Cross-trained techs are popular with therapists

New positions are part of redesign

(Editor’s note: In the February and March issue of Rehab Continuum Report, you learned how Bryn Mawr Rehab redesigned its service delivery to a patient-centered care model and how the hospital achieved staff buy-in for the extensive changes. This month, we’ll tell you about their new rehab tech positions.)

The new rehab tech positions created during Bryn Mawr Rehab’s re-engineering project have worked out so well the therapists are asking for more, reports Helen Cioschi, MSN, CRNP, CRRN, administrative director of the orthomedical section at the Malvern, PA, hospital.

Increased opportunities for techs

"We are hearing from therapists and nurses, that they would like to have more rehab techs to support them in delivering care. We are looking at more opportunities for partnerships between our professional and our technical staff," Cioschi says.

The hospital created the new position of rehab tech, along with patient support attendant, when it implemented its new patient-care model in July 1995.

The new rehab tech position is a combination of a therapy aide and a nursing aide with other technical skills such as EKGmonitoring, glucometer checking (sticks for blood sugar), and phlebotomy (drawing blood).

The new patient support attendants are responsible for taking vital signs, making the beds, escorting and transporting patients, serving and collecting trays, and doing light housekeeping in the patient rooms.

Technical training

The scaled-down housekeeping staff is still responsible for the large common areas and heavy duty floor care.

At Bryn Mawr, rehab techs are trained during an eight-day classroom session taught by nurses and therapists, followed by four days of skilled technical training in the laboratory. They then spend two weeks being observed by therapists and nurses and have to complete a competency checklist. They are supervised by the team coordinator.

The training was designed by the hospital’s three clinical educators, representing physical therapy, occupational therapy, and nursing.

They started with the job descriptions of the therapy aides and nursing aides, melded them together, and added the technical skills.

Staff already working as therapy aides and nursing aides were given the opportunity to apply for the new jobs. They received pay increases because of their new skills.

Some of the techs are assigned to teams, others are shared by therapy and nursing, and some are floaters.

Bryn Mawr is looking at hiring a pool of part-time rehab techs to call in when the census increases or patient acuity increases.

First training, then reassessment

For the first six months of the program, the hospital has trained all its rehab techs in all skills. Now, the administration is reassessing the extent of the training and is considering targeting only certain employees to become advanced rehab techs and receive the advance level of technical training, such as phlebotomy skills.

The administration is looking at the cost-effectiveness of training all the rehab techs to draw blood and do blood sugar sticks because the majority of the work falls on the night shift, says Daniel Keating, PhD, administrative director for the hospital’s neurocognitive division.

"If we train all the techs and they don’t get an opportunity use their skills, all that training goes to waste. We are evaluating whether all need to be trained, or only a selected few," he adds.