Tracey Harris, MD, director of the stroke rehab program, shared with Becker’s how the Mount Holly team committed to establishing an AHA-certified program.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What specific clinical protocols and standards did your facility implement to meet the American Heart Association’s certification criteria for stroke rehabilitation?
TH: Mount Holly’s personnel, both licensed and non-licensed, were provided education about stroke and the stroke program’s mission, vision and plan. Patient and caregiver education plans were developed to focus on disease and medication management, the program’s various rehabilitation components, and comorbidities and complications related to stroke.
Goal-directed clinical management was a huge component and focused on optimizing medical treatment and rehab management. That included monitoring for, identifying and managing complications and prioritizing “Treat in Place” to avoid unplanned rehospitalization, when possible.
An ongoing internal quality improvement plan was also developed to continually measure and monitor our process and outcome matrices.
Q: How can hospital and health system leaders better collaborate with skilled nursing facilities like yours to optimize post-acute stroke care and reduce readmission rates?
TH: Healthcare leaders must embrace a sense of urgency to improve care, quality and outcomes for the 795,000 people who experience stroke each year.
Hospital systems, post-acute care providers and community care providers all need to agree that there is a one spectrum for one disease, and one care plan across the recovery path, keeping one focus in mind: the stroke patient.
This requires a true acute and post-acute partnership that is self-evident and credible for maximized physical, rehabilitative, psychological and social recovery. That is the key to improving quality of life and reducing the risk/rate of complications and secondary prevention.
In short: one team, one patient at a time.
Q: What lessons did the Mount Holly team learn from the certification process, and how do you see the future of stroke rehabilitation evolving in the skilled nursing setting?
TH: The Mount Holly team learned that the best-quality patient care and outcomes happen when a skilled nursing facility can demonstrate commitment to a high standard of service, standardize care and remove variation, provide a framework to improve patient outcomes, and help to organize teams across the continuum of care.
Skilled nursing providers are in a unique position to improve stroke rehabilitation by fundamentally changing their care models. Mount Holly believes the certification will help improve care, result in better outcomes and provide superior experiences.