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Written by: Bob Habasevich, PT on Friday, September 16, 2011 Posted in: Inpatient Rehab

Today, I was asked by one of our sales executives to respond to the often referenced problem of patient acuity measurement appropriate for nurse staffing in an IRF. Another blog was again stimulating responses on this topic from the rehab nursing community with comments of “how we do it” and providing as many varied staffing ratios as there were posts. This social/professional forum provides the vehicle for anyone to make a contribution in addressing the problem at hand; everyone is invited to join the conversation. While this is important and provides opportunity to state an opinion, blogs could perhaps increase the knowledge share if bloggers would comment on the rationale for why things are done rather than simply state how.

The blog continued throughout the day with one nurse posting, “What is the budgeted Nursing HPPD?” another responding,”8.775.” It wasn’t too long before another post stated, “Wow, can you send me your staffing grid?”

While information shared in this manner serves a purpose and may inform, it lacks the depth and understanding of fact or evidence to justify change or improve effectiveness. Blogs and the opinions stated can be likened to a weather vane giving indication to which way the wind is blowing. However, if you want to know if you will need a raincoat, other predictive information is required.

The rehabilitation industry is changing and we all need a deeper drill down to find the evidence supporting our cause.

At Mediware, we’ve been actively engaged with unraveling the dogma associated with the rehabilitation industry. When it comes to applying the correct prescription for a patient’s rehabilitation, we understand there is no black and white formula for care and many test/retest stops must be put into the care plan for real-time course corrections. The coordination and communication associated with this iterative process is mandated both in care delivery standards and legislated guidelines for Medicare payment. This not only provides insight to what is working and what is not, but helps to develop a predictive assessment for the next patient we encounter with similar problems. This has been labeled as interdisciplinary team process and is the expectation of all IRF providers. Professionally, this is how we gather information and insight required to solve clinical problems.

If patient care conferences were held electronically with members blogging in their respective opinions of how they see the patient problem, the resulting rehab outcome would be different than could be expected when the group conversation focuses on the problems with opinions and facts presented, challenged and discussed. Understanding and solving problems with multidimensional agreed rationale has demonstrated its value in patient care.

Blogging and social media will continue to grow and occupy an increasing presence in the way we communicate with each other. However, to date its value as transforming knowledge to solve problems is limited. That’s just my opinion; I have to go write another blog now.