Format for Strategic Plan – 3 year plan
Contributors:
Kay McGee, MS, OTR/L
Aileen Eviota, PT, NCS
Edlyn Laviste, RN
Julie Welsh, RN
Marika Greiff, MD
Sriramjini Muthukrishnan, MD
Keir Ringquist, PT, PhD, GCS
Paul Gorksi, Hospital Administration
Mamie Kutame, MSW
Linda Banks-Woodard, RN
Kimberly Zimmerman, SL/P, CCC-S
Gail Buenventura, RN
Multidisciplinary Clinical Team
Stakeholders
Statement of Purpose for the Strategic Plan for UI Health Rehabilitation Unit
The purpose of the strategic plan for the UIH Rehabilitation Program is to ensure that the program makes a strategic contribution to the mission of the Hospital and the University.
The UIH Rehabilitation Program Mission Statement
The mission of the rehabilitation program is to provide excellent quality, patient-centered inpatient rehabilitation services, to promote a culture of respect within the health system for persons with disabilities and to provide excellent quality educational experiences for students in the health professions. In alignment with the organizational goal, UIH Rehab Unit focus is on eliminating health disparities for those we serve.
Vision for the UI Health System’s Rehabilitation Program
The UIH Rehabilitation Program is perceived within the Health System and the Chicago Rehabilitation Community as offering comprehensive inpatient and outpatient rehabilitation services through a variety of interdisciplinary programs with a specialization in servicing patients who have sustained a cerebral vascular accident.
The vision for the Inpatient Rehabilitation Services is to offer Comprehensive Medical Rehabilitation Unit on an expanded 25 bed rehab unit (currently UIH Rehabilitation has Medicare certification for 18 beds) and to be the provider of choice for rehabilitation for providers and patients within the hospital. The vision for Outpatient Services is to increase multidisciplinary follow-up to patients who need outpatient services.
The UIH Rehabilitation Program make significant contributions to the mission of the University through the provision of excellent patient care, high quality education of health professionals and an active program of rehabilitation research. UIH Rehabilitation Professional Staff have an active role in facilitating the full participation of persons with disabilities through campus and community activities and share their expertise in local and national forums.
SWOT Analysis with Rehab Unit Staff
Strengths
1. Quality Monitoring (KPI board)
2. Great teamwork
3. Strong leadership team
4. Continuity of care (therapy acute care to rehab; MD does pre-op screens to unit)
5. Discharge planner and social worker
6. Availability of consulting services as needed during patient rehab stay
7. Medical/Surgical desire for rehab services
8. PPS Coordinator
9. Dedicated and committed staff to patient care
10. Specialized/advanced skills of staff
11. Daily Huddle Communication
12. Pre-admission planning
13. Stroke Support group
14. Rehab Psychologist
15. Student Involvement
16. FIM Efficiency improvement
17. ROUT Forum for leadership meetings
18. RUSM Forum for staff education, communication, meetings
19. Nursing Education
20. Staff engagement
21. Cater to multi-disease, low socio-economic population
22. Patient-centered
23. Patient satisfaction
24. Profitable unit for organization
25. Evidence-based practice
26. Interdisciplinary communication
27. Most Wired Hospital
Weaknesses
1. Lack of equipment/environmental issues (SCI, Bariatric, Single Occupancy)
2. Staffing issues – MD backup
3. Population specific preparedness/deficits (SCI)
4. Skill Knowledge deficits in specific areas (SCI, Splinting, etc.)
5. Physical environment limiting
6. Limited weekend provisions
7. Limited weekend social opportunities
8. Therapy carryover by nursing
9. Completion of depart process
10. Pre-admission process
11. No weekend admissions
12. Software doesn’t support pull through options easily
Opportunities
1. Have dedicated therapy teams on rehab
2. Decreasing insurance network issues/delays
3. Single occupancy rooms/bariatric room
4. Review of patient cases lost to outside facilities
5. Community reintegration groups
6. Other UI Health medical service education, communication, marketing
7. Reducing pressure ulcers
8. FIM Improvement and sustainability (outcomes progress in general)
9. More Rehab Certified Nurses
10. External Referrals (internal reliance too high)
11. Formal measure of staff engagement
12. Resident education – timeliness of referrals
13. Rehab led consulting for hospital wide activity increase for patients
14. Volunteer usage (weekends and evenings)
15. Therapy carryover by nursing
16. Pushing activity in therapy and on weekends/carryover
17. Interdisciplinary communication
18. Increased marketing to outside facilities that don’t have rehab (U of C) – become preferred rehab facility
19. Utilization of students from UIC on the unit
20. Enhancing brain injury programing for patients
Threats
1. Low census
2. Unkown payment mechanisms
3. Insurance network issues/delays/denials
4. Rapidly changing healthcare system
5. Budget cuts
6. Lack of external referrals
7. Percent of undocumented/uninsured patients
8. Registration issues
9. Old facility
Current Environment
Identified Strengths by Rehab Leadership
• The Inpatient Rehabilitation Staff members are team and patient oriented, they have a positive attitude about rehabilitation and they are committed to achieving positive outcomes for our patients.
