Three key areas that contribute to LTACHs attaining enhanced outcomes when providing care for medically complex patients include:
Expertise in ventilator care
Efficiencies and improvements gained by early discharge to LTACHs can largely be attributed to this setting’s specialized pulmonary and ventilator care. Ventilator supported patients, who make up more than 25 percent of LTACH admissions, receive
expert treatment from a team led by pulmonologists and respiratory therapists.4
This expertise can help improve outcomes for critical pulmonary patients. Research has found that discharging ventilated patients earlier from an STACH to an LTACH is associated with a higher probability of liberation. In fact, a one-day
delay in LTACH discharge after intubation is associated with an 11.6 percent reduction in the odds of weaning.5
Interdisciplinary care teams
Medically complex patients with multiple comorbidities often require a team of specialists who can address the different facets of their conditions. At an LTACH, physicians, respiratory therapists, dietitians, bedside nurses and other healthcare staff
formally collaborate as an interdisciplinary care team to develop comprehensive treatment plans. This level of collaboration can help improve outcomes by reducing the risk of miscommunication, which is a primary cause of adverse events.6
The benefit of interdisciplinary care team collaboration is particularly clear when looking at patients requiring mechanical ventilation. One case study found an association between long-term liberation plans led by an interdisciplinary
team and reductions in mortality and time on ventilator.7
Specialized rehabilitative care
Early and comprehensive rehabilitation is also essential for patients with multiple chronic conditions and acute illnesses. Rehabilitation services provided at an LTACH are led by PTs, RTs, OTs and SLPs, and are integrated with specialized acute care
to help patients achieve the fastest and most complete recovery possible.
Early mobilization is especially important for critical pulmonary patients. One case study found that improving access of ventilated patients to pulmonary rehabilitation in an acute care setting could reduce time on ventilation by two
days.8 Studies such as these have contributed to the recommendation by the American Thoracic Society and American College of Chest Physicians to implement early mobilization protocols for ventilated patients.9