Niche Programs & Integrated Care: The Power of Partnering

LeadingAge Michigan ~ 50th Anniversary Annual Conference & Solutions Expo

Niche Programs & Integrated Care:

The Power of Partnering Clinical Care

LISA ANDERSON, PT, MHSA

SHERRI SCHULTZ, MA, CCC-SLP, MBA


Course Objectives• Describe how to identify a potential niche market

opportunity using a collaborative practice approach

• Understand the development and implementation of niche programs to: improve functional outcomes, decrease costs and increase customer satisfaction

• Describe how superior outcomes can be used to market and significantly grow specific services lines increasing overall census


The Collaborative Team• Administrator

• DON and all Nursing Staff

• Therapistso PT/PTA

o OT/COTA

o SLP

• Social Work

• Aides

• Dietary

• Housekeeping

• Activities


Niche Programs Components• Goals of Niche Programs

o Decrease Costs

o Increase Customer Satisfaction

o Improve Functional Outcomes

• Building blocks for Niche Programso Education

o Technology

o Clinical Excellence


• Restorative/Rehab Wellness

• Fall Prevention Balance/Proprioception

• Vestibular

• Wound Care

• Continence/Men’s and Women’s Health

Niche Program Examples• Heart Failure

• Cognition and Dementia

• Aquatic

• Pain Management

• Low vision

• Neuro/Ortho


Objective 1:

Identify Potential Niche Markets

• Collect and analyze data

• Identify facility strengths

• Identify facility challenges


Collect and Analyze DataFacility and Healthcare System• Admission sources history

• Profit/Loss

• Length of stay

• Readmission Rates

• Facility or system initiatives

• Physician practice patterns/Physician champion

Community• Population/Census data

• Area market

• Competition analysis

• Community needs/interest


Identify Facility Strengths• Staff

o Consistent/knowledge & expertise

• Equipment

• Facility Reputation

• Physician Support


Facility Challenges• Clinical staff turnover-some markets

• Processes for collaboration

• Equipment-some higher cost

• Financial-initial cost


Objective 2:Develop and Implement Niche Programs• Planning the Program

• Implementing the Program

• Evaluate/Improve


Planning the Program• Community Need, Physician Request or Staff Expertise

• Literature Review

• Gantt chart-working schedule

• Identify clinical best practice/standards/outcomes


Implementing the Program• Patient/resident education material

• Staff education plan

• Supporting facility processes

• Piloting the niche program

• Past findings include: more education needed, more variation for MD’s, different technology


Evaluate/Improving the Program• Based on data and feedback from residents, clinicians, and

internal or external customer

• Schedule time for team process improvement

• Data to evaluateo Reimbursement

o Hospital length of stay

o Readmission rates

o Staffing

o Program costs: education materials, supplies


Education is Key


Objective 3:

Market and Grow Niche Programs•Analysis of outcomes

• Costs/Reimbursement• Advanced functional outcomes• Employee• Customer satisfaction

•Market Outcomes to target audiences• Hospitals• Community• Physicians


Advanced Functional Outcomes• Measure Specifics based on Niche Program

o Facility length of stay and functional scores

o Percent of patients that return to prior living environment

o Specific examples

Heart Failure-ADL’s and Quality of Life

Total Joints-Visit number up and down steps reciprocally

Cancer Related Fatigue-RPE, Pain, Fatigue Scale, Facit Scales


Employee/Customer SatisfactionEmployee• Measure objectively• Staff Retention/recruitment• Early notification of hospital discharge with Niche programs

Resident• Consistent knowledgeable caregivers• Standardized education materials/complete packet• Decrease in variation with improved care outcomes• Increased QOL• “Cutting edge program”

Physician• Customized communication• Track specific physician requested functional outcomes• Increased patient compliance with plan of care


Market Outcomes to Target Audiences: Selling PointsHospital• Customer Satisfaction• Decrease Complications• Decreased LOS/Readmissions• Increased physician satisfaction

Community (senior centers, facilities, insurance companies)• Continuity of care• Improved outcomes-clinical, satisfaction and cost• Improved QOL

Physicians• Specialty physicians are attracted to progressive leading programs• Provide outcome data/articles• Customize orders/communications• Build relationships


Marketing Niche Programs (General)• Take someone that has a passion for the program to sell it

• Utilize staff development as a marketing tool

• Offer something they “need”

• Be a leader in Clinical Programs

• Customize based on geography

• Teamwork-involve all clinical staff


Summary• Define the need

• Develop the plan

• Deliver the service better


References• Jacobs, D. (2014). Evidence Based Falls Management Program

in the Nursing Home. ScholarWork@Bellarmine. Retrieved April 12, 2018.

• McCarthy, R., Adedokun, C., & Moody-Fairchild, R. (2009). Preventing Falls in the Elderly Long Term Care Facilities. Journal of Nursing. Retrieved April 12, 2018.

• Bonner, A. (2006). Falling into Place: A Practical Approach to Interdisciplinary Education on Falls Prevention in Long-Term Care. Annals of Long-Term Care,14(6). Retrieved April 12, 2018.


Questions?

“I am a great hockey player not because I go where the puck is, but where the puck will be.”

Wayne Gretzky #99

Documents

Niche Programs & Integrated Care: The Power of Partnering