Format for Strategic Plan – 3 year plan



Contributors:

Elena Espirtu, OTR/L, OTD

Aileen Eviota, PT, NCS

Edlyn Laviste, RN

Julie Welsh, RN

Marika Greiff, MD

Sriramjini Muthukrishnan, MD

Keir Ringquist, PT, GCS

David Miller

Mamie Kutame, MSW

Linda Banks-Woodard, RN

Kimberly Zimmerman, SL/P, CCC-S

Statement of Purpose for the Strategic Plan

The purpose of the strategic plan for the UIHHSS Rehabilitation Program is to ensure that the program makes a strategic contribution to the mission of the Hospital and the University.

The UIHHSS 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 medical center for persons with disabilities and to provide excellent quality educational experiences for students in the health professions.

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). The vision for Outpatient Services 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) Skilled staff

2) Interdisciplinary teamwork and communication

3) Availability of specialty Medical Services as part of larger health organization/hospital

4) Being part of Academic Hospital that has education and research activities

5) Ability of staff to maximize the limited resources of our patients

6) Patient focused care

7) Access to students

8) Continuity of care and easy transition from acute care to rehab since we usually keep same therapists

9) Improved space in PT gym and OT room

10) Stroke support group

11) Stroke educational sessions

12) CARF certified with specialty in stroke

13) Profitable unit for Health System

14) Music therapy

15) Pet therapy

16) Spirituality groups

17) Our patient mix fits/allows us to meet the 60% rule

18) Electronic medical record

19) Rehab Unit Staff Meetings consistently occurring

20) Staff commitment and dedication

Weaknesses

1) Shortage of DME on the unit

2) Frequently broken equipment

3) Cleanliness of rooms poor at times

4) No dedicated Rehab Psychologist

5) Lack of SCI and Bariatric equipment

6) Difficulty for patients with food menus and getting right order

7) Staffing quantity (not quality) – all disciplines

8) Lack of weekend and evening activities

9) Practice stairs in the dayroom

10) Patient schedules – when unit full, not as consistent with schedule so patient not aware of changes

11) Communication on patient needs for ADLs between therapy and nursing so patient ready for therapy

12) Recreational therapy

13) Patients not eating in the dayroom consistently for at least one meal

14) Process of scheduling OP therapies

15) Depart Process

16) Management of space

17) Patients having and taking correct equipment at discharge

18) Inaccurate and late FIM data entry

19) Educating staff on business side of rehab (reimbursement)

20) Links to other services for continuum of care (OP services)

21) High reliance on internal referrals

22) Family involvement and family meetings

23) Patient rooms are outdated

24) Limited number of Dynamaps

25) Limited Storage space

26) Bathroom accessibility

27) Limited administrative support (intake and PPS coordinator)

Opportunities

1) Improvements in Group Therapies

2) Staff Specializations and training

3) Home Visits

4) Utilizing Family conferences

5) Increase our links to community (public service)

6) More external referrals

7) Increase number of patient beds

8) Clinical research

9) Family involvement

10) Increase referrals

11) Capturing ECIN referrals

12) Increase awareness & understanding of rehab and disability to rest of Health System, University, Community

13) Increase patient satisfaction regarding returning home/post discharge quality of life issues

14) Analysis of outcomes for specific patient groups

Threats

1) Increase in census without adequate staffing could result in lower quality and lower patient/staff satisfaction

2) Patient safety secondary to faulty or lack of equipment

3) Nurses that aren’t rehab nurses floating to frequently to the unit

4) Adequate spacing - Particularly challenging patients in terms of social and economic issues (limited social support; limited or no insurance) resulting in less stable discharge environments

5) New initiatives in healthcare and the impact for Rehab

6) Decreased budget might cut CE for staff

7) Lack of private beds – patients will choose to go elsewhere

8) Undocumented/uninsured patients

9) Budget cuts

10) Lack of compliance with all rules and regulations of rehab

11) Administrative support - No intake coordinator or data manager can decrease admissions and decrease reimbursements

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 good outcomes for our patients.

• The unit shows good profitability per case

• Clinical outcomes for effectiveness, efficiency, and satisfaction are very good. Business measures have also surpassed budgeted expectations.

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.

• More than 95% of our referrals come from within UIHHSS.

• The accessibility of the UIHHSS environment and the overall appearance of the unit and the patient rooms.

• Compliance with input of FIM scores is poor across all disciplines.

Priorities

• Continue to provide care of unmistakable high quality

• Build the census

• 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 FISCAL YEAR 2013

1) Increase ADC to 13 – Last year 10.3

2) Increase external admissions to >24 per year

3) Patient Satisfaction, develop Pt/Client centered aspects of care – ongoing from previous Strategic Plan

4) Improve FIM compliance and accuracy – ongoing from previous Strategic Plan

5) Increase internal and external marketing activity

6) Improve continuity of care for amputee patients via Outpatient Services

STRATEGIC GOALS TO BE ACHIEVED IN FISCAL YEAR 2014

1) Increase ADC to 14.5

2) Increase external admissions to 35 per year

3) Maintain high Patient Satisfaction marks

4) Improve FIM compliance and accuracy (ongoing from previous year)

5) Increase number of Medicare Certified Rehabilitation beds to 20

STRATEGIC OUTCOMES PROJECTED FOR FISCAL YEAR 2015

1) Increase ADC to 16

2) Increase External admissions to 50 per year

3) Increase number of Medicare Certified Rehabilitation beds to 22

4) Recertification for Inpatient Rehab with Stroke Specialty by CARF

5) Review and plan for other specialty areas (i.e., NTSCI, Limb Loss)

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