Get your unit on the right track

Specialty units require planning, promotion

Subacute providers with the flexibility to treat ventilator patients anywhere in the facility can gain a marketing edge over the competition by emphasizing the point that no ventilator patient is ever turned away.

The best way to offer that flexibility is to build your ventilator unit from the ground up, says Keith Bakken, RN, BSN, director of managed care and public relations for Transitional Hospitals Corp. (THC) North Shore, a new freestanding subacute hospital in Chicago.

THC North Shore is Chicago’s first new hospital since 1993 and is located in a five-story building formerly occupied by Rush Presbyterian St. Luke’s Medical Center.

Although North Shore offers specialized care for ventilator patients, it doesn’t have a specific unit for them. Instead, each of the rooms is equipped with everything needed for respiratory therapy.

Subacute providers who are considering opening a ventilator unit in the facility should also make sure each room has the necessary equipment, says Bakken. "The costs might be increased upfront, but the flexibility the facility will have in the future is worth the effort and cost as opposed to retrofitting a building for ventilator care, which can pose problems down the road," he adds.

Bakken offers the following tips for subacute managers who are developing a ventilator unit:

Start small and develop specialized units as needed.

Although North Shore is a 103-bed facility, it currently has about 20 patients.

"It doesn’t make sense to start with a specific vent unit. With our care protocols, the patients receive the same weaning and rehab whether they are in our ICU or on a regular floor. At a later date, a specialized unit can be developed," explains Bakken.

Set realistic goals.

Don’t expect your ventilator unit to fill up overnight, says Bakken.

"We went from zero to 70 patients in three years at our other facility here in Chicago. We feel like we can accomplish that same goal in half the time or within a year at North Shore based on our established record of care at [the other facility]," he adds.

Cross-train staff early.

Because each room at North Shore is equipped for respiratory equipment, a ventilator patient can be located next to a wound care patient. This flexibility allows for a patient-focused care environment by bringing the care to the patient’s room — whether that be wound care or respiratory therapy care. The flexibility also offers staff the opportunity to become versed in two or more specialties, notes Bakken.

Conduct an on-site clinical evaluation of the patient.

THC sends a nurse to the prospective patient’s hospital to conduct a comprehensive clinical assessment and evaluation. "It’s a pretty thorough eight-page evaluation and lets me know whether or not the patient is a good candidate for subacute care," says Bakken.

Provide on-site tours.

Promoting your program in a brochure is one means of marketing your services, but payers need to see the facility, says Bakken.

"Once the payers actually see the facility, they see how sick the patients are and the kind of care we provide. Then they believe in the value of our program," he adds. Bakken offers tours to managed care representatives during the contract negotiation process to let them see first-hand what THC’s charges represent.

Market the cost savings to payers.

Show insurers how they can save costs by transferring patients to your facility as soon as possible, notes Bakken.

THC negotiates a cost of care rate for patients based on information from a clinical evaluation and assessment conducted while the patient is still in the acute care hospital. "We can determine what the costs for caring for patients will be based on how many medications they’re on and the kind of care they’re receiving," explains Bakken.

"Let them know that you can accept the patient as soon as they’re stable so that the payers’ can save costs. The value of THC’s ICU is the significant cost saver over a regular hospital’s. Emphasize that your ultimate goal is to get the patient back home," explains Bakken.

Comparing subacute charges, which typically average half of those of acute care, to the hospital down the street is another effective marketing strategy, notes Bakken.

"The lack of the overhead at a THC hospital compared to a typical hospital structure in itself is a cost savings," notes Bakken.