A Leader in CARF-Accredited Care
The Joint Commission sets minimum standards for hospitals to achieve and maintain to be accredited. Being certified by the Commission on Accreditation of Rehabilitation Facilities (CARF) goes beyond those standards. Achieving CARF accreditation shows that a program is committed to the highest level of safe and effective patient care through risk management, optimal care delivery and a focus on employee growth and development.
While Adventist HealthCare Rehabilitation has been CARF-certified for three decades, the program recently set its sights beyond general inpatient rehabilitation. They were able to achieve CARF accreditation for specialized rehabilitation programs:
Beyond achieving CARF accreditation, Adventist HealthCare Rehabilitation’s dedicated team was honored to learn that their dedication to patients was validated on the program’s most recent CARF survey.
“We achieved ZERO recommendations for improvement on our last survey,” said Graham Moore, RN, director of Quality Services and Patient Safety Officer at Adventist HealthCare Rehabilitation. “Fewer than 3% of CARF-accredited facilities receive zero findings.”
How CARF Accreditation Translates to Patient Safety
CARF-accredited programs are expected to track data on patient outcomes and implement strategies to improve performance and safe, effective delivery of care to patients.
Adventist HealthCare Rehabilitation has demonstrated these strategies time and time again. For example, falls and pressure ulcers are unfortunately common conditions in hospitalized patients, particularly those with significant debility. These complications are associated with significant morbidity and related healthcare costs. The team at Adventist HealthCare Rehabilitation has developed and implemented several strategies to reduce the risk of these conditions to improve the safety of their patients.
While the national average of hospital-acquired pressure injury is estimated to be 5.85%, Adventist HealthCare Rehabilitation celebrated one year without hospital-acquired pressure ulcers in March 2024. The attentive inpatient rehabilitation staff is well versed in implementing effective methods for pressure ulcer prevention.
The program also excels at fall prevention. The national benchmark for falls is 4.38 per 1,000 patient days, and Adventist HealthCare Rehabilitation had a fall rate of 2.76 per 1,000 patient days in 2023 – well below the benchmark.
“Our rate of all falls in inpatient rehab has progressively declined year-over-year for the last five years,” Graham said.
Proactive planning drives the program’s success in preventing patient falls. Adventist HealthCare Rehabilitation initiated a telemonitoring system about six to seven years ago, which allowed the staff to monitor multiple patients at once via a livestream camera. This implementation continues to help staff view situations and behaviors that could increase fall risk so they can anticipate the need for intervention prior to a fall occurring.
Program locations also hold a daily behavioral huddle where each patient at high risk for falls is discussed in a coordinated manner with the interdisciplinary team, including our neuropsychologists.
One location, Adventist HealthCare White Oak Medical Center, is pioneering the use of an overhead track system to further reduce fall risk for qualifying patients. Patients are fitted with a harness that is attached to the pulley system, which extends from the bed to the bathroom.
“If they lose balance and begin to fall, the harness system will support their weight, preventing the fall,” Graham said. “We think that has contributed our decrease in our fall rates.”
The Patient Experience
Adventist HealthCare Rehabilitation has also made patient experience a top priority, implementing several unique features to improve patient safety and patient satisfaction.
“We have increased our rates of purposeful hourly rounding, which allows our patients’ needs to be proactively met before they ask for assistance,” Graham said. “Additional strategies are leader rounding, where leaders use a standardized script to round on patients at least a few times per week. Both initiatives have improved our patient satisfaction.”
In an illustration of facility design geared toward enhancing patient safety and healing, Adventist HealthCare White Oak Medical Center is comprised of two units, each with 21 private rooms. Both units have separate gyms, to accommodate the varying needs of their patients depending on how much stimulation they need. One of the units and gyms is centered toward the specialized care of patients who would benefit from limited stimulation, such as patients with brain injury, dense strokes and/or cognitive issues.
“We consider this to be our ‘quiet’ unit,” Graham said. “It has a quiet gym, and noise is kept to a minimum on the unit so as not to stimulate the patients unnecessarily.”
Adventist HealthCare White Oak Medical Center also offers an apartment for patients to practice activities of daily living so they can prepare for independent living prior to discharge, which can further identify areas of need so staff can work with rehab patients to help them regain their independence.
Additionally, Adventist HealthCare Rehabilitation employs two neuropsychologists, one at each of its two hospital locations, to better serve their patients.
“This has no doubt helped to improve the care and treatment of our patients with brain injury and other conditions that require their expertise to direct the treatment team on the best approaches,” Graham said.
Continuously Striving for Next-Level Excellence
Another element of CARF certification is continued growth and development for staff.
“We promote certification, and, in fact, many of our therapists and nurses are certified,” Graham said. “There has been a push to promote certification of our nurses.”
Thanks to the leadership of the chief nursing officer, Adventist HealthCare Rehabilitation recently received a grant which allowed a significant number of nurses to pursue certification.
While CARF accreditation is not required in most states, general rehabilitation accreditation is required in Maryland. However, Adventist HealthCare Rehabilitation has additionally pursued and achieved specialty rehabilitation certification.
“We have embraced the requirement,” said Graham, who understands the significance of accreditation to referring providers and, most importantly, patients requiring rehabilitation services. “Without a doubt, it signifies expert-level achievement and quality of care for our patients.”
For a healthcare professional, a genuine reflection of the quality of care at any healthcare institution is often whether they would recommend the facility to their loved ones, and Adventist HealthCare Rehabilitation passes the test with flying colors for Graham. When Graham’s father required inpatient and outpatient rehabilitation a few years ago, he was a patient at Adventist HealthCare Rehabilitation.
“He had an exceptional experience,” Graham said. “He has nothing but good things to say about our program.”
