How to extend treatment for round-the-clock care
How to extend treatment for round-the-clock care
If you're concerned about providing consistent rehab services every day of the week for all three shifts, here are some tips from the experts:
1. Cross-train your staff. Choose four or five things that might be most important to patients during a 24-hour stay, and concentrate on cross-training all staff on those items, suggests Connie Burgess, MS, RN, president of Connie Burgess and Associates, a Lakewood, CA, consulting firm specializing in rehab management issues.
For example, your team might choose ambulation, transfers, bowel and bladder issues, and assistance in dressing as cross-training items.
The discipline traditionally responsible for the tasks should conduct the training. For example, physical therapists should cross-train all disciplines on transferring and ambul a tion. When staff are cross-trained, if a patient needs to go to the bathroom in the middle of a speech therapy session, the speech pathologist helps the patient transfer, instead of calling the nurse.
2. Develop a transdisciplinary plan. Instead of each discipline coming up with a separate plan of care, a transdisciplinary team should develop a single plan of care, based on the key issues for that patient, Burgess says.
"That single plan of care belongs to the patient, as opposed to each discipline," she adds.
3. Get staff buy-in for your 24-hour rehab plan.
Your evening, night, and weekend staff must buy into the 24-hours-a-day rehab concept. All must all work toward a common goal: getting the patient independent enough to function at home.
To obtain staff buy-in, get them involved in coming up with ways to improve the process. At RehabLink/Marianjoy Rehabilitation Hospitals and Clinics in Wheaton, IL, the concept is discussed during staff meetings, by process improvement teams, during focus groups, and whenever there is an opportunity for staff to brainstorm, says Linda Peterson, MS, MBA, vice president of InteRehab at RehabLink/Marianjoy.
4. Improve your communication techniques so all shifts are aware of what is happening at other times.
The night and evening staff need to know what is going on during the day. The day staff also need to know what issues surface at the end of the day and during the night when the patients are tired, so these issues can be addressed during therapy.
Work to strengthen your off-shift staff's involvement and ability to give input into what goes on on other shifts. For example, you might develop a brief written communications form, change the hours of some staff so the shifts overlap, and make sure to include staff from all shifts on quality improvement teams and other facilitywide committees.
5. Share your outcomes data, performance improvement studies, patient satisfaction data, and risk management indicators with all shifts, all days of the week.
"This also supports the 24-hour-a-day milieu you're trying to create," Peterson says. "This helps everyone on all shifts understand their part in achieving favorable outcomes or their participation in reducing the frequency of falls."
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