Study laws, guidelines before changing staff mix

Before you change your staffing mix, make sure what you want to do falls within the practice guidelines of each therapy discipline and state laws, warns an administrator who's been there.

The management team at Rehabilitation Hospital of Indiana (RHI) studied each discipline's practice acts, code of ethics, state laws, and professional association position papers before embarking on a project to change its staffing patterns and set up a rehab tech program, according to Donna Cameron, chief operating officer of the Indiana polis hospital.

"There are so many emotional responses to any kind of change that when you start looking at changing how individuals practice within their profession, it is important to have good objective information," she says.

Staff at RHI found the principles of prac tice and licensing requirements vary for each discipline. "You cannot approach such changes in a vanilla fashion. It was important for us to have good information," she says. In Indiana, for instance, a speech tech must be registered under the licensure of one specific speech pathologist and be supervised by that speech pathologist. It's important to know which guidelines and state licensure requirements pertain to your area of practice and take those into account when setting up job descriptions and training programs, she says.

During the process of creating the therapy tech position, the clinical work group shared information with each staff member and asked for comments, questions, and concerns. They were able to answer the questions and concerns, based on the information they had compiled.

"We started with a strong foundation of information that immediately gave us the ability to discuss with people their emotional reactions," Cameron says. For instance, if a therapist was concerned about whether the licensed staff had to do the documentation, the clinical team was able to give them the answer, based on state licensing laws and the discipline's professional practice act.

"It was important for us to have the staff comfortable that we were operating on fact. We told them that we wanted to change the staffing mix to operate more cost-effectively but that we wanted to operate within the discipline guidelines, laws, and practice issues," she says.