Orthopaedic Rehabilitation Program-Proposal

Orthopaedic Rehabilitation Program-Proposal

Statement of the Problem

Recent and proposed changes in home care reimbursement have had a profound effect on the delivery of nursing care. Fewer nursing visits are performed due to these cost-reduction strategies. Consequently, each visit that is made must be efficient and high quality. Traditional medical-surgical home care nurses may not have the experience or training to provide the diagnosis-related specialty care for home care patients. A specialty orthopaedic/rehabilitation program can improve the patient care for this population and provide long-term savings to the agency. The development of this program is a model for the development of other specialty programs in home care.

Importance of the Problem

Managed care and the proposed prospective payment system have dramatically impacted today's health care delivery system. Multiple restructuring initiatives have been introduced in response to the changing economy. An example of a cost-saving measure was the elimination of specialized nursing teams within the acute care settings. For example, in the early 1980s, a number of acute care facilities used an intravenous (IV) specialty team. Then, in the early 1990s, the IV teams were disbanded as a cost-reduction strategy. This initiative affected the quality of nursing care. The long-term effect of focusing so intently on short-term cost reductions has been to adversely affect the quality of patient care.' These issues affect home care nurses as well. The complexity of the conditions of the patients being discharged from hospitals, the decreasing number of reimbursed visits from managed care, the Prospective Payment System (PPS), and the sheer volume of patients that home care nurses must see on a daily basis all affect the delivery of nursing care. One positive sign that the primary focus of managed health care may be returning to patient care, after years of seemingly exclusive preoccupation with cost management, is that specialty nursing teams are being reinstituted. This shift is due in part to the fact that health care systems today are being forced to compete not only on the basis of increasing efficiency and reducing costs, but also on the basis of improving the quality of the care being provided.

Purpose of the Study

Our premise is that specialty nursing, in this case the orthopaedic/rehabilitation nursing team, not only ensures quality patient care, but also can be cost-effective. The development of our program, which is a model for the development of any specialty program, will be described in this article. We will also describe the improved patient care and pa tient outcomes, as well as the cost savings, provided by specialty nursing. Competent orthopaediclrehabilitation nurses can prioritize nursing interventions and patient education and reduce the number of necessary home care visits. Specialty nurses can make every visit count.

Research Design (Methodology)

This research is based on the secondary data. The research methodology used is the survey of various orthopaedic rehabilitation program practices as available online. This research involved studies in detail the news, articles from journals, and online material available on the web. Using the methodology tested in previous studies, this study began with ...