Presentation on theme: "ACUTE CARE THERAPISTS CAN SURVIVE AND THRIVE IN UNCERTAIN TIMES Combined Sections Meeting 2015 February 6 th, 2015 Indianapolis, IN."— Presentation transcript:
ACUTE CARE THERAPISTS CAN SURVIVE AND THRIVE IN UNCERTAIN TIMES Combined Sections Meeting 2015 February 6 th, 2015 Indianapolis, IN
Speakers Baylor Institute for Rehabilitation System Directors of Acute Care Therapy Services: Brian Hull, PT, MBA Cathy Thut, PT, DPT, MBA Donna Fitch Kaufhold, OTR Sharon Cheng, PT, MBA, MSPT
Course description The current environment of health care reform and cost cutting require hospital therapists take significant steps to manage their culture and actual practice patterns. The physical therapy profession consistently promotes advancement, but are hospital therapy programs consistently following through with true best practice top to bottom? Are hospital therapists aware of health care system politics? Do hospital therapists have strategies to successfully navigate politics and influence change? How is a therapy department viewed by executive leadership in a hospital? How can hospital therapy programs ensure they are seen in a positive light? This course will discuss the urgent need to manage culture to help lead health care reform change in today’s hospitals to avoid becoming irrelevant.
Objectives Upon completion of this course, you will be able to: 1. Recognize the impact of health care reform on acute care therapy practice. 2. Determine the correlation between hospital finances and therapy productivity. 3. Evaluate perceptions and its implications to the future of therapy programs. 4. Create strategies to advance professionalism within hospital practice.
Uninsured Rates for Adults Ages 18-64 The Baker Institute 2014 Health Reform Monitoring Survey
Texas % Uninsured by Federal Poverty Level The Baker Institute 2014 Health Reform Monitoring Survey
Disproportionate Share Hospital Allotments Kaiser Family Foundation 2014
More People and Better Service and Higher Quality and Better Outcomes with Less Money to Pay for it all??? More People and Better Service and Higher Quality and Better Outcomes with Less Money to Pay for it all???
Tier 1 Survival Degree of Health/Recovery Tier 2 Time to recovery and return to normal activities Disutility of care or treatment Tier 3 Sustainability of health/recovery Long term consequences of therapy Care induced illness Recurrences Health status achieved Process of Recovery Sustainability of health Porter, 2010 The Outcome Measure Hierarchy
TiTer 1 Survival Degree of Health/Recovery Tier 2 Time to recovery and return to normal activities Disutility of care or treatment Tier 3 Sustainability of health/recovery Long term consequences of therapy An Example from our BPG on Falls Mortality Functional level achieved Pain level achieved Return to Prior level of Function Time to treatment Time to return to PLOF Pain, LOS, PE, DVT, delirium Maintain functional level Ability to live independently Loss of mobility due to recurrent falls Risk of fracture Reduced mobility Tier 1 Tier 2 Tier 3
Comparison of Pre & Post Data: Falls October & November 2013 January & February 2014 January thru February 1-17, 2014 February 18-28, 2014 Education PT: 0/80 (0.00%) OT: 1/59 (1.69%) Education PT: 33/77 (42.86%) OT: 12/71 (16.90%) Education PT: 27/67 (40.30%) OT: 7/63 (11.11%) Education PT: 6/10 (60.00%) OT: 5/8 (62.50%) Special Test PT: 0/80 (0.00%) OT: 0/59 (0.00%) Special Test PT: 39/77 (50.65%) OT: 28/71 (39.44%) Special Test PT: 31/67 (46.27%) OT: 21/63 (33.33%) Special Test PT: 8/10 (80.00%) OT: 7/8 (87.50%)
Strategy vs Culture “Culture eats strategy for lunch” ~Peter Drucker
“Culture Eats Strategy for Breakfast, Lunch, Dinner and a Midnight Snack” ~Sharon Cheng
“In reality, culture does not trump strategy, rather they work together to enhance the success of one another.” ~Mike Myatt
Definition of Culture “Culture is the deeper level of basic assumptions and beliefs that are shared by members of an organization, that operate unconsciously and define in a basic ‘taken for granted’ fashion an organization's view of its self and its environment.” ~Edgar Schein
You probably can’t do more if you continue to do things the way you have always done them Are you still focusing on units/visits? Are you consistently using evidence-based practice? Reality Check
This Change is All About YOU “If you do not change direction, you may end up where you are heading.” ~ Lao Tzu
No More Blame Game Successful people focus on their strengths The best way to learn is to teach Function as an extended family, a community in which every member helps the others
