Putting rehab services on wheels increases profits, promotes goodwill
Mobile rehab van in Kentucky helped Christopher Reeve
Northern Kentucky residents sometimes get a glimpse of a bright, multicolored 40-foot tractor trailer rolling down the highway carrying something a bit more unusual than cereal boxes and soda cans. The truck, called Health Care Express, contains rehab equipment and a small staff of professionals who are prepared to treat athletes injured during a game or to assess the health of factory workers.
The mobile rehab program, implemented last year by the Frazier Rehab Institute of Louisville, already has brought in enough revenue to cover expenses and produce a tidy net income. This is a nice benefit to the program, which began primarily as a community service, says Joanne Berryman, FACHE, senior vice president of Jewish Hospital HealthCare Services, the parent company of Frazier Rehab.
"We’re not-for-profit, and we want to give back to the community whatever we can," Berryman says. "The van serves a wonderful role to go out into the community for health fairs."
The Frazier network includes two rehabilitation hospitals, eight satellite outpatient locations, and six regional network locations. Jewish Hospital has a regional network of more than 2,400 beds at more than 35 locations in Kentucky and Indiana.
The mobile rehab program combines occupational medicine, sports medicine, and community service. From a financial perspective, the contracts with employers provide the program’s bread-and-butter income, Berryman says. "We have contracts with the major employers in town," she adds.
The van and its colorful exterior, which features Frazier Rehab’s name and a billboard that changes to suit a particular venue, also serves as a compelling marketing tool. Van images include gigantic photos of athletes, health care professionals, and workers in hard hats. The message might draw people’s attention to the rehab facility’s occupational medicine program, called EmployCare. It’s difficult to miss the van when it’s parked at every University of Louisville home football game.
"When we park the van, it draws attention, and we begin to get calls from employers and business managers of major companies asking what this was all about," Berryman says.
Superman’ actor travels in rehab van
Soon after the mobile rehab program began, the rehab facility was asked to use the van to help transport "Superman" actor Christopher Reeve to speak to the Kentucky General Assembly about spinal cord injury research.
The van picked up Reeve from the airport and transported him in comparative luxury, considering that the tall actor rarely rides in a van long enough to permit him to recline. Plus, with the van’s trained rehab staff, Reeve was assured a safe trip.
"We wanted to show we could transport him better than anyone in the world," Berryman says.
Most of the mobile rehab program’s duties are more mundane, although each day is different for the staff. Here is a description of the program’s features:
1.
Sports medicine. Two years ago, Frazier Rehab Institute began a formal relationship with the University of Louisville in Kentucky to provide on-site rehab services to college athletes. Prior to this agreement, it was standard practice for athletes injured on the field to be transported to the nearest emergency department for X-rays.
"It appeared that we needed multiple facility sites, so we said to ourselves, Let’s get one on wheels,’ and that’s how the idea began," says Berryman.
"Then we looked at other similar kinds of activities that a rehab hospital would be involved in, and we found there was a huge similarity in occupational medicine and sports medicine," she adds. "In occupational medicine, you try to keep people at work, and in sports medicine, you try to keep people in their game."
Between those two programs, the van would stay busy, hospital officials reasoned.
The van was purchased and furnished using a $500,000 grant from the Frazier Endowment Fund. It is outfitted with X-ray equipment, audiometric equipment, and other technology necessary for screening, physicals, and treatment.
The rehab facility staffed the program with employees who were willing to be versatile in
the hours they would work and in their roles. For example, the program’s registered nurses and an athletic trainer were cross-trained to drive the van and obtained a commercial driver’s license, says Cheryl Fugatte, RN, MSN, assistant vice president for community-based rehab at Jewish Hospital Health Care Services in Louisville.
Nurses were trained to perform hearing testing and limited radiology. Whenever a specialized rehab service is needed, the rehab facility has one of its regular therapists assist the mobile program. Likewise, the van’s staff work at the rehab facility whenever they have extra time.
The athletic trainer assists a sports medicine physician in making X-rays of injured athletes. Because the service is provided immediately after an injury at the athletic field, the physician can decide fairly quickly whether the athlete can return to the game. The same service is offered to visiting teams and reimbursed by the athlete’s individual insurance.
All of the hometown athletes are registered during the preseason physical, which also is done in the van. When an athlete is injured during a game, it takes no time to pull up the file and complete all necessary documentation on the van’s computer, Fugatte says. "It’s a very quick process."
If spectators suffer minor injuries, they are treated at one of the rehab facility’s six first aid stations on site. Those with significant injuries are taken by ambulance to the hospital of their choice. While the first aid services are free to the public, they serve the same purpose as the van in raising the Jewish Hospital System’s visibility in the community, Berryman says. "We believe our payback is the recognition we get," she adds.
The van provides health services to athletes in other sports as well, including national soccer tournaments, golf classics, volleyball tournaments, the Conference USA Women’s Basketball Tournament held in Louisville this year, and others.
"Louisville is more of a college sports community than a professional sports community," Berryman says. "So our relationship with the University of Louisville puts us in a position to be visible to other sports events, such as the women’s basketball tournament."
2.
Occupational medicine. Large manufacturers found that it costs too much in lost employee productivity time to give workers a half day off to visit their physician for annual physical exams. Instead, they contract with the mobile rehab program to visit their site to provide checkups on site.
"Our first thought was we would prefer a clinic to take care of the local companies and use the mobile program to go to companies outside Louisville," Berryman says. "But what we found out is that some of the bigger companies preferred for us to bring the mobile unit to their site so their employees didn’t have to be off-line for very long."
Employees could complete the physical in half an hour in the rehab van. Physicians or nurse practitioners can perform a new physical every 15 minutes or an audiometric exam in seven minutes. They often begin the checkups at 7 a.m. and work through the day and night to cover all of a factory’s shifts, Fugatte says.
The companies pay physicians a premium to do the on-site exams, so everyone wins, says Berryman. "Since we are so accommodating to companies, we’ve built a relationship with them, and they are using our clinics for other things," she adds.
The mobile rehab program is licensed to provide services to about 15 counties in Kentucky, and the hospital plans to expand to more areas.
3.
Community service. Accredited by CARF The Rehabilitation Accreditation Commission in Tucson, AZ, the rehab facility makes it a priority to perform community education and outreach, Berryman says.
Mobile unit teaches kids about bike safety
For example, the mobile rehab unit spent a weekend in a neighborhood where children were documented to have a high rate of bicycle injuries. The staff gave out bicycle helmets and talked about bike safety as children gathered around the van.
The mobile rehab program also coordinates large health fairs, school fitness screenings for children, and pulmonary screenings in conjunction with the American Lung Association, Fugatte says.
Other community projects include the sports medicine accredited programs offered through the Kentucky High School Athletic Association. One such program involved a symposium on sudden cardiac death in athletes. There also are outreach programs offered through the local Jefferson County school system.
Frazier Rehab and the sports medicine program participated in the Kentucky Derby Festival Mini Marathon and the pre-race Running Wild Pasta Dinner and Expo as part of the two-week event leading up to the Kentucky Derby, which is held each May in Louisville. Rehab staff handed out water bottles, did medical assessments, and offered free massages to marathon runners prior to the race.
Among the mobile rehab program’s three primary areas of service, it stays busy five or six days a week. In fact, it has been so successful that the rehab facility’s board is considering buying a second van, Berryman says.
"First, we’re going to see how we can improve scheduling," she explains. "Then maybe we could use a smaller van that could follow this van or go to events that might not need all of the medical equipment."
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