What Does Care Coordination Look Like at Restore First Health?

At Restore First Health (RFH), care coordination is the heartbeat of our wound care program. It’s the meticulous process of weaving together various aspects of patient care to ensure that the overall health of each patient is thoroughly evaluated, every provider is on the same page, and every patient receives the best possible outcomes.

The RFH Difference: A Personalized Approach

Our approach to care coordination is rooted in personalization and communication. We start by understanding the unique needs of each patient. Our dedicated wound care coordinators are the linchpin in this process, acting as the primary point of contact between the patient, their family, and the entire care team. This ensures a seamless coordination of care.

Here’s how it works:

1. Scheduling and Insurance Coordination: Our wound care coordinators take care of all the logistics. When a person is identified by home health, discharge planners, or patients themselves, they call our office to begin the coordination process. Wound care coordinators work with the patient and care team to schedule consultations, verify and pre-authorize insurance, and obtain necessary medical records. This relieves the referring partner, patient and their family of administrative burdens and allows them to focus on healing.
2. Initial Consultation and Evaluation: We begin with a thorough evaluation of the patient’s wound and overall health. This includes not just the clinical aspects, but also factors like nutrition, mobility, and the home environment.
3. Collaborative Care Planning: We believe that effective care coordination involves collaboration with all involved parties. Our team works closely with home health providers, visiting physicians, primary care doctors, specialists, and even social workers. We ensure that everyone is aligned on the care plan and that any changes in the patient’s condition are communicated swiftly.
4. Ongoing Communication and Follow-Up: Care doesn’t stop after the initial treatment. Our coordinators regularly check in with patients and providers to monitor progress, communicate adjusted treatment plans as needed, and ensure that the patient and providers are educated and informed. We provide medical updates to authorized providers, ensuring continuity of care.
5. Holistic Care Integration: Beyond wound care, we integrate our services into the patient’s overall health plan. This often involves connecting patients to additional resources, whether it’s specialized therapy, nutritional support, or home care services. Our goal is not just to heal the wound but to improve the patient’s overall quality of life.

Real-Life Impact

Consider the case of a 72-year-old woman with a lower extremity venous stasis wound that did not progress in healing with conventional treatment. With RFH’s care coordination, we facilitated vascular studies, adjusted her wound care protocol, and provided weekly visits over five weeks. The result? A fully closed wound and a dramatic improvement in her quality of life.

Why Care Coordination Matters

At RFH, we understand that wound care is not just about treating the wound; it’s about treating the whole person. Our care coordination ensures that patients receive comprehensive, continuous care tailored to their unique needs. It’s this dedication that sets us apart and drives our mission to provide advanced, compassionate care to those who need it most.