At a glance: The pluses of restorative care
Is restorative care right for you? How to decide
Ask yourself these questions to find out
Depending on the market your company is in, starting a restorative care program might not necessarily be a cost saver. Here are some guidelines for deciding whether you should consider starting a restorative care program:
* Do you have a shortage of therapists in your market?
If you answer "no," to this question, then you should think hard about why you want to start restorative nursing at your company, says Mary Alice Culler, RN, BSN, the director of Northern Hospital Home Care in Mount Airy, NC. You probably don't need a restorative nursing program if you have enough therapists to cover your company's needs, she says.
* Do you have a lot of unbillable physical therapy visits?
Look through your records of physical therapy patients to see whether your therapists did visits that couldn't be billed but were medically necessary. If you have more than a few of these, then you should consider providing restorative care.
* Is your patient volume high enough?
Record the number of patients who could have been restorative nursing patients in a given period of time in the recent past, Culler advises. Would the volume of restorative nursing patients have been large enough to justify the cost of starting up the program? If not, then don't waste your money on it.
If you think you would have the patient volume to make a restorative nursing program successful, then ask yourself if you would have saved money on these cases if you had been able to provide them with restorative care.
Estimate roughly how much it would have cost you to care for these cases that could have been restorative nursing patients. Include in your estimate the time and materials you might put into training staff and providing patients and their caregivers with the extra educational materials the program would require.
Would it have been cheaper to have a restorative nursing team take care of these cases that could have been restorative care patients? If the answer is "yes," then you should definitely consider starting a restorative nursing program, Culler says.
* What are the demographics of the health care industry in your market?
Take into consideration factors such as the average age of your clients and your community, as well as whether your market has a lot of orthopedic patients, or stroke victims. If there are a lot of people in these categories, your market might be ripe for restorative home care.
* Where would your referrals come from?
Survey the physicians who refer patients to the company, and ask if they would refer patients to your proposed restorative care program, advises Marcy Rothfuss, BSN, CRRN, the rehabilitative manager at Susquehanna Regional Home Health Services in Williamsport, PA. You can do this informally by asking the physicians about this when you're getting new orders or paperwork signed. You could also call or meet them specifically to ask this question, or add this question to a regular physician survey.
Get commitment for budget upfront
If your community has a rehabilitation hospital, this could be a big source of referrals, or it could be competition. Consider surveying the nurses and doctors at this facility, too.
* What would your competition be?
Many nursing homes have begun offering restorative care as a selling point, Rothfuss says. There might also be a strong outpatient rehabilitation facility near you. You will have to decide whether you want to go up against these competitors.
* Can your company afford to start restorative care?
You have to be sure of your company's commitment to the program in terms of resources. Don't secure the budget for the program in bits and pieces. Even if you're not going to start the whole program up all at once, you have to be sure you've got a solid commitment for the budget you'll need, Culler says.
"If you don't do this, you'll end up fighting for funding each step of the way, and everyone suffers as a result," Culler says. *
At a glance: The pluses of restorative care
No downsides to it, managers say
These are the benefits of providing restorative care, say hospital-based home care managers who provide the service:
* Patients get well faster, helping reduce the cost of caring for managed care clients.
* Therapists have more time to see a greater number of patients, though they see each patient fewer times.
* Your company can offer same-day or
24-hour response time to therapy referrals,
as your therapists have more time to see new patients.
* Your cost per visit goes down because you're combining therapy and nursing or aide visits, instead of sending out expensive therapists three times a week.
* Patient satisfaction goes up because their nurses and aides spend more time with them.
* Physician satisfaction goes up because their patients get well faster. *
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