Power of Rehabilitation: Best Hostpials and Recent Trends
Written by Richard Heap
Basic Tenet of Accountable Care
The term "Accountable Care Organization" (ACO) was first used by Elliott
Fisher, Director of the Center for Health Policy Research at the Geisel
School of Medicine at Dartmouth in Hanover, NH. In essence, ACO is based on
the concept of "provider-led organizations with a strong base of primary
care that are collectively accountable for quality and total per capita
costs across the full continuum of care for a population of patients."
One interesting aspect is the discussion involving "full continuum of care" and
how that affects hospital relations with physician groups, insurance
providers and other hospital networks. This has led to a particular concept
based around ensuring the patient receives the appropriate evaluation and
treatment at the appropriate time in their recovery process, commonly
referred to as a "Life Coach" or "Patient Concierge". In essence, once a
patient is admitted to a healthcare network, a representative is assigned to
be with the patient from initial testing completion through follow up and
therapy if required.
Position of Rehabilitation Hospitals
The goal for rehabilitative care is to ensure that patients are able to be
discharged to their homes instead of an acute care or nursing facility. To
this end, rehabilitation hospitals are already on the cutting edge of what
healthcare reform is all about because their approach to patient care is
very much team-based care. "In rehab, you are putting the whole person back
together. It can't be just the physician; there is the need for the
therapist, the case manager, the whole team. It is part of the recovery
process", 2 says Charles Pu, MD, Chief Medical Officer for Spaulding
Hospital in Boston, MA. With the increasingly aging population and a focus
on full continuum of care, rehabilitative care will become a progressively
more important component to the healthcare delivery process.
Relationships between acute care facilities and rehab hospitals can result in improved
outcomes and reduced expenses through collaboration and cooperation. "An
interdisciplinary team approach is the foundation of the system. The team
consists of physical, respiratory, occupational and speech therapists, as
well as a neuropsychologist, physician, nurse, dietitian, infection control
nurse and clinical case manager, which allows patients to see a wide variety
of spinal cord specialists".
Recent Trends in Rehabilitation Services
Rehabilitation hospitals occupy a unique position within the spectrum of
aging/patient care with connections both into acute care hospitals and into
senior living/skilled nursing facilities. In a recent white paper released
by RehabCare, "there are opportunities to proactively prepare for changes
and anticipate positive clinical and business outcomes. Rehabilitation
programs present an immediate opportunity to achieve increased operational
excellence in providing quality outcomes in a cost effective setting".
The paper goes on to suggest 10 steps to improve rehabilitation services:
1. Build your program around quality people
2. Invest in the professionalism of the Therapy Department
3. Develop specialized programs that meet the needs of the facility and community
4. Excellent therapy management
5. Know the rules and follow them
6. Know your customers and the market
7. Strategically approach census development
8. Make it easy for your customers
9. Manage the rehab stay
10. Keep your customers happy
In the ever-increasing consumer empowerment of healthcare selection, I would
propose that the order should start with #8, followed by #10. To achieve
those metrics, the facility must excel at all of the other steps. Having a
strategic design partner to assist with thought leadership and national best
practices and ensure that the facility design matches the forward thinking
of the operational process is the next logical step.
About the Author
Richard Heap, Associate AIA, IABC Director Arate Communications Consulting, Inc.
Market-focused Visibility. Professional Integrity. For 15 years.
How healthcare can safeguard itself against cyberthreats
One of the most fundamental lessons from the COVID crisis is that health should always be a priority. In a similar fashion to the human body that frequently fights off viruses and foreign invaders that intend to cause it harm, the sector itself is now a prime target for another type of external threat: cyberattacks.
The figures speak for themselves: between December and January this year, hospitals in the UK were at 89% capacity, with 7,000 fewer available beds than there usually are. As the pandemic increased pressure on hospitals, clinics, and research facilities to create a treatment for patients globally, it has left the sector exposed to hackers who, like a virus, have been targeting it relentlessly and evolving their tactics.
From patient records being held ransom, to fake emails claiming to originate from the UN WHO, the NHS, or vaccine centres, through to attacks on the cold supply chain to find out the secret formula of the COVID vaccine, the healthcare industry is facing constant cyberattacks and struggling to cope. This threat is unlikely to go away anytime soon – and as such, the industry needs to take a proactive, preventative stance to stay safe in a dynamic digital world.
