Know therapists' concerns when hiring for a home health agency
May 1, 2006 6 minutes read
Know therapists' concerns when hiring for a home health agency
Recognize emphasis on outcomes and teamwork
Everyone knows the challenge of finding qualified home health nurses, and home health managers have found creative ways to find, train, and retain the good RNs that they do find. With the emphasis on outcomes, the impending arrival of pay-for-performance, and the importance of therapy on outcome improvement, the new challenge for managers is finding and retaining qualified therapists.
Finding the right therapist for home health is similar to finding the right RN, says Cindy Krafft, MSPT, COS-C, director of rehabilitation for OSF Home Care in Peoria, IL, and vice president of the home health section of the American Physical Therapy Association. "There are more therapists graduating in recent years; but because home health agencies don't typically take new graduates, we have not been able to tap into this group of candidates," she explains.
While hiring new graduates for home health positions might fill some therapist openings, it is not the answer for most home health agencies, admits Krafft. "A therapist needs one to two years of clinical experience before he or she can go into the field with no direct supervision," she says. One exception to this rule in her agency is a physical therapy assistant who was the primary caregiver for a family member prior to her graduation. "She is used to working on her own and is familiar with working in a home, so she was a good fit for us," she explains.
Another exception also could be therapists for whom physical, occupational or speech therapy is a second career, says Mary Calys, MSPT, formerly a rehabilitation supervisor at North Kansas City (MO) Hospital Home Health. "I was a nontraditional student because I had previously been a social worker," she recalls. "I was hired by a home health agency upon graduation and I had no trouble with home health because I was accustomed to working on my own," she explains.
Calys also has hired new graduates for the agency but she does admit that you have to evaluate the new graduate carefully. "I have hired second- or third-year doctoral students and I've hired new graduates who are nontraditional students with previous career experience," she says. "The most important things to look for in a new graduate are a person who wants to treat the patient in a holistic manner and a person who is seasoned or experienced enough in life not to need daily supervision and coaching," Calys explains. "Remember that a therapist doesn't need to know everything, but does need to know where to go to get the information," she adds.
Therapists don't see HHA as an option
With these few exceptions, the fact that home health agencies don't typically hire new graduates means that managers usually are trying to get therapists to leave more traditional settings.
"Home health is not usually presented to therapists as an option during their education," says Krafft. "They don't perceive it as a fulltime opportunity, just as a part-time, occasional opportunity to earn some extra money," she says. "Most therapists believe that home health care has a nursing focus only, and that therapy is not considered a key part of patient care."
One way to educate therapists while they are still in school is to work with local schools to offer internships, suggests Krafft. Even if you won't hire someone immediately after graduation, you get a chance to introduce home health to therapists while they still are open-minded, she explains. "I also talk to as many classes as I can to present a true picture of home health-based therapy and the impact it has on patients' lives."
To address these concerns when you are interviewing potential new hires, be sure you know a therapist's language and focus, suggests Krafft. "Therapists focus on outcomes, so be sure you explain your agency's need for another therapist in terms of improving patient outcomes," she says. Share some of your agency's outcomes with the candidate to show what areas you want to focus on for improvement, Krafft recommends. Talking to the therapist in terms of clinical expertise and outcomes will demonstrate your understanding of therapy's role and your acknowledgement of its importance, she adds.
Keep in mind that many therapists in traditional settings believe that all home health patients are bed-bound and living in horrible conditions, says Krafft. "It's up to the home health manager to present a more accurate picture of the type of patients who receive therapy," she says. "The chance to spend 45 minutes to one hour one-on-one with a patient is a big attraction, so emphasize the fact that the therapist will get to see the patient for this length of time," she says.
While interviewing candidates, be sure you point out that a home health therapist must be creative and self-motivated, says Calys. "One disadvantage to home health is that you don't have a staff of other therapists around you to brainstorm different ways to help your patient," she admits. That's why it is important to have a rehabilitation supervisor available who can be a source of information, represent therapists on the administrative level, and be a brainstorming partner, she adds. "You need someone on staff who can focus on researching advances in therapy and share that information with the staff," she says.
Even with a rehabilitation supervisor, make sure your therapists are part of a multidisciplinary team that develops and oversees patient care, says Krafft. "The team leader is usually an RN, but if your RNs recognize the importance of therapy and include the therapist in the development of the care plan from the beginning, not only will patient outcomes improve, but retention of the therapy staff will also improve," she says.
When interviewing therapists, remember that many therapists go into physical therapy or occupational therapy with the mindset that they will work with young people recovering from athletic injuries, says Calys. "Few therapists think they will choose to work with geriatric patients so it's important to point out the benefits of working with older patients," she says. "Not only are geriatric patients more fun to work with because of their responsiveness to your help, but therapy has a great impact on the patient's quality of life."
Young therapists like flexibility
Another attractive feature of working in home health is the flexibility of the job, says Calys.
"Therapists with young children like the ability to see their child's play or attend a teacher conference during the day, even when they know that they will be finishing their documentation at night," she says. "All of our therapists use laptops for their documentation, and some staff members finish their documentation during the day, others complete it at night, whichever is best for their personal schedule."
The use of technology for documentation is a great benefit to promote your agency to potential employees, says Calys. "You want to hire people that are computer-literate because it does save time on most visits," she says. An admission will always take the same amount of time, but documentation of subsequent visits or evaluations do take less time with the laptop, Calys adds. "Therapists also like having access to the entire chart so they can see what may have happened on other visits," she adds.
While word-of-mouth is the best way to find qualified therapists, be sure you study competitors' ads for therapists, suggest Krafft. "Signing bonuses are becoming popular now, but that tends to backfire as employees jump from place to place, staying just long enough to keep the bonus," she adds. Recruiters can be helpful if you are looking for therapists in small communities or rural areas, Krafft says. "Recruiters should be the last step because they can be expensive but they do have access to people we won't find in more traditional ways," she explains.
The key to attracting and keeping good therapists is to treat them like professionals, respect their perspective on patient care, and give them a chance to grow, says Calys. "It's taken some time for home health to figure out how therapy fits into home health because therapy has not always been part of a home health agency. Now, we see the value of therapy with an emphasis on outcomes, and working in home health can be very rewarding for a therapist."
Sources
For more information about recruitment of therapists for home health, contact:
- Mary Calys, e-mail: [email protected].
- Cindy Krafft, MSPT, COS-C, Director of Rehabilitation, OSF Home Care, 2265 W. Altorfer Drive, Peoria, IL 61615. Telephone: (309) 683-7830. E-mail: [email protected].
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