by Kimmer O’Neill, DOR/MOTR

I build programs.

I’ve done it as a high school coach, a community volunteer, and am doing it now as a director of therapy for Clear Choice Health Care in Port Charlotte, Fla. If you’re interested in refocusing your facility from a run-of-the-mill rehab center to a facility that stands out, read on; I may save you some time and hassle.

I currently serve as a regional director of therapy for Clear Choice Health Care and as the director of therapy at Port Charlotte Rehabilitation Center, where we provide both inpatient and outpatient care. We have 132 beds—60 for long-term patients and 72 for short-term rehab. Our inpatients stay in our care between 5 days and 4 months, depending on the severity of their diagnosis. Staff here integrate modern therapeutic equipment, an interdisciplinary approach, and the latest conveniences to create a rehabilitation experience that fulfills patient care needs.

When I came to Clear Choice Health Care several years ago, there were seven therapists on staff. I noticed quickly that the facility was largely homogenous with those in the surrounding area, offering many of the same treatment modalities and programming as other rehab centers—heavy on hips, knees, and shoulders. This particular facility did not stand out and, therefore, it was clear that focus and specialization would be needed to successfully grow.

Importance of Specializing

The following statement may seem like an oxymoron: Suggesting growth by serving a smaller niche. As counterintuitive as that statement may seem, it is true that uncovering the less obvious needs in the surrounding community is the key to discovering where your facility can stand out. Providing treatment for knees, hips, and shoulders is commonplace. To be successful, a rehabilitation facility must find and serve a more specific niche.

In order to develop this business, I went into the community and spoke with patients, physicians, and case managers. Likewise, I conducted patient surveys and analyzed statistics to determine what aspect of the healthcare community was underserved. In Port Charlotte I found two main areas of opportunity: pulmonary care and aquatics therapy. Pulmonary patients had a 3-month waiting list for the only pulmonary program in town. For aquatics, at the time, there was one large indoor therapy pool in town that did not host much activity; it stayed empty, which appeared to be the effect of ineffective marketing. This discovery marked the best place to focus activities to cultivate growth.

I realized that we could serve both of these markets by bringing aquatic therapy in-house. As I began to discuss this with other caregivers and began to research pools, I found a robust backing from the physicians in the area; they were excited about what therapy pools could do for their patients. I approached management about the opportunities. They listened. And with very little hesitation, they agreed with my findings and analysis, and we moved forward with purchasing a pool. Within months, the facility was on its way to developing two new programs.

Developing a Pulmonary and Aquatics Program

The market for aquatic therapy products and accessories has plentiful options to assure a facility can deliver the aquatic rehab activities its clientele demands. For smaller spaces, manufacturers offer compact, above-ground modular systems that can fit inside an office. These systems are built to accommodate a single user and are comprised of an exercise chamber and equipped with features such as an underwater treadmill, whirlpool jets, and resistance jets. Large, freestanding fiberglass pools and in-ground pools may meet the needs of facilities where greater space and budget are available. These pools can accommodate multiple users and include features such as spa jets and resistant swim currents. Large, commercial pools such as these are available at custom sizes and depths, and can provide monitored viewing through windows. They are also equipped with underwater treadmills, entry stairs, and ladders. After extensive research, this facility partnered with a manufacturer that provided an underwater treadmill, resistance jets, educational videos, training, and marketing assistance. A wall monitor and underwater camera system were also purchased for patients to monitor their progress and be able to share data about that progress with their surgeons.

Water opened a world of possibilities to patients who were unable to do traditional, land-based therapy. Its buoyancy supports their body and provides low- and no-impact resistance that helps them improve mobility, strength, and function more rapidly than with traditional therapy alone. Chronic obstructive pulmonary disease, or COPD, is a leading cause of disability and mortality throughout the country. Aquatic therapy helps to both treat and prevent this condition through water temperature, buoyancy, and resistance.