Therapists Can Add Value Active participation in decreasing Average Length of Stay (ALOS) Active leadership in fall reduction Minimize low potential referrals and treatments Intervene purposefully using our strengths
How YOU Can Survive and Thrive Define your passion Share with your manager Share with your work support system Share with your home support system
How YOU Can Survive and Thrive Find out if you are a team of one or many Pick your first project Figure out what support you need Ask for support
“ The greatest danger in times of turbulence is not the turbulence – it is to act with yesterday’s logic.” ~Peter Drucker
Contact Info Brian.Hull@BaylorHealth.edu CathyT@BaylorHealth.edu DonnaFi@BaylorHealth.edu Scheng@bir-rehab.com
References Abrahams J, Zucker D., Zucker J., Airplane [DVD]. United States: Paramount Pictures: 1980. By the Numbers. (2014, July). PT in Motion, 64-64. Dunleavy J, Steffes, L. Managing the Transition from Volume to value: Productivity Standards. APTA Webinar Series: April 17, 2014 Federal Medicaid Disproportionate Share Hospital (DSH) Allotments. (n.d.). Retrieved May 5, 2014, from KFF.Org Francke, A. L., Smit, M. C., de Veer, A. J., & Mistiaen, P. (2008). Factors influencing the implementation of clinical guidelines for health care professionals: a systematic meta-review. BMC medical informatics and decision making, 8(1), 38. Frederick Winslow Taylor. (n.d.). Retrieved November 4, 2014, from http://www.ibiblio.org/eldritch/fwt/taylor.html Grimshaw, J., Thomas, R., MacLennan, G., Fraser, C., Ramsay, C. R., Vale, L.,... & Donaldson, C. (2004). Effectiveness and efficiency of guideline dissemination and implementation strategies.
References Grol, R., & Wensing, M. (2004). What drives change? Barriers to and incentives for achieving evidence-based practice. The Medical Journal of Australia, 180(6 Suppl), S57-60. Ho, V., Marks, E., and Bray, P.G. James A. Baker III Institute for Public Policy, Rice University, The Episcopal Health Foundation, Health Reform Monitoring Survey – Texas, Issue Brief #3. Houston, Texas: 2014. Jette, A. M. (2012). Face into the storm. Physical therapy, 92(9), 1221-1229. K. Davis, K. Stremikis, C. Schoen, and D. Squires, Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally, The Commonwealth Fund, June 2014 Kaplan, R. S., & Porter, M. E. (2011). How to solve the cost crisis in health care. Harv Bus Rev, 89(9), 46-52. Kocher, R. P., & Adashi, E. Y. (2011). Hospital readmissions and the Affordable Care Act: paying for coordinated quality care. JAMA, 306(16), 1794-1795. Kotter, John P., and James L. Heskett. Corporate Culture and Performance. New York: Free, 2011. Print. Orszag, P. R., & Emanuel, E. J. (2010). Health care reform and cost control. New England Journal of Medicine, 363(7), 601-603.
References Our Accomplishments. Delancey Street Foundation Web site. http://www.delanceystreetfoundation.org/accomplish.php. Published 2007. Accessed November 3, 2014. Ploeg, J., Davies, B., Edwards, N., Gifford, W., & Miller, P. E. (2007). Factors Influencing Best‐Practice Guideline Implementation: Lessons Learned from Administrators, Nursing Staff, and Project Leaders. Worldviews on Evidence‐Based Nursing, 4(4), 210-219. Polynesia’s Genius Navigators. PBS.org Web site. http://www.pbs.org/wgbh/nova/ancient/polynesia-genius- navigators.html. Published February 15, 2000. Accessed November 4, 2014. Porter, M. E. (2010). What is value in health care?. New England Journal of Medicine, 363(26), 2477-2481. Porter, M. E. This framework paper is Supplementary Appendix 1 to Porter ME. What is value in health care? New England Journal of Medicine, 363(26), 2477-2481.
References Porter, M. E. This framework paper is Supplementary Appendix 2 to Porter ME. What is value in health care? New England Journal of Medicine, 363(26), 2477-2481. Pravikoff, D. S., Tanner, A. B., & Pierce, S. T. (2005). Readiness of US nurses for evidence-based practice: many don’t understand or value research and have had little or no training to help them find evidence on which to base their practice. AJN The American Journal of Nursing, 105(9), 40-51. Prior, M., Guerin, M., & Grimmer‐Somers, K. (2008). The effectiveness of clinical guideline implementation strategies–a synthesis of systematic review findings. Journal of evaluation in clinical practice, 14(5), 888-897. RMS Titanic. Titanic Pages: Titanic History Web site. http://www.titanicpages.com/ Published 2007. Updated 2014. Accessed October 3, 2014. Rothstein JM. Thirty-Second Mary McMillan Lecture: Journeys beyond the horizon. Phys Ther. 2001;81:1817–1829
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