Enhancing the care continuum
Our facilities and billing
What we do differently:
Life Rehabilitation units’ different practice numbers facilitate the global tariff structure. This tariff includes all professional services that the patient may need, irrespective of the amount of input required, and patients are treated by all appropriate members of the interdisciplinary team. Medication, ward stock and assistive devices are not included in the tariff. The numerous advantages of this tariff include its administrative ease for both funder and provider, with no hidden costs, and our ability to add significant value to the rehabilitation process through inclusion of essential (but non-billable) services such as team meetings, family and patient education programmes, detailed reporting and intensive team interaction.
Life Rehabilitation has been developing rehabilitation facilities around South Africa since 1997, and has developed a sound body of knowledge and expertise in the process. A fully integrated team is employed full time to ensure comprehensive service. This includes the case manager, who liaises between family, funder, referring doctor and team, and the clinical team, comprised of a rehabilitation doctor (enabling the team to manage co-morbidities and other medical challenges), rehabilitation nurses, physiotherapists, occupational therapists, speech therapists, psychologists, social workers, and a dietician. The patient and family are considered essential members of the rehabilitation team, as they are the people who are living the experience and adapting to its challenges. Importance is placed on ongoing staff development and training to ensure high levels of service and best practice.
Active and ongoing team interaction is a key principle underpinning the comprehensive nature of our service and our ability to ensure that therapeutic goals are integrated and focused. Decision-making is constantly reviewed by the funder and clinical team through detailed reporting and regular interaction. Our teams meet regularly with each other and with the patient’s family to discuss patient progress, the therapeutic programme, and discharge planning. The relevant managers are intrinsically involved in the process, and meet regularly with their teams to ensure quality delivery.
The team is well equipped to deal with patients that are cognitively disabled, as the programme is customised to provide the necessary structure and intervention for each individual. Daily treatment includes intervention by all appropriate team members, to address medical, physical, cognitive and psychosocial goals of treatment.
Considerable emphasis is placed on the education of patients and their families and care givers to improve their coping skills. Educated, empowered patients and families thus gain improved knowledge, understanding and insight into their condition, thereby facilitating long term self-management, and significantly less complications with resultant re-admissions into acute care environments.
Length of stay is predicted following detailed patient assessment and team discussion (within 24 hours of admission), and reviewed with the funder and patient (or family members) on an ongoing basis, depending on progress. The average length of stay across diagnostic groups is four to six weeks.
Patient progress is carefully monitored and measured by the team, using a variety of clinical outcomes and internationally researched outcomes measuring systems called the Functional Independence Measure (FIM) and Functional Assessment Measure (FAM), ensuring that we measure all the domains of function relevant to daily life. The continual monitoring of progress gives the team the ability to adjust the programme on an ongoing basis to ensure the best possible outcome.
Prospective rehabilitation patients that are admitted into trauma, neurosurgical, orthopaedic or medical wards should ideally be assessed as soon as possible after the disabling incident.
Once a referral has been received and confirmed with the attending doctor, the admission case manager for the unit closest to the acute care environment, will visit the patient to carry out a functional and rehabilitation screening assessment in order to establish the patient’s suitability for rehabilitation. The case manager will provide the referrer and the patient’s funder with the results of this assessment, and request authorisation of funds (in writing) should the patient be an appropriate referral. The case manager will also discuss rehabilitation services with the patient and his/her family to ensure that all stakeholders are prepared for the rehabilitation admission.
Following admission, the patient will be assessed by all team members within 24 hours, and a full assessment report sent to the funder and attending specialist within 72 hours of admission. This report will predict length of stay, and give the decision-makers sufficient information regarding the patient’s condition and proposed rehabilitation programme.
Discharge planning is carried out throughout the programme to ensure that patients, funders and families are adequately prepared for a smooth transition from the rehabilitation unit back to the home and community settings.
Progress reports are provided on a weekly basis to ensure that the patient’s progress justifies the costs. Case managers will follow up on updates and ensure continued authorisation based on these reports. On discharge, a detailed discharge report, including recommendations for outpatient intervention and ongoing care, is provided.
Quality management systems
Although Life Rehabilitation units were included in the Life Healthcare Group ISO 9001 multi-site certification, achieved in 2007, a decision was taken in 2009 to embark on a separate certification for the business, with an emphasis on specific rehabilitation processes and customer needs.
Life Rehabilitation has now achieved separate ISO 9001:2008 certification, making it the only certificated networked group of rehabilitation units in the country. This certification underpins Life Rehabilitation’s commitment and ability to provide its patients with world class rehabilitation services.
The following components of the quality system were developed and implemented: