MSN, RN, ONC, CNL, CRRN Rehabilitation Nurse - - PowerPoint PPT Presentation
Preparation for Discharge Day Judith Ann Tinelli MSN, RN, ONC, CNL, CRRN Rehabilitation Nurse Clinician Teresa Robosson BSN, RN PPS Coordinator UPMC St Margaret 12/13/2011 The Goal of Rehab Generally, the goal of the Inpatient
SLIDE 2
SLIDE 3
UPMC St Margaret Performance Improvement Plan
- Education of nursing staff November 2010
- Implement Preparation for Discharge Day
- Multidisciplinary Preparation for Discharge Day
10am-10am Procedure and Functional Forms
- All FIM scores entered from 10am the day prior
to discharge through 10am the day of discharge are the final FIM scores which navigate to the IRF-PAI, which is the Medicare assessment which drives rehab reimbursement
- Evaluate results of FIM and CMI based on
benchmarks
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SLIDE 4
Report Card Patient
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- MULTIDISCIPLINARY FORM INDEPENDENCE DAY
- Name
Weightbearing Status
- Device
Precautions
- Ambulation: Level of Assist
Comments:
- Bed Mobility: Level of Assist
Comments:
- Sit ←→ Stand: Level of Assist
Comments:
- Toilet Transfer: Level of Assist
Comments:
- Toileting: Level of Assist
Comments:
- UB Dressing: Level of Assist
Comments:
- LB Dressing: Level of Assist
Comments:
- Grooming: Level of Assist
Comments:
- Bathing: Level of Assist
Comments:
- Eating: Level of Assist
Comments:
- Swallowing: Level of Assist
Comments:
- W/C mobility: Level of Assist
Comments:
- Comments:
- Nrs:
Date
- PT:
Date
- OT:
Date
- SLP:
Date
- MD:
Date
SLIDE 5
Certificate of Graduation-sticker
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SLIDE 6
FIM to FIM change
- How did we do?
- What does this look like on a spider graph with
the 18 areas of FIM?
- How much assistance does the patient need?
- 56 FIM on admission (Burden of Care is equal to
>4hrs/day)
- 92 FIM on discharge (Burden of Care is less than
- ne hour/day)
- Good discharge plan
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SLIDE 7
Spider Graph
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SLIDE 8
Admission Functional Independence Measurement Scores
50 60 70 80 Admission FIM 2012 1st quarter 2012 Admission FIM 2011 Admission FIM 2010
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SLIDE 9
FIM Change
5 10 15 20 25 30 FIM change 2012 1st quarter 2012 FIM change 2011 FIM change 2010
FIM change
FIM change
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SLIDE 10
Length of Stay Efficiency
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1 2 3 LOS 2012 1st quarter 2012 LOS 2011 LOS 2010
LOS efficiency
LOS efficiency
SLIDE 11
Case Mix Index
- Case Mix Index (CMI): The Rehab
patient’s acuity of care is determined by Physician documented admission Rehab diagnosis, Co-morbid conditions and team documented admission FIM assessments.
- See graph comparing SMH CMI to
regional and national benchmarks.
- Accurate documentation is
important for reimbursement, patient progress and outcomes and appropriate staffing levels.
0.2 0.4 0.6 0.8 1 1.2 1.4 SMH Region Nation
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SLIDE 12
Press Ganey Patient Satisfaction Scores-compare scores nationally
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SLIDE 13
Community Discharge
- 78.7% discharged to the community setting
average over the past 3 years
- July of 2012 82.1%
- 80.8% average for the region over the past 3
years
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SLIDE 14
Outcomes
- 98th percentile on Press Ganey
- Length of stay efficiency in 2010 2.25 and is now
2.79 in 2012.
- FIM change increased from 18 in 2010 to 25.4 in
2012.
- Admission FIM was 73.3 in 2010 and is now 63.2 in
2012.
- Our multidisciplinary committee has not only
increased the functional status of our patients for discharge, but has also increased our patient satisfaction rates with a truly interdisciplinary effort.
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