Overview of LTACHs

Jul 19, 2016

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As number of patients with chronic critical illness grows, so does need for long-term acute care

Article in American Journal of Critical Care provides overview of long-term acute care facilities as part of continuum of care

ALISO VIEJO, Calif. — July 19, 2016 — Advances in technology have helped more patients survive acute illness and trauma, and these patients are increasingly transferred to long-term acute care hospitals (LTACHs).

Long-term acute care is a growing segment of the healthcare continuum, and a special commentary in the July 2016 issue of the American Journal of Critical Care (AJCC) provides an overview of LTACHs.

The AJCC commentary, “Long-Term Acute Care: Where Does It Fit in the Health Care Continuum?” describes the roles and practices of LTACHs and how they work in partnership with intensive care units (ICUs) and providers.

LTACHs specialize in the care of high acuity patients who become chronically critically ill and require medical treatment beyond the normal length of stay in a short-stay acute care hospital and beyond the scope of practice of inpatient rehabilitation or skilled nursing facilities. Many of these patients require prolonged mechanical ventilation or have experienced multisystem organ failure. Their recovery may occur slowly over weeks or months.

“LTACHs provide high-quality care to the chronically critically ill patient population and partner with ICUs to ensure these patients transition seamlessly to the best level of care possible, helping to ensure successful clinical outcomes,” said lead author Taryn Miller, RN, DNP, NEA-BC, clinical leadership development specialist with the LTACH division of Select Medical, Mechanicsburg, Pennsylvania. “The LTACH environment, with a focus on the patient’s return to normalcy through the implementation of evidence-based protocols, has produced positive patient outcomes.”

These hospitals may be located within the walls of a short-term acute care hospital, or they can be a freestanding facility. Categorized as a post-acute care facility, an LTACH provides care for patients with higher acuity needs than an inpatient rehabilitation facility or skilled nursing facility.

Patients are frequently referred directly out of the ICU but may also transfer from a progressive care unit or complex medical-surgical setting. Physicians and case managers identify patients who will benefit from an LTACH stay before transitioning them to a lower level of care.

Patients requiring acute dialysis, liberation from mechanical ventilation, complex wound management, management of one or more infectious disease processes, and those who require frequent administration or adjustment of intravenous medications may all be eligible for admission to an LTACH.

LTACHs typically use a multidisciplinary approach to care, which includes physicians, nurses, respiratory therapists, physical therapists, pharmacists, dieticians and case managers, a model which supports improved outcomes.

To access the article and its full-text PDF, visit the AJCC website at www.ajcconline.org.

About Select Medical: Select Medical is one of the nation's largest providers of specialized acute and post-acute care. Its network of more than 40,000 employees operates or supports more than 100 hospitals specializing in long-term acute care, 19 rehabilitation hospitals and more than 1,500 outpatient clinics offering physical and occupational therapy. In addition, Select Medical offers occupational medicine and urgent care at 300 centers through Concentra. Select Medical (NYSE: SEM) was founded in 1996 and is based in Mechanicsburg, Pennsylvania. For more information, visit www.selectmedical.com or youtube.com/selectmedical.

About the American Journal of Critical Care: The American Journal of Critical Care (AJCC), a bimonthly scientific journal published by the American Association of Critical-Care Nurses, provides leading-edge clinical research that focuses on evidence-based practice applications. Established in 1992, it includes clinical and research studies, case reports, editorials and commentaries. AJCC enjoys a circulation of more than 107,000 acute and critical care nurses and can be accessed at www.ajcconline.org.

About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, California, the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than 500,000 acute and critical care nurses and includes more than 225 chapters worldwide. The organization's vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution.