Marshfield Medical Center-Park Falls (MMC-PF) is a CMS certified swing bed hospital. For patients receiving swing bed care (e.g. post-acute care), the need to strengthen interdisciplinary communication to help patients reach mobility and self-care goals to heal and return home as soon as possible was identified. With the goal of strengthening communication between therapy staff, nursing, the patient and the patient’s family and to improve the hospital’s swing bed metrics, MMC-PF participated in Stroudwater’s Swing Bed Quality Improvement Project (funded through the Office of Rural Health) from late fall of 2021 through June 2022.  

Qualitative Results:

• Increased communication between therapy staff, nursing, and the patient
• Education for nursing staff on the difference between post-acute and acute care (with special focus on motivating patients to do things for themselves)
• Utilization of the whiteboard to outline clear expectations for staff, patients, and patients' families, and
• Development of a plan for each nursing shift to work with patients on reaching self-care and mobility goals

A team consisting of quality, nursing and therapy was assembled to review and discuss the current state of the swing bed program, analyze available data and identify the desired outcomes and goals of the QI project. Based on the discussion and data review, MMC-PF selected strengthening “mobility and self-care metrics” to promote positive patient outcomes and worked with Stroudwater to employ the following tools and resources:
 

• Stroudwater’s Swing Bed Quality Assurance Performance Tool
• Training and education for the Swing Bed Quality Improvement Project
• Peer-to-peer networking meetings
• Action planning, data trending, and benchmarking

Although baseline data was not available for the purpose of comparison, the team felt that the QI project was a huge success per qualitative and quantitative results. The collaboration MMC-PFs had with Stroudwater resulted in a clear process that is followed when patients are admitted to a swing bed at MMC-PFs and significant improvement in communication and care coordination which have all led to meeting the patient’s mobility and self-care goals and a timelier discharge. 

Quantitative Results: 
Risk adjusting the mobility and self-care assessments produced an expected improvement score for mobility and self-care. Stoudwater compared the actual improvement score to the expected improvement score and calculated the percentage of discharges that met or exceeded the expected improvement score. There were seven swing bed patients during the time frame.

• Mobility: 42.9%, which is better than the national median of 27%
• Self-care: 71.4%, which is better than the national median of 48%