Foreign fundersA specialist facility to optimise functional independenceOur teamLife 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 on a full time basis 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 hospital manager and nursing services manager are intrinsically involved in the process, and meet regularly with their clinical teams to ensure quality delivery. Our facilities and billingLife Rehabilitation facilities are accredited by the South African Department of Health according to a strict list of criteria, and are licensed as dedicated and specialised rehabilitation facilities by the Board of Healthcare Funders. The buildings are custom designed to ensure appropriate accessibility and skills retraining. Specialised equipment is upgraded on an ongoing basis to ensure that treatment is consistent with international standards. Life Rehabilitation units’practice numbers facilitate the global tariff structure. This tariff includes all professional services that the patient may need, irrespective of 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, 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. Family participation in the rehabilitation process is recommended, and easily accessible accommodation, sited close to each unit, is available at reasonable rates for family members that wish to travel with the patient. Our therapyPatients are admitted as soon as they are capable of active participation in a structured rehabilitation programme. 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. 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 caregivers 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. The outcomeLength of stay is predicted following detailed patient assessment and team discussion (within 24 hours of admission), and reviewed with the funder and patient on an ongoing basis, dependant on progress. 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). Life Rehabilitation is actively involved in reviewing and updating the progress measures used by our clinical teams, to ensure 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 outcome. The processProspective rehabilitation patients not currently resident in South Africa will benefit significantly from a period of rehabilitation in one of our units. Arrangements can be made with a foreign patient organisation to liaise with us regarding the patient’s admission, as well as funding arrangements. All communication is then directed through the organisation. Alternatively, enquiries can be made in a personal capacity and following a telephonic assessment a quotation will be provided. A deposit is required prior to the patient being admitted. Following admission, the patient will be assessed by all team members within 24 hours, and a full assessment report sent to the funder 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 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 a community setting. Progress reports are provided on a weekly basis to ensure that the programme is intensively monitored and the patient’s progress justifies the costs. On discharge, a detailed discharge report, including recommendations for outpatient intervention and ongoing care, is provided. Quality management systemsAlthough 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:
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