Implementation of an Outcomes Tool

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Implementation of an Outcomes Tool

• Britt Zink, MSPT, Cert MDT
• Outpatient Rehabilitation Manager
• Sioux Valley Hospital USD Medical Center
• Sioux Falls, South Dakota

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Sioux Valley Hospital Health System

• Tertiary non-profit health system with over 150
  healthcare facilities, over 300 physicians
• 10,000 employees
• 5 Centers of Excellence
• Oncology Cancer Center
• Cardiology
• Neurosciences/Orthopedics
• Womens Childrens
• Trauma

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Sioux Valley Hospital USD Medical Center

• Certified Level II Trauma Center
• Only designated Stroke Center in the region
• Recognized as Americans top 100 hospitals in
  cardiac, stroke orthopedics
• Two year recipient of JD Powers Associates
  Recognition for providing an outstanding patient
  experience

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Physical Medicine Rehabilitation Services

• Four product lines
• Acute care (also encompasses pediatric therapies)
• 29 Bed CARF-Accredited Rehabilitation Unit
• Sports Medicine
• Outpatient Rehabilitation

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Outpatient Rehabilitation Services

• Two sites of service
• NORTH Center (Neurosciences, Orthopedics,
  Rehabilitation Team Healing)
• Satellite clinic
• Full spectrum rehabilitation of neurological and
  orthopedic impairments
• Numerous specialized programs

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Leadership

• Evolution of leadership and accountability
• Cultural change
• Outpatient Rehab 5 managers in 10 years

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Selection of an Outcomes Tool

• Prior to 2001 department had utilized
  independently developed measurement of functional
  performance
• Emphasis on strategic planning fiscal
  accountability and market development
• Assessment of several outcomes tools FOTO was
  the evident choice

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Implementation

• Live with CADI early 2001
• Staff perception
• FOTO implementation immersed in an environment of
  tremendous change transition of managers, new
  construction with physical move of department,
  new environment of accountability

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Implementation Continued

• Early on implementation unsuccessful
• Move to new building January 2002
• January 2003 minimal progress with
  implementation transition of managers
• FOTO task force formed with concurrent mandatory
  departmental FOTO meetings every other week

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Identification of Barriers

• Lack of understanding of clinical significance
• Disagreement over definition of roles
• Time factor
• IT issues
• Staff perception

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Action Planning

• Simultaneous development of FOTO Task Force and
  Discipline Collaboration Task Force
• Definition of data pool
• Development of algorithm of intake survey process
• Backup system implemented for IT problems

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Action Planning

• Collaborative effort of athletic trainers,
  clerical staff, exercise physiologist, therapists
• Implementation of status triggers
• Accept the change

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Action Planning

• Performance Improvement projects
• Monitoring of number of intake, status, discharge
  surveys
• OP Rehab manager attended 2003 FOTO Users
  Conference
• Staff education on clinical significance,
  marketing strategies

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Life after FOTO Conference

• Implementation of regional, clinician-specific,
  DRG-specific, physician-specific outcomes
• Closure rate benchmarking
• Closure rate incorporated into performance
  evaluations
• Quarterly meetings to discuss outcomes,
  problem-solve and educate

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Clinic Closure Rate
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Managers Role

• Monitoring of survey completion compliance
• Interpretation summarization of outcomes
• Staff education
• Marketing of physician outcomes
• Strategic planning
• Staff empowerment

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Success Strategies

• Define intake process
• Backup paper process
• Status survey triggers
• Accountability
• Incorporation into employee performance
  evaluations
• Support of Physicians Executive administration
• Cultural change

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Future Considerations

• Improvement of functional outcomes
• Continued staff education
• Guide continuing education needs
• Staff development
• Incorporation into an electronic documentation
  system

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Questions????