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Stressing new projects, opportunities can work
If you’re not careful, coming to work in the rehab business these days can lead to a serious depression or, at the least, an annoying headache that won’t go away. Headlines screaming of declining unemployment rates among therapists, financial losses at rehab companies, and declining government reimbursements for rehab providers are enough to make anyone’s head spin. How can you as a manager motivate employees in these trying times? It can be done, insist managers interviewed by Rehab Continuum Report.
An approach that works for Karen Crockett Lindstrom, PT, MBA, divisional director of professional support services for SunPlus Home Health Services in Burbank, CA, is to focus on the positive aspects of change. "Yes, the changes being forced upon us by prospective pay are painful to go through. But administrators who continue to focus staff on doing a better job and don’t let them get stuck in thinking about how it used to be can succeed. It helps to go over [patients’] record reviews and see that patients are reaching their goals and that they’re still getting good care. The bottom line is, we’re still getting good outcomes."
Lindstrom also helps therapists recognize they have skill sets that reach beyond the traditional treatment and educational role. Therapists should be willing to take the lead and identify cost-effective solutions for hospital management or corporate clients.
"Therapists can serve as a case manager, just as many nurses have done in the past," she says. "The educational background, along with some continuing education courses, allow therapists to step into that role. This is actually a compliment and recognition of the skills and abilities of therapists. Expanding their skill set to be able to do this well will secure them a place in the health care environment of the future and will better secure their jobs long-term. If a therapist can be an active participant in coming up with solutions, they will become more valuable. It’s an opportunity for therapists to grow and develop if they aren’t already there."
Lindstrom says she also encourages therapists to work actively to help identify other treatment alternatives without taking on the case manager role. For example, a physical therapist could come up with a care plan that involves an initial assessment visit by a physical therapist, followed by several visits from a physical therapy assistant at a lower rate than the physical therapist normally would charge. If state regulations allow it, a physical therapy assistant can be a cost-effective option as long as there is adequate supervision by a physical therapist.
"If a physical therapist steps in this way and says, I can find a way to reduce your costs. I’ll do the assessment, I’ll supervise the physical therapy assistant, and I’ll assure the service she is providing is appropriate,’ this helps clients reach goals for less money. And the therapist becomes a resource in the process," Lindstrom says.
At Rehabilitation Affiliates in Wayne, PA, regional director Wendy Coulter, OT, MS, focuses on two areas: the job flexibility available to staff (Rehabilitation Affiliates is part of Jefferson Health Systems, an integrated delivery system) and getting clinical employees involved in program development.
Rotations let staff see the big picture
At Rehabilitation Associates, staff rotations are available every three to six months, Coulter says. Therapists can work in a freestanding rehab hospital, a home care setting, in long-term care, and in a teaching hospital. "It’s exciting for people. They really get to look across the system and see where care is applied across the continuum. They feel they have an impact across several different areas," she says.
Coulter acknowledges that not every facility has this luxury. But another element of her motivational strategy could be transferred to organizations that are not part of an integrated delivery system. She encourages clinicians to get involved in program development, working with employees from several departments to help develop new products or services.
Coulter lists two examples of programs currently under development: an occupational rehab services area, which conducts assessments and treatment plans at area work sites, and a community-based pediatric program that includes an occupational therapy component for neonatology patients.
These programs help employees feel they are part of a bigger picture and can even open up new career paths, she says. "There are so many different roles therapists can play beyond traditional rehab, and this helps them branch out."
Lindstrom says there always will be jobs for good therapists. "I know how hard it is for people now to be able to not have jobs at their will. But I think it will actually raise our standard of performance. The therapists who are the best will get the work. They have to be good clinicians, have strong assessment skills, and be team players." n