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Written by: Bob Habasevich, PT on Friday, June 24, 2011 Posted in: Inpatient Rehab

Don’t be intimidated when asked.

With increasing frequency, the quality and cost of healthcare is debated with concern that both cannot be sustained at current levels. It is not surprising to anyone that a reengineering of our healthcare system is required to affect a meaningful change; and, that change will not be effective nor meaningful if the discussion fails to encompass all stakeholders, and that includes me and you regardless of on which sided of the healthcare equation we fit.

Healthcare reform will never be a one size fits all solution; the agreement of what healthcare should be after reform is not supported with common expectations. Providers struggle in pursuit of alternative means to deliver less expensive patient care while reductions in payment threaten to erode quality and reduce availability of services.

The cost-quality issue must be in balance to assure access in any healthcare delivery venue. This is the basis for most transformation discussions. The necessity to examine and evaluate all evidence to support proposed solutions is paramount. So far the approach has been predominately cost focused and will continue, but the quality side of the equation must be considered to impact healthcare value. Assessment and analysis will raise the discussion to effective and efficient with cause and effect demonstration.

Providers in the inpatient rehabilitation business certainly stand to feel this scrutiny as performance and quality measures become mandated for payment. Currently quality is not defined for hospitals providing inpatient rehabilitation (IRFs and IRUs.) In the absence of standard quality definition and measures the perceptions of quality varies across the post acute continuum. Loosely defined expectations of quality opens the door to varied perceptions of what is acceptable care, especially when describing which hospital is best.

And finally, what should this all mean to the doctors, nurses and therapists who spend the majority of their efforts addressing patient problems in attempt to heal and restore what has been injured? Knowing ones effectiveness should not be minimized, it is the basis for all improvement. When asked, a clinician must not cower or shy away from the question. Instead, be prepared with valid response to satisfy and convince whoever asked. The response must be thought through and previously considered to demonstrate the professional’s commitment to self assessment of their professional role. “How effective am I and how could I improve?” is the first step to transforming healthcare with personal accountability and attention given to the effectiveness-efficiency issues of care delivery.

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