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Written by: Darlene D'Altorio-Jones (1959-2015) on Saturday, December 15, 2012 Posted in: Inpatient Rehab

Measurable outcomes. If every clinician’s evaluation did not end up in a resultant assessment and expected measurable outcome then what purpose was the evaluation in the first place?  Notice I did say ‘expected measurable outcome.’  How often do staff cleanly define the minutia of detailed impairments but forget that the end result of that assessment is the major factor for why their professional skill set is necessary to overcome the issue? What specific practice skills do they possess that in lieu of the impairments can provide an outcome that is measurable and acceptable to enable the individual to achieve the discharge goal/status desired? Functionally as well as medically, these skill sets define the effectiveness of our rehabilitation plan of care.

Then, if on an interdisciplinary team like that in multi-service outpatient care or in an inpatient rehabilitation unit/facility, what specific impairments are considered roadblocks to discharge? And if  given those roadblocks, what level must be achieved to enable that particular patients resources or themselves to handle these impairments successfully and safely? When you have that answer, you have the million dollar solution and the road map to its accomplishment partially ‘in the bag’ so to say.

Once the very specific roadblocks are defined, every person on the team must work toward the solution(s) in a measurable way so that day-to-day you know exactly which areas need more practice, reinforcement and/or additional problem solving to occur. It can’t wait until the next 10 day progress note OR for the weekly conference. These concepts must be engaged on each encounter with the patient so that skillfully, the clinician can concentrate on their expertise and input toward resolving each barrier they have input toward.

If at any point during the patients care you do not have the information that provides you the present status of that patients progress in meeting their roadblock(s), and how you specifically will reinforce progress toward the expected outcome, you are not being a good steward of health care dollars.

Often this type of information is difficult to collate or summarize as a glance, a benchmark or a ‘report card’ of progress. When that is true you may not have the right tools or reports to enable you to be the most effective and efficient that you can be. In today’s healthcare, with shrinking dollar coverage and margins, the only way to successfully dispel barriers more quickly and for teams of professionals to act in unison is through information.

Specifically, state the expected long term goal (LTG) as a measurable term that the patient and their resources can safely manage. You should provide progress toward that LTG as a measured present status statement; this provides comparison to expected outcome and always provides the short term progress toward the expected result. If you can eliminate short term goals and replace with short term progress toward the LTG you are more effective in keeping all focus on the FINAL outcome rather than baby steps that run short on time.

Last but not least, we are in a measurable, outcomes-driven society and the faster we can move staff toward gathering meaningful data that steers specific outcomes focused-care planning, the quicker we can move toward successful outcomes. Being good stewards of health care dollars is in the practice pattern of every professional. Be actionable and utilize clinical intelligence and progress status in real-time to be most effective.

If you need help in getting there perhaps a Mediware demo or a CORE visit is in your future.

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