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by Bonnie | Jan 8, 2014 | CARF Preparation, Physician Education, Rehab Physical Medicine

Well here we go into a new year!  It seems as though I just got used to writing 2013!  Now I have to work on 2014!  Cheers to cognitive flexibility and learning!

The last discussion of 2013 was about vision statements that answer the question of “Why we are here?”  As your organization embraces CARF preparation it is important to understand where the mission statement and core values fit in. So, let’s explore the mission statement and core values.

The mission statement talks about the present and defines how you will get to where you want to be.  What you do may change as time goes by but will always tie back to the vision for the organization/program.  Doctors may not know it, but they do care about the mission statement because it answers the question, “What do we do?” Many of us are most comfortable with the here and now and have a large investment in what we do as it impacts our day-to-day lives.  Put in this context, doctors are usually quick to get involved in a discussion about the organization’s/program’s mission!

With vision and mission statements covered, what are core values and where do they fit in?  Core values are several statements that describe the principles that drive the organization’s/program’s internal conduct as well as its relationship to the world. The core values encompass the ethics, principals, and beliefs of the organization/program.

Hmmmm…….adding core values to the mix always confuses me.  However, I have found that if I pay attention in the world, many of the companies that we regularly deal with put these principles out to the world. For example, I found myself ordering boots for me during the holidays (when I was supposed to be shopping for my family, what is that about?). The boots arrived from Zappos.com and as I excitedly, albeit somewhat embarrassed, tore open the box, I noticed on the side of the mailing box, “Zappos Family Core Value #8: Do More With Less.”

Core values are probably absolute and unalterable principles such as honesty, respect, and continual self-improvement. I think when we stop to think about what principles drive our organization’s/program’s internal conduct as well as its relationship to the world, they are pretty easy to identify.

Clearly vision, mission, and core values work in harmony.  The vision statement describes what the organization/program wants to be in the future, the mission statement describes what the organization/program wants now, and the core values guide an organization’s/program’s internal conduct as well as its relationship with the external world.

If you need help in engaging your doctors with creating the vision, mission, and core values, contact Donna Jo Blake, MD, BRB Consulting, Inc. for physician-to-physician guidance and training.  As your doctors take ownership of the vision, mission, and core values of the organization/program, they will become more effective program advocates and leaders.

Sharing Successes
by Bonnie | Sep 25, 2011 | Uncategorized

BRB Consulting is committed to making today’s healthcare environment a better place for providers and consumers.  During the past year, Bonnie Breit, working with Tom Moore, developer of Midg-ett Tables™   launched EZ-Rest Retractable Folding Chair® as a solution for persons needing a quick rest in hallways or while waiting in areas of refuge.

Following  a comprehensive  accessibility review,  Kingston General Hospital (KGH) located in  Kingston, Ontario recognized an unmet need from their   patients who regularly expressed concern of needing a place to rest while traveling  KGH’s many long hallways.

So,  KGH bought and installed EZ-Rest®. Visitors can stop, sit  and take a quick rest on the new “Rest Station”.  Now everyone at KGH is  discovering the benefits of EZ-Rest® directly.

We invite you to read  their story to see the how adding EZ-Rest® in your building can improve not only access, but consumer satisfaction as well.

Feel free to contact us for more information and see how EZ-Rest® is improving access…one chair at a time.

A Season for Change
by Bonnie | Oct 13, 2011 | Performance Improvement

As the weather begins its transition into fall,  and the leaves begin to turn  colors,  it is a perfect time to think about change on a larger scale.  Many of us reflect from time to time on what we or our organizations could do better or even about things we  wish we could stop doing altogether.

So where to begin? Start with  something that matters, a facility problem, an employee issue or maybe a challenge for patients/clients.  Once  you decide what it is you want to tackle,  gather a team to help; successful change  requires analysis  and planning;  for that  two,  or even more heads are definitely better than one.

Next try  a brainstorming session to first define the issue,  then let loose  creative ideas on what might be a fix.  (Do have someone take notes!)  Then begin analyzing and weighing the team’s thoughts,  it is okay to take time.  Give  your group permission to “reflect” on the concepts that have been shared.

After thoughtful consideration, the team’s imperative is  to select the best approach to address the change desired.  Now the work should  focus on creating the actions for making something different happen.

As the team defines these procedures, establish just  one  goal for one small change.  Although  it may not seem like much, targeting that will lead the team to achieving the larger goal.

“Rome was not built in a day”  may become a mantra for the team. Working together, know the change can happen -there’s proof – Rome still exists  today!

With those beginning steps, you are ready to become a change agent. Join us again in two week for the next installment of A Season for  Change.

To learn more now or want some help in starting change in your program- contact BRB Consulting toda

IRF Funding at Risk- Reach Out Today!
by Bonnie | Nov 10, 2011 | Legislative Issues

If you are reading this post, then you probably understand the value of rehab….unfortunately- not  everyone does and sometimes, even our legislators don’t either.

The recent Obama deficit reduction proposal poses to  disproportionately cut inpatient rehabilitation hospitals and units (IRH/Us) in order to save dollars.  Of $320 billion President Obama has proposed for Medicare and Medicaid savings, $42 billion would come from post acute care providers.   The current  deficit reduction proposal would decrease market basket updates by 1.1% for IRFs in FYs 2014-2021; implement site neutral payments for three conditions plus those which the Secretary may designate; and reinstate of the 75% Rule compliance threshold.   Clearly -these changes would severely compromise IRF’s ability to deliver care to many who need it!

