Cross-train rehab and acute care therapists
Program makes for better communication
Cross-training provides a hospital and rehab facility with flexibility when confronted with particularly high or low census periods. It’s also a way to bring inexperienced staff up to speed with veteran staff.
Ingham Regional Medical Center in Lansing, MI, moved to cross-training inpatient rehab therapists and acute care therapists after managers realized there was a big gap in experience between the acute care and rehab occupational therapists (OTs).
"For our two OTs on the acute care campus this was their first job out of college," says Teresa Vinson, MPA, PT, rehab supervisor for Ingham Regional Medical Center. The hospital has 230 acute care beds and 20 rehab beds.
The hospital’s rehab therapists, by contrast, were experienced and trained in many different aspects of therapy.
Cross-training gives staff big picture’
Rehab therapists didn’t have a good overall picture of what happened to patients, however, because they began to see them only in rehab. The acute care therapists, on the other hand, had the opportunity to observe what happened to their patients when they left the acute care setting.
"So our rehab OTs needed process training on how the system works here," Vinson says. "They needed to grasp an understanding of how acute care is very different and you can’t do everything in acute care because the pace is so much faster."
A cross-training program proved to be the ideal learning process for therapists in both acute care and rehab.
Anecdotal evidence suggests it also has saved the hospital money and improved patient care, Vinson says. So far the facility hasn’t studied its benefits and outcomes formally, but may look into tracking data related to the change.
Here’s how the program worked:
• Rotation: The facility required the two acute care OTs to rotate to the medical rehab unit for two months each, and the four medical rehab OTs rotated to acute care for one month each. The rotations were concurrent and lasted for four months. Each OT was assigned a mentor during the rotation. "We brought in extra staff to help them have time to do mentoring," Vinson says. (See chart on OT mentoring and cross-training.)
| OT Mentoring and Cross-Training | |
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Ingham Regional Medical Center of Lansing, MI, had its rehab department occupational therapists cross-train with the acute care OTs. This chart explains how the program works: |
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| PURPOSE: To increase the knowledge and skills of the OT staff providing services in acute care by exposing them to inpatient medical rehabilitation. It is anticipated that mentoring with the medical rehab OT will broaden evaluation and treatment methods to be utilized in the acute care setting. Developing an understanding and appreciation for the continuum of care will provide a focus for the intent and value of acute care OT. |
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| GOAL | PLAN |
| Greenlawn OTs will be proficient and skilled in providing services to the inpatient rehab population (Penn Campus). |
• Greenlawn OTs will complete a two-month rotation to the inpatient medical rehabilitation unit. • Greenlawn OTs will be assigned a mentor during their rotation. Mentoring will involve but is not limited to observation, feedback, orientation, and instruction. |
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That each OT will maximize the experience obtained on the medical rehabilitation unit by integrating evaluation and treatment techniques as able in the acute care setting. |
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Greenlawn OTs and Penn OTs will collaborate on acute care to identify opportunities for integrating skills obtained on med rehab. |
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Med Rehab OTs will be cross-trained in acute care OT in order to assist in coverage when needed, with minimal orientation necessary. |
• Med Rehab OTs will complete a one-month rotation to acute care. • Greenlawn OTs will provide orientation and feedback on procedures and treatment methodology in acute care during the Penn OTs’ cross-training experience. |
• Feedback: The OTs reported that they found the rotation very helpful. The acute care OTs learned from their rehab counterparts how to do a kitchen skill assessment and treatment. "The kitchen had been available, but they didn’t use that resource," Vinson says. "And now they try to put it into the treatment plan of patients when appropriate."
Acute care OTs also have changed their perception about how to prioritize patients, she adds. "In acute care the patient’s length of stay is so short that they’ll evaluate a patient and don’t have the opportunity to treat that patient," she explains. "Now they think that maybe it’s more important to treat the patient they’ve already assessed and hold off on starting with a new patient."
The rehab OTs said the rotation helped them learn and understand the difficulties the acute care OTs have because of the faster pace of their work. "Rehab care OTs might have five patients on caseload in a day, while acute care OTs might have 14 or more," Vinson says. "That’s definitely been consistent feedback from rehab OTs." Now when acute care OTs call for help, saying they’re busy, the rehab OTs know they really mean it, she adds.
• Efficiency: Although the rehab and acute care units are on different campuses, the OTs have been able to fill in for one another since the cross-training was complete.
"They’ve been able to go from one campus to another on a moment’s notice and pick right up with the work, helping out," Vinson says. "Before, we would have to call a PRN person who would have to receive some orientation."
Need More Information?
Teresa Vinson, MPA, PT, Rehab Supervisor, Ingham Regional Medical Center Rehab Department, 401 W. Greenlawn Ave., Lansing, MI 48910-0899. Telephone: (517) 377-8412.
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