Love hurts PAC relationships

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Renee Kinder
Renee Kinder

When it comes to developing strategic partnerships across the post-acute care spectrum, love can cloud our judgment. We have all experienced the effects and impact love has on “likability,” “favoritism” and — heaven forbid — “loyalty.”

Admit it: You have all heard lines like below in your skilled nursing facilities.

“Don't you just LOVE Happy Health Home Care? They always bring the best donuts to our facility.”

“What about ‘Duration Durable Medical' — have you seen the cool stylus pens they hand out? LOVE it!”

“We LOVE the outpatient PT practice next door. They have been a loyal partner for years.”

All this emotion (gag!) can, however, cloud our better judgment when it comes to partnerships that push our buttons, question our practices, and seek of all things the sweetest quality outcomes.

“Did you hear about the meeting we had last week with the new Ortho Docs practice? It was tough ... they are really pushing for more quality outcomes across the whole PAC spectrum and that includes us! I don't love their assertiveness. Should we partner with them?”

Often the better relationships — in terms of quality — are the ones that make us feel a bit uncomfortable and cause us to evaluate the care we provide and outcomes we achieve.

So, what emotion-free, time to get real, questions should you consider when developing relationships? 

Consider these:

•  While not focusing blindly on length of stay alone, what practices do you have in place to ensure the individuals your therapy and nursing teams serve maintain their functional gains within a reasonable and just timeframe?

•  What quality communication systems, beyond simply sharing paperwork, do you have in place across the entire post-acute care spectrum from SNF, Home Care, and potentially Outpatient? Is there a provider in your region with distinct interdisciplinary care pathways to promote quality and fluid transitions across these setting levels?

•  Who is the individual patient's first line of contact when there is a “change”, and how in a true, measurable form does the patient know there has actually been a “change” in his or her functioning? How do we, as spectrum providers, determine these measures together?

•  When do we as a unified PAC team make the decision to re-admit to the SNF for a period when declines are noted or the individual and loved one's decide, “Maybe we were not really ready for all that was required at home”? And could patients' and loved ones' understanding of this choice prevent further decline and potential need for another acute-care stay?

In closing, this Valentine's Day weekend don't be swayed by those who are on the surface immediately kind, sweet, and loved by all.

Instead, search for those who may at first make you feel a bit sour. Those who make you work for the relationship.

What you may find is the sweetest outcome of all.

Renee Kinder, MS, CCC-SLP, RAC-CT is Director of Clinical Education for Encore Rehabilitation.  Additionally, she serves as Gerontology Professional Development Manager for the American Speech Language Hearing Association's (ASHA) gerontology special interest group, is a member of the University of Kentucky College of Medicine community faculty, and is an advisor to the American Medical Association's Relative Value Update Committee (RUC) Health Care Professionals Advisory Committee (HCPAC).

Rehab Realities

Rehab Realities is written by Renee Kinder, MS, CCC-SLP, RAC-CT.  She currently serves as Director of Clinical Education for Encore Rehabilitation and acts as editor of Perspectives on Gerontology, a publication of the American Speech Language Hearing Association.

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