The responsive nature of healthcare – particularly of hospitals – means that efficiency is crucial to the industry’s standard operations. To support this, the sector has been embracing technological advancements that can improve the quality of work, enabling staff to meet pressing deadlines, and enhancing patient care. For example, the industry has been digitising records and improving its ways of working through digital means over the past few years.
This shift is critical to offer high quality patient care; yet, it also means the sector has become more dependent on IT, which can come with a risk if cybersecurity processes employed are deemed as inadequate.
Without the correct security measures in place, the desired efficiency gains realised, can be easily lost in a heartbeat. Simply put, an elementary glitch in the system can have a tremendous ripple effect on many areas, from accessing patient records and conducting scans, to maintaining physical security and protecting the intellectual property of experimental treatment development.
To prevent this, healthcare organisations need to ensure they’re considering cybersecurity as part of their overall digital transformation strategy – and setting the right foundations to create a culture where safety goes hand in hand with patient care.
Before implementing cybersecurity process, healthcare organisations need to assess the potential risks they face. Depending on how much confidential data the trust has, where it is stored, who has access to it and via which means, the cybersecurity strategy and associated solutions will change.
It’s fair to say that a medical device start-up where all employees have a corporate-sanctioned laptop and access data via a VPN will have radically different needs to a large hospital with hundreds of frontline workers connecting to the hospital’s Wi-Fi using their personal device.
These requirements will pale by comparison to a global pharmaceutical giant with offices in multiple locations, a large R&D department researching new treatments for complex diseases and a fully integrated supply chain. Considering the existing setup and what the organisations is looking to achieve with its digital transformation strategy will therefore have an immediate impact on the cybersecurity strategy.
Despite this, there are fundamentals that any organisation should implement:
Review and test your back-up policy to ensure it is thorough and sufficient – By checking that the organisation’s back-up is running smoothly, IT teams can limit any risks of disruption in the midst of an incident and of losing data permanently.
In our recent State of Email Security report, we found that six out of ten organisations have been victims of ransomware in 2020. As a result, afflicted organisations have lost an average of six days to downtime. One third of organisations even admitted that they failed to get their data back, despite paying the ransom. In the healthcare industry, this could mean losing valuable patient records or data related to new treatments – two areas the sector cannot afford to be cavalier about.
Conduct due diligence across the organisation’s supply chain – Healthcare organisations should review their ways of working with partners, providers and regulatory institutions they work with in order to prevent any weak link in their cybersecurity chain. Without this due diligence, organisations leave themselves exposed to the risks of third party-led incidents.
Roll out mandatory cybersecurity awareness training - Healthcare organisations shouldn’t neglect the training and awareness of their entire staff – including frontline workers who may not access the corporate network on a regular basis. According to our State of Email Security report, only one fifth of organisations carry out ongoing cyber awareness training.
This suggests it is not widely considered as a fundamental part of most organisations cyber-resilience strategy, despite the fact many employees rely on their organisation’s corporate network to work. By providing systematic training, healthcare organisations can help workers at all levels better understand the current cyberthreats they face, how they could impact their organisation, the role they play in defending the networks, and develop consistent, good cybersecurity hygiene habits to limit the risks of incidents.
Consider a degree of separation – Information and Operational Technology (IT and OT) networks should be separated.
Although mutually supported and reliance on each other, employees shouldn’t be accessing one via the other. This should be complemented by a considered tried and tested contingency and resiliency plan that allows crucial services to function unabated should there be a compromise. Similarly, admin terminals should not have internet access to afford a degree of hardening and protection for these critical accounts.
As the sector becomes a common target for fraudulent and malicious activity, putting cybersecurity at the core of the organisation’s operations is critical. It will help limit the risks of disruption due to cyberattacks, reduce time spent by the cybersecurity team to resolve easily avoidable errors, and ensure that institutions can deliver patient care, safe in the knowledge that their networks are safe.
Fighting future threats
With technology continuing to change the face of healthcare, the surface area and vectors available for attacks by malicious actors is constantly increasing. With the introduction of apps, networked monitoring devices, and a need for communication, the attack vector is ever expanding, a trend that needs to be monitored and secured against.
To prevent any damage to patients, staff, or the organisation they are responsible for, healthcare leaders must put security front and centre of their digital transformation strategy. Only then can the sector harness the full benefits of technology. Doing this should include implementing cybersecurity awareness training to challenge misconceptions around security, encourage conversation, and to ensure employee knowledge of the security basics and threats faced.
This ultimately allows healthcare organisations to do what they do best: provide the highest standard of patient care, safe in the knowledge that their operations, patients, and data are safe.