Implementing Prehab: Laying Groundwork to Maximize Value

1. Defining and Debunking Prehab

“Prehab” has a varied level of understanding depending on the audience. Clearly defining what prehab is to your health care system, and therefore clearly relaying that to the patient, is crucial. To the patient, prehab is the work they are doing to prepare for surgery, treatment, or radiation. To the provider team, prehab is any intervention prior to and throughout the initiation of treatment that may aide in sustaining a safe level of function. To the Payor, prehab is a "dirty" word indicating the visit is pre-event and there would not be a functional impairment. We know this to be a common misconception.

2. Identify Outcomes and Supportive Content

When we are involved with “getting patients earlier,” it can be easy to overpromise results. Aligning the vision of the referring team and the treatment team will alleviate disconnect down the line. This section will cover the current research and implications, as well as options for assessment tools to demonstrate effective outcomes. The role of a rehab clinician is an optimal fit for a variety of reasons as well as advising on wellness.

3. Prehab vs. Wellness

Organizing and offering a continuum of care beginning with prehab, onto rehab, and finally to wellness is often a goal for health care organizations. However, each of these points within the episode of care has distinct goals and intentions. Discussing appropriate patient populations and appropriate referrals to each will keep all stakeholders satisfied.

4. Prehab Appropriate Populations

When launching a prehab program, it is vital to determine which patient populations can best benefit from intervention. Blindly referring patients will result in negative feedback, as not all patients will find value added from these services. Discussion will include potential for high impact on particular patient populations.

5. Program Considerations and Community Partners

As is common with patients who undergo significant medical care, they quickly become savvy consumers of health care knowledge and will be able to “sniff out” any providers that are not aware of current standards, etc. It will be a pillar of success for colleagues to be up on information, have access to patient plan of care, and open communication channels to the medical team. Discussion will include methods for competency and opportunities for multidisciplinary collaboration.