So, what can you do?

If you are a Rehab provider , please  reach out to your legislators and members of the Super Committee to oppose these reductions.

If you are a recipient of rehab care-  tell the legislators your story…protect the funds to allow IRF to deliver that rehab care today and tomorrow.

Not sure who represents you…Click on either  the Senate or the House and find out and email or call today.

Legislators need to hear all the stories  about  rehabilitation and the impact  these services have on the lives of their constituents.

Take time now to share the benefits of  REHAB…If you need  more detailed information related to this,   BRB Consulting suggests contacting AMRPA!

Special Open Door Forum: IRF 11/29/11 by Bonnie | Nov 23, 2011 | Uncategorized

With Thanksgiving being just  a day away, Inpatient Rehabilitation Facilities  (IRFs) are working hard to keep supporting patients needing rehabilitative care.  Clearly  the value of rehab can be seen by Representative Giffords’ remarkable progress.  The recent ABC special highlights those successes.   However, there continue to be legislative efforts which will ultimately reduce access to rehab care. Many IRF programs are concerned about their future ability to provide rehab to the community.  Visit AMRPA to learn more about what you can do to keep rehabilitation a right for all people.

Even with these funding cuts on the horizon, IRFs strive to optimize  quality care. Next Tuesday CMS is hosting a special forum.  Everyone is welcome to join the call…

If your organization delivers IRF care,  plan to listen in-the new measures will be discussed. (No registration is needed.)

Special Open Door Forum: Inpatient Rehabilitation Facility Quality Reporting Program (QRP) Tuesday, November 29, 2011 2:00 pm – 4:00 pm ET Dial: 1-800-837-1935 Reference Conference ID: 21834666.

The Centers for Medicare and Medicaid Service (CMS) has scheduled a call that will give an overview of the IRF QRP (http://www.cms.gov/LTCH-IRF-Hospice-Quality-Reporting) , review of the Affordable Care Act Section 3004 (b) and the Quality Reporting Program for IRFs, and quality measures for the IRF QRP. Questions and comments can be sent to [email protected].  If you wish to participate, dial: 1-800-837-1935 and Reference Conference ID: 21834666. An audio recording and transcript of this Special Open Door Forum will be posted to the Special Open Door Forum website at http://www.cms.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading on or around December 9, 2011 and will be available for 30 days. Please see the Downloads section at the following URL for the full participation announcement: http://www.cms.gov/OpenDoorForums/18_ODF_Hospitals.asp.

If you need additional information on how these measures will impact your organization- contact BRB Consulting.  We are here for you.

Keeping Track of CMS….
by Bonnie | Feb 9, 2012 | CMS, Legislative Issues, Performance Improvement, Rehab Physical Medicine

As 2012 begins,  everyday life seems to be getting more complicated.  Not only have the political  campaigns taken hold  of the airwaves-yes there is an election in 9 months;  the weather has many of us trying to choose  between shorts and parkas;  and as part of the regular day-to-day quality care practices,  Rehab providers strive to deliver optimal care in this increasingly complex environment. This month’s topic focuses on one of  CMS’s newly revised regulations designed to “improve service delivery”.

Sometimes- new  revisions  simply DO NOT  appear to that.

For example,  CMS  Transmittal 72 11182011 was released in November 2011 under no special circumstances or with any requests for comments. The transmittal  states that all orders for rehabilitation therapies both inpatient  and outpatient must be written by a practitioner aka doctor or nurse practitioner  who is a part of the  hospital staff where the patient is to be treated.  On inpatient- this is not a big deal. It actually  works, when patients receive care in a hospital,  every doctor  who delivers care in that space is a part of  the staff.  Even if the patient came from another state, that new patient will  become  part of the admitting doctor’s service and be under her care for orders.

BUT on outpatient, the interpretation and implementation of this transmittal can be  VERY BIG deal…so let’s consider a real life situation  and analyze that.

For a patient who has received special hospitalization in other city, county or even state, the special therapy orders written  by the discharging doctor  would not be valid at the patient’s local hospital. Like a person who suffers a spinal cord injury while driving from SC to Florida,  is injured in Atlanta and receives care at the special rehab spinal cord center in Georgia.

Once the discharge plans were set,  the patient going back home to SC would have to see the  hospital staff doctor in SC to get new orders to be treated at the local hospital in his hometown town.  Probably- not too quickly either- you know how long it can take to get a non-emergency appointment….plus there is that additional financial cost of co-payments  plus  the real effort for  the patient and family in arranging an additional trip to the new “hospital” doctor.  Clinically, the first doctor knew the patient and his history and wrote the outpatient treatment orders based on those needs;  but the new doctor must start at the beginning….maybe giving similar orders- BUT may not.

Maintaining  quality care and improving access are concepts regularly stated by CMS.   We are just not sure this transmittal’s regulations meets those two goals…what do you think?

AMPRA is actively monitoring the next steps from CMS and the  response from the Rehab industry on Transmittal 72111802011.  If your organization has  have you been affected by this practice – Please contact AMPRA.

Looking to learn more about regulations, quality care and how to positively  impact  your organization- BRB Consulting would welcome hearing from you. Contact us today.