Clinisign Q&A With Dr. Hani Bashandy

Clinisign Dr Hani Bashandy
 
At Victoria Healthcare Costa Mesa, we conducted a Q&A with one of our doctors, Dr. Hani Bashandy, about our newest Optima product, called Clinisign. Victoria Healthcare is one of the pilot facilities of Clinisign. So far, we have signed up three doctors to this program. Dr. Bashandy has been a huge supporter of Clinisign, and he was kind enough to share his thoughts about the product. Below is the interview.

What are the differences between the hospital and a SNF setting in terms of documentation?

It is very different in a hospital setting. Everything in the hospital setting is computerized. We do everything on the computer. Documentation is immediate. We sign our documents immediately from the computer.

In the SNF setting, all documentation are hand-written. We always have way too many papers to sign that I just discovered lately when I started following my patients from the hospital.

What are the usual challenges you have when you go to a SNF regarding signing rehab documents?

The biggest challenge I have is trying to find them exactly where they are in the chart. It takes a lot of time browsing through the chart and looking for them. I make sure that I know what my patient’s progress is since I base my decisions off what I see on therapy documents when I need to discharge them or keep them in the facility.

When did you hear about Clinisign?

It was introduced to me by Victoria Healthcare through the Director of Rehab.

How long have you been using Clinisign?

I’ve been using it since October 2016.

How has Clinisign helped you enhance your practice as a physician who follows patients in a SNF setting?

Clinisign definitely makes it easy for me to look and check the rehab documents quickly and sign them in real time. It also gives me flexibility as to when and where I can check the documents. I can check it anywhere and anytime. I can also sign the documents where I don’t have to be present in the facility. This definitely saves me time.

Are there any suggestions that you can give to enhance and improve your experience using Clinisign and Electronic Rehab Documentation?

One suggestion that I would like to make is for the system to generate a summary of the patient’s progress on a day-to-day basis that would be sent to me through emails or texts. This will help me work more efficiently and at the same time provide me information that would be useful to update when I talk to my patients and their families on how they are doing with therapy.

Submitted by Franco Estacio, DOR, Victoria Healthcare, Costa Mesa, CA

Heart PARC Case Story

Heart PARC (post-acute rehab care) is a multi-disciplinary approach to working with patients who have cardiac diagnoses. The therapists and nurses work closely to partner with cardiologists in the community so that they can fine-tune established protocols for cardiac care. Many patients are not yet ready to return home with home health services after a cardiac surgery or a cardiac episode, and the program is the bridge to get them home safely. The Heart PARC program uses evidence-based approaches and is outcomes-based.

A great example of excellent results from this program comes from Park View Post-Acute Care (PVPA) in Santa Rosa, California. A 71-year-old man was admitted to the hospital because of dizziness and a loss of consciousness, and tests at the hospital revealed that he had aortic valve stenosis and coronary artery disease. The patient underwent a CABG, and the original plan was for him to discharge home after surgery.

Prior to discharge, the patient became dizzy and was demonstrating irregular cardiac rhythm. The cardiologist was aware of the Heart PARC program at PVPA and recommended that he first go for therapy services and skilled nursing services before going home.

The patient had skilled therapy services that included teaching the patient and wife how to monitor heart rate and blood pressure during activities, activity pacing, energy conservation, body mechanics and sternal precautions, and the use of adaptive equipment for safety at home. Nursing and dietary provided education and training on diet and medication management.

The patient made excellent progress, and in eight days, he was able to discharge home safely, ambulate 250 feet, and dress and shower himself. He expressed that although he was very reluctant to go to a skilled nursing facility after surgery instead of home, once he understood all of the wealth of services and education that he would receive, he was “all in.” His wife was with him every step of rehabilitation, and she also expressed that she was far less apprehensive about being at home alone with her husband after such a life-changing cardiac event.

Heart PARC can greatly reduce the potential for readmission to the hospital because patients are surrounded by highly trained nurses and therapists to ensure that they are truly ready for the challenges at home.

Submitted by Park View Post-Acute Care, Santa Rosa, CA

Four Reasons Why Cardiac Post-Acute Rehab Care Fills the Gap between Hospital and Home

Cardiac PARC fills gap between hospital and home
 
Every 42 seconds, a person suffers a heart attack. Despite the fact heart disease remains the leading cause of death in both men and women in this country, the incidence of death because of heart disease is declining. And if you are one of the more than 30 percent who survived a heart attack last year, consider yourself lucky. Your second chance at life is about to get better, and the staff at Monte Vista Hills Health Care Center is here to help.

“I’ve seen this Heart PARC (cardiac post-acute rehab care) program help numerous lives for the better,” said Clayton South, executive director for Monte Vista Hills. “It has provided excellent outcomes throughout the industry, and I’m excited about its implementation here at Monte Vista.”

The concept of providing rehabilitation therapy is not new, but to offer services that cater specifically to cardiac care is a tremendous resource for patients and their families who are facing a permanent life-changing event. Here are four reasons why this cardiac program makes my heart skip a beat.

 

1. The staff provides focused care.

While other rehab therapy centers address a variety of conditions, this program focuses on the heart and all of the factors associated with recovery and education. Many patients are not yet ready to return home after cardiac surgery or a cardiac episode. This program bridges the gap that ensures patients are physically and emotionally prepared to return home safely.

“This isn’t just therapy. Instead, this is an interdisciplinary program,” said Dr. Jared Lundquist, director of rehabilitation for Monte Vista Hills. “It’s not just about the therapy but the skilled nursing and everyone else involved in this program.”

This multi-disciplinary approach focuses on the specific needs and concerns often shared by cardiac patients.

“Our team works together to progress each patient through five care levels and prepare them to succeed at home,” Lundquist said.

