A Unique Level of Care for Post-Acute Patients

By Thomas Crocker
Monday, November 20, 2017

Soon to open, Rapid Recovery Center-San Antonio by Mainstreet Health (RRC-SA), brings an innovative model of post-acute care to our community. The resort-like RRC specializes in short-term post-acute care rehabilitation for patients recovering from illness, injury and surgery and for patients requiring medically complex care. RRC delivers high-quality outcomes for diverse patient populations while maintaining high customer satisfaction.

Rapid Recovery Center’s goals for patients include:

  • Transitioning out of hospital sooner
  • Returning home faster
  • Reducing the likelihood of returning to the hospital

In large part, these goals are accomplished by Mainstreet’s commitment to clinical care excellence, the foundation of the RRC model.

The transition from hospital to a skilled nursing facility often includes a significant drop-off in the level of care for patients, a major concern for hospitals and physicians, according to Mark Fritz, President of Mainstreet Health for Arizona and Texas. RRC’s model mitigates the risk of the move by providing a care team that incorporates an around-the-clock registered nurse supervisor, acuity-based clinical staffing, and 100 to 120 hours a week of on-site coverage from physicians including internal medicine, PM&R, pulmonology, cardiology, wound care and pain management. Furthermore RRC embeds an advanced practice nurse, APRN, on-site to provide direct patient care and to educate and mentor clinical staff.

“The Director of Clinical Services — an APRN — is on-site at Rapid Recovery Center Monday through Friday to be an extra set of hands, eyes and ears for the physicians,” Fritz says. “The APRN adds a layer of expertise and ensures we’re able to respond to changes in patients’ statuses quickly, especially when physicians are not present. Having an on-site APRN is a crucial component of our ability to care for high-acuity patients.”

“Having an on-site APRN serve as our Director of Clinical Services signals to physicians and hospitals that we have a level of nursing expertise that is familiar to them and in which they can have confidence.”
— Mark Fritz, President of Mainstreet Health for Arizona and Texas

Ensuring Safety With Swift Action

Nurse practitioner Mel Wilson, DNP, ACNP, FNP, CWS, brings 27 years of healthcare experience — the past seven in post-acute care — to her role as Director of Clinical Services at RRC-SA. Her duties include making patient rounds, ensuring the facility meets state and Joint Commission standards, educating and mentoring nursing and clinical staff, facilitating smooth transitions for newly arriving patients, easing handoffs between nurses, and developing protocols and identifying quality indicators related to issues such as antibiotic stewardship and pain management.

One of Wilson’s most important functions is leading the Rapid Response Team, an RRC team that address subtle and sudden changes in patients’ conditions, such as confusion, chest pain or elevated temperature. Identifying and responding promptly to shifts in status can prevent unnecessary transports and admissions to the hospital.

“In the event of a sudden change in a patient’s condition, I take quick action, such as prescribing intravenous fluids, starting an antibiotic course or ordering lab work, and communicating with the patient’s physician,” Wilson says. “If a nurse alerts me that a patient doesn’t look right, I assess the individual and determine what that truly means before we contact the physician.”

More Than a Provider at the Bedside

Patient care is only part of the director’s role. The other is more wide-ranging and just as impactful.

“My role also includes staff training and quality assurance — monitoring our care in real time to assess its impact, identifying what changes we can make to improve its quality, and in determining how we can maximize our nurses’ knowledge and abilities,” says Christina Romain, RN, MSN, ANP-BC, Director of Clinical Services at the soon-to-open Rapid Recovery Center-Round Rock. “An important part of that is communication between nurses and physicians. I want to be sure our nurses accurately report and convey their objective and subjective assessment findings to the patient’s physician(s).”

To that end, the Director of Clinical Services instructs the nurses in the use of the SBAR (Situation, Background, Assessment, Recommendation) technique to make communications with clinicians standardized, concise and efficient.

“Physicians’ time is precious; we ensure our nurses gather all of the important patient information, such as vital signs, lab work, lung and cardiac assessments, beforehand,” Wilson says. “Being prepared promotes physicians’ trust in our nurses.”

Wilson views herself as a teacher as much as a hands-on provider. Her training role encompasses a wide range of topics, from instructing nurses how to identify subtle patient status changes, such as the phases of sepsis, to coaching them on how to be more empathetic at the bedside. The purpose of the ongoing continuing education, skills assessment and training serves to ensure RRC nurses are clinically competent, efficient and skilled communicators.

“This is a new, exciting time for skilled nursing in San Antonio,” Wilson says. “We want physicians to have peace of mind, knowing they will enjoy open and accurate communication with us and have confidence we will notify them when a patients’ status changes. Most importantly, their patients will receive excellent care.”

For more information about Rapid Recovery Center’s model of care and amenities, as well as future locations throughout Texas and Arizona, visit rapidrecoverycenter.com.