Cross-trained staff join forces on patient care
At Centegra Health System’s neurotrauma day treatment center, physical therapists work on cognitive tasks as they ambulate patients, the speech therapist may take a patient to the bathroom, and the neuro-psychologist has a turn at supervising lunch. It’s all a part of the transdisciplinary team approach to treating patients at the Crystal Lake, IL, facility.
The clinic has five treatment rooms, but none is designated for any particular therapy. There is one big gym area instead of a dedicated PT or OT area. Each therapist is encouraged to incorporate all the other therapies into their treatment session.
"We aren’t trying to make speech therapists into physical therapists, but we do want to treat the whole person. Any therapist working on a particular goal can incorporate other goals into the activity," explains Barb Wasilk, MA, CCC/SLP-L, program supervisor.
When the program was started in November 1995, Wasilk hired experienced professional staff who were flexible and open to learning new tasks. Staff went through extensive team-building activities and inservice training to develop a better understanding of what each discipline has to offer.
"It’s an ongoing thing. We don’t want everybody to fal back into their same rut of doing just their discipline-specific tasks," Wasilk says.
The center has regular cross-training inservices and staff are encouraged to continue to cross-train each other in the course of the day. For instance, the physical therapists show the rest of the staff general ambulation techniques and safety methods during the inservices. Then, when a patient is learning to use a quad cane, the therapist shows each member of the team how to use the cane, what the goals are, and what pitfalls to watch for, such as toe drag.
Wasilk, a speech therapist, may tell the rest of the staff that a particular patient isn’t good at following oral directions and suggest that they give written instructions instead.
"It’s not something you can have a seminar on and be done with it. It is truly ongoing. The staff need to be on an even playing ground so they feel comfortable with working with each other," she says.
Everybody on the treatment team has learned to how take vital signs, ambulate, and toilet the patients. They all supervise lunch on a rotating basis. "At lunch, patients tend to let their guard down and relax more. The staff are able to see if they are carrying over what they learn in therapy, such as ambulating safely," Wasilk says.
The staff can observe if patients ask for assistance when needed, or if they get up and do something in an unsafe manner. They can monitor fine and gross motor skills by observing how the patients feed themselves and whether they can open their food containers.
The cross-training also allows staff to take patients to the bathroom without interrupting somebody else’s therapy session or when the nurse is otherwise occupied, or to walk them down the hall without help from a PT.
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