• Team communication is strong and completed in multiple ways including daily huddles, weekly conferences, monthly interdisciplinary and team meetings, and daily informal communications amongst team members, patients and families.
• The unit shows good profitability per case; business measures have also surpassed budgeted expectations.
• Clinical outcomes measurement through KPI board have enhanced our already good effectiveness, efficiency, and satisfaction outcomes.
Identified Opportunities for Improvement
• The rehabilitation unit is small compared to other services. Our annual discharges are low compared to the other highly profitable services. A higher number of discharges and a higher ADC would be beneficial to the Health System and would likely bring increased recognition and support to the unit – improved over past year but still with opportunity to grow.
• More than 95% of our referrals come from within UIH.
• The accessibility of the UIH environment and the overall appearance of the unit and the patient rooms.
• Compliance and accuracy with input of FIM scores can continue to improve across all disciplines.
• Ensuring that we are not only in-network but that we are a preferred rehab provider for insurance companies as well as improve delays in authorizations and registration errors will allow more patients access to the rehab unit.
Priorities
• Continue to provide care of unmistakable high quality
• Build the census including building relationships with internal and external referrals
• Demonstrate the contribution the unit makes to the patient care continuum and the financial health of the organization
• Compliance with input of FIM scores as well as accuracy of FIM scoring
• Staffing levels to be appropriate for full census
• Having appropriate equipment to treat patients of varying diagnoses on the Rehabilitation Unit
STRATEGIC GOALS FOR CALENDAR YEAR 2015
1) Increase ADC to 13
2) Increase external admissions to 20 per year
3) Identify lost patients to outside
4) Identify nurses to take CRRN
5) Identify staffing, equipment and education needs to enhance SCI patient outcomes
6) Develop and educate staff on procedure to obtain bariatric equipment through rental process
7) Decrease pressure ulcers to less than 75th percentile in NDNQI
8) Be at or below 50th percentile for fall rate for NDNQI
9) Dedicated rehab therapy teams
10) Complete at least 2 rehab marketing educational session to internal and external referral sources
11) Maintain >95% patient satisfaction scores
12) Develop and complete formal measure of staff engagement
13) Develop and implement at least 1 additional activity group for patients to participate outside of therapy sessions
14) Improve FIM accuracy and compliance
STRATEGIC GOALS TO BE ACHIEVED IN CALENDAR YEAR 2016
1) Increase ADC to 14
2) Increase external admissions to 25 per year
3) Decrease percentage of lost patients to outside by 5%
4) Have 2 nurses complete CRRN
5) Complete at least 2 items identified on needs assessment for SCI patient outcomes
6) Obtain at least 1 piece of bariatric equipment for the unit
7) Decrease pressure ulcers to less than 50th percentile in NDNQI
8) Complete at least 2 additional rehab marketing educational session to internal and external referral sources
9) Maintain >95% Patient Satisfaction scores
10) Improve FIM compliance and accuracy (ongoing from previous year)
11) Be at or below 25th percentile in fall rate for NDNQI
12) Maintain >95% patient satisfaction scores
13) Pending results, maintain or improve staff engagement
14) Develop and implement at least 1 additional activity group for patients to participate outside of therapy sessions
STRATEGIC OUTCOMES PROJECTED FOR CALENDAR YEAR 2017
1) Increase ADC to 15
2) Increase External admissions to 30 per year
3) Decrease percentage of lost patients to outside additional 5%
4) Have 2 nurses complete CRRN
5) Complete additional 2 items identified on needs assessment for SCI patient outcomes
6) Convert one room to bariatric equipped room
7) Decrease pressure ulcers to 25th percentile in NDNQI
8) Complete at least 2 additional rehab marketing educational session to internal and external referral sources
9) Be at or below 25th percentile in fall rate for NDNQI
10) Have single room occupancy beds
11) Be at or below 50th percentile for pressure ulcers for NDNQI
12) Maintain >95% patient satisfaction scores
13) Maintain high staff engagement scores
14) Develop and implement at least 1 additional activity group for patients to participate outside of therapy sessions
15) Improve FIM compliance and accuracy (ongoing from previous year)
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