At chest deep, a person is bearing only 20% to 25% of his or her body weight. Hydrostatic pressure naturally reduces swelling and inflammation, and the constant resistance water provides strengthens muscles and provides kinesthetic awareness to promote relaxation. The warmth of the water (we keep our pools at 88 degrees and 92 degrees) relaxes joints and muscles, promoting early range of motion and increased flexibility.

For pulmonary patients, the decision was made to place oxygen tanks on the side of the pool as patients walk on the underwater treadmills. Several of these patients who struggled significantly only months prior now thrive because they can exercise. They have built stamina and endurance, and regained their lives.

At this facility, staff members have witnessed the following results produced by water: faster postsurgical rehabilitation, reduced inflammation, increased joint range of motion, pain relief, enhanced mobility, improved muscle strength and flexibility, improved balance, and effective cardiovascular training without wear and tear on joints.

Writing a Marketing Plan

Although the new equipment was visually impressive and helped to inspire staff members and patients, there was still an imperative to market the new pool and program. And not just the steak; referral sources needed to understand the sizzle. Why and how would our new programs benefit their patients? What would the outcome be? How would it help their practices?
One must be deliberate about developing, then implementing, a marketing plan. As a team, it was decided which groups would be targeted first, second, third, and so on with face-to-face meetings, open houses, and other events. Everything was written down and committed to the plan.

An open house also was planned and referral sources were invited to evaluate the new state-of-the-art offerings. Physicians were shown how oxygen tanks could easily stay to the side of the pool while their patients unloaded in the water and exercised without pain, surpassing anything the patient could do on land.

Those who viewed the new modality and learned about the program offerings were impressed. After an open house visit, one physician offered to be the facility’s medical director. He is now on board and continues to operate his own practice and educate the public and his colleagues about aquatic therapy’s benefits.

A training program was also developed for physicians who met requirements for their continued education. It taught them about therapy equipment and its uses. Not only that, it showcased this organization’s commitment to new technology and forward thinking. We also brought in case managers and asked them to bring their swim suits to try out the pool. All of these efforts worked together to create word-of-mouth chatter and excitement around the new programs.

Outcropping of Other Programs

Though we began with a pulmonary program in the new pools, there has been a natural outcropping of other programming. Soon multiple sclerosis, Parkinson’s, balance, and weight loss programs took off as a natural extension of patients’ needs. We developed written marketing strategies with each of these new programs and collaborated on the best means and methods to help our patients and get the word out to referral sources, duplicating the model we’ve successfully used in promoting other programs.

Additionally, after developing the aquatics and pulmonary programs, we realized we were uncomfortable with the uncertainty in the quality and continuity of the care our patients received upon discharge. Again, we approached the leadership team and began discussing the creation of an outpatient program. Within months, we proceeded with an outpatient program, with three initial patients.

Hiring for Passion

Hiring the right team members is also crucial in building programs. When I interview potential hires, I ask them what aspect of the profession excites them and empowers them. What have they learned on the job, through CEUs, through personal research? Applicants must convey enthusiasm for a specialty to be considered for the team.

No program will take off without a team of dedicated believers. Educating passionate people and helping them understand the organization’s mission and vision plays a profound role in their continued engagement. Education creates loyalty and passion for team members’ approach to their work and how they interact with patients.

We began with seven therapists and no specialized programs, no outpatient care. Today, the therapy team consists of more than 40 therapists. Approximately 1,200 aquatic patients per month are seen with more than 2,000 patients in outpatient care.

Building programs is a step-by-step process that requires dedication, passion, and know-how. With a collaborative, team approach and an awareness of the local community, a facility can transform itself from ordinary to extraordinary. RM

Kimmer O’Neill, DOR/MOTR, is director of rehabilitation at Clear Choice Health Care, Port Charlotte Rehab Center, Port Charles, Fla. For more information, contact RehabEditor@medqor.com.