2.The staff communicates with the hospital.

The highly skilled, board-certified cardiac specialists review each patient’s medical history and regularly collaborate with the cardiologist to design a personalized care plan that matches the patient’s level of needed care, diet, risk levels, and ability to function.

“Each care plan is specific to the patient,” South said.

And the cardiologist is kept informed and conferred with during each phase of recovery.

3. The staff builds a relationship with each patient.

The one-on-one care each patient receives creates a unique and helpful relationship; the weekly interaction with patients means staff can perform ongoing assessments and evaluate the patient’s progress, subtle changes in symptoms, and projected responses to recent procedures, diet, medications, exercise levels, among other things. Should symptoms worsen, the staff can perform acute therapies to improve the patient’s condition.

4.The staff is prepared should immediate care be required.

The PARC environment is designed to focus on progress and recovery. During treatment, patients are assisted by a staff possessing acute knowledge in overall heart function, abilities, diseases and behaviors. This staff also knows the history and past procedures of each patient and directs a patient’s treatment plan to prepare them for existing challenges at home. But should a setback occur and emergency care is needed, it is good to know patients are surrounded by a qualified staff that can perform life-saving care until the patient can be admitted to the hospital. This reduces the chance of irreversible damage and increases a patient’s prognosis for a full recovery.

“The comfort and safety our patients feel while in this care makes a huge difference in the overall recovery process,” South said.

By being able to provide focused care, collaborate with team members and specialists, build a supportive relationship with patients and be prepared for whatever need should arise, the Monte Vista Hills is proud to offer this high-level cardiac care to the community.

Published online by The Idaho State Journal, Nov. 4, 2016
Submitted by Monte Vista Hills Health Care Center, Pocatello, ID

Cardiac Specialty Programs: Why Should They Matter to You?

Why should cardiac programs matter to you? Research shows that most hospitals have a cardiac diagnosis within their top five admitting diagnoses. CMS has identified heart failure and MI as two of the most expensive diagnoses for Medicare, and new cases are increasing at a rate of 550,000 annually. The next mandatory bundled payment being considered by CMS is cardiac conditions.

Where Does the SNF Fit Into All of This?

We can be the best post­acute care partner in our communities by sharpening our clinical skills in nursing and therapy to bridge the gap between a hospital stay and home.

Since implementing the Heart PARC (post­acute rehab center) program in 16 of our buildings over the past year, we have begun to see some encouraging results:

  • Increased skilled census for this condition type
  • Reduced re­hospitalization
  • Increased functional outcomes using the CARE data
  • Increased confidence in working with clinically complex patients due to focused training and education
  • Increase confidence from our health partners in our clinical expertise

The graph below shows the cardiac-­specific skilled census at Park View Post­Acute (PVPA) in Santa Rosa, California, from September 2015 (first month of Heart PARC implementation) to December 2015:

 
Graph - Skilled Cardiac Admissions
 

This graph shows the shift in skilled census at PVPA from September 2015 to December 2015:

 
Shift in Skilled Census
 

The below graph shows PVPA hospital readmissions from September 2015 to July 2016:

 
30 Day Hospital Readmission
 

The side-­by-­side graphs from PVPA below show that during the eight months of implementation, the cardiac census went from 20 over an eight-month period prior to HP up to 81 patients in the eight-month period post-Heart PARC. The bars below demonstrate a significant change in function using the CARE item set. Prior to Heart PARC implementation, on average, the cardiac patients still required 25 percent physical assistance at discharge. After Heart PARC implementation, on average, the patients only required verbal cueing.

 
Jan-Aug 2015
Sep-Apr 2016
 

So How Do I Get Training in My Building?

Currently therapy and clinical resources are being trained in a train-­the-­trainer format. Please signify your interest in bringing this program to your building by reaching out to your therapy or clinical resource, and we will get information to you on first steps.

Ensign Therapy Job Fair

Therapy Career Fair Calendar

Graduating soon? Looking for a change in your therapy career? If you’re a physical therapist (PT), occupational therapist (OT), speech language pathologist (SLP), PTA or OTA, visit the Ensign Therapy booth at a nearby job fair or conference and learn about career opportunities. Therapists thrive in our unique anti-corporate culture.

Upcoming Career Fairs and Conferences

Build Something Great

Ensign Therapy Is Offering FREE CEUs!

Borderline or Bulletproof
Borderline or Bulletproof?
Strategies for Medicare Therapy Documentation
in SNF and Outpatient Settings

by Lori O’Hara, MA, CCC-SLP
Director of the ADR and Appeals Team for Ensign Services, Inc.
(2 credit hours)

Free! No cost or obligation! (But seating is limited…)

Register today by contacting Jamie Funk at 1-877-595-0509 or email
jfunk@ensignservices.net

Two Class Times and Locations

Tuesday, June 21st, 6-8 pm
Gateway Transitional Care Center
527 Memorial Drive
Pocatello, Idaho 83201

Wednesday, June 22nd, 6-8 pm
Parke View Rehabilitation & Care Center
2303 Parke Avenue
Burley, ID 83318

Free CEUs

Develop a vocabulary to have at your fingertips that shows how your services are reasonable and necessary, and showcases your skill as a therapist. This course will show you how to think your way through the CMS requirements to quickly and efficiently find the language you need so your documentation can stand up to an audit.

Lori O’Hara, MA, CCC-SLP, directs the ADR and Appeals team for Ensign Services, Inc. and teaches documentation strategies designed to help amazing therapists be equally amazing documenters of their services. She has more than 20 years of experience in the field of SNF and outpatient therapy as a director and trainer.

This course is free but pre-registration is required. To register please contact Jamie Funk:
1-877-595-0509 or jfunk@ensignservices.net