Ten years ago Good Shepherd Rehabilitation Network, responding to the requests of local acute-care hospitals, began providing a new level of care to a unique segment of patients. The Good Shepherd Specialty Hospital was the first long-term acute care hospital (LTACH) in the region to care for individuals who are medically stable, but who have complex issues, such as ventilator dependency, wounds that won’t heal or multiple serious injuries or illnesses.
Prior to the opening of the Specialty Hospital, these patients simply had nowhere to go once their conditions were stabilized at an acute-care hospital. They often remained in hospital intensive care units for weeks, where they were managed for the acute nature of their illness. Good Shepherd made the choice to begin serving these patients because we believe long-term acute care is the first step in the post-acute care continuum. It is our mission to help these individuals begin their long road to recovery with the specialized care they require.
At the Specialty Hospital, these individuals receive focused care from clinicians who specialize in their unique needs, such as complex wound care, ventilator weaning and the therapies necessary to set them on a path to restorative health. Their care is coordinated by physicians, including more than 350 who have been approved to see patients at Good Shepherd. These physicians are fully integrated into the care process. They are available on site during days and via state-of-the-art telemedicine during nights, and many of them are specialists who also care for patients in acute-care hospitals. Good Shepherd’s active Medical Executive Committee, which provides clinical oversight and develops policies relating to patient care, is comprised of highly skilled physicians specializing in pulmonology, infectious disease, wound management and critical care.
In the past decade, nearly 3,000 individuals have received this focused long-term acute care at the Good Shepherd Specialty Hospital. This focused care has helped many of our patients continue their recoveries and to, eventually, get back into their lives. The community has also benefited from the Specialty Hospital, as it has allowed acute-care hospitals to transition patients out of their units sooner. This makes additional intensive care beds available for others who require acute medical care.
Unlike many LTACHs that have opened in the past decade, the Good Shepherd Specialty Hospital is a non-profit entity, and any surplus must be funneled back into operations. Quality of care and patient outcomes are our focus, not profit margins.
The outcomes achieved by patients at the Good Shepherd Specialty Hospital speak volumes. In the second quarter of the current fiscal year (October-December 2009), no Specialty Hospital patients suffered from pressure ulcers or ventilator-associated pneumonia, a feat that is routinely accomplished in the facility. For the past 5 years, more than 90 percent of ventilator-dependent patients at the Good Shepherd Specialty Hospital were successfully weaned. This is significantly higher than the national average of 72 percent. These individuals, who are now able to breathe freely, can speak to the necessity of the long-term acute level of care.
While LTACHs play an integral role in helping critically ill patients achieve optimal function, they are among the most heavily regulated facilities in health care. For example, the Centers for Medicare and Medicaid Services (CMS) dictate the average length of stay for Medicare patients in total (25 days) and from where they can be admitted (no more than 25 percent of patients can be admitted from any single hospital).
LTACHs are also heavily scrutinized to ensure that best clinical practices are being implemented. Good Shepherd Specialty Hospital’s management is held to account using a scorecard that incorporates key metrics, including quality, patient satisfaction, staffing and financial measures. Also, the Good Shepherd Specialty Hospital is fully accredited by the Pennsylvania Department of Health and the Joint Commission, both of which require that the Specialty Hospital adhere to the same comprehensive regulations as acute-care hospital systems.
In July of 2008, Penn Medicine (The University of Pennsylvania Health System) selected Good Shepherd Rehabilitation Network to be its post-acute care partner. The resulting joint venture, known as Good Shepherd Penn Partners, allowed Good Shepherd to take its proven LTACH model to Philadelphia. Together with Penn Medicine, Good Shepherd’s expertise in this field is now benefiting patients throughout eastern Pennsylvania and southern New Jersey.
The management of patients with complex medical issues requires specialization, focused care, compassion and a commitment to continuous quality improvement. In its first decade, the staff members at the Good Shepherd Specialty Hospital have proven adept at applying their expertise in these areas. I would like to thank them. I would also like to recognize our patients, who have inspired us and who have put their faith in us. Thank you, all, and congratulations on reaching this impressive 10th year milestone.
Samuel Miranda, Jr., MS, RN, NEA-BC, is Senior Vice President and Chief Nursing Officer at Good Shepherd Rehabilitation Network.