Re-engineering: Here’s how the team worked
Redesign was one-year effort
When the Bryn Mawr Rehab administration declared its intention to change to patient-centered care in July 1995, it set a goal of one year for implementation. In the first few months, the design team did research on re-engineering at other rehab facilities and made several site visits, says Daniel Keating, PhD, administrative director for the 141-bed hospital’s neurocognitive division.
In January 1996, plans for the new model were announced to staff with a July 1996 target date for implementation.
The design team included Keating, the director of nursing, the director of physical therapy, a staff nurse, a physician, the materials management and housekeeping supervisor, and a division manager who was coordinator of the project.
Two people were relieved of all responsibilities except the redesign, and others were expected to devote significant amounts of their time to work on the project.
A steering committee of about 30 clinical and management staff helped gather and evaluate information, acted as a sounding board for the redesign team’s ideas and acted as a liaison between the design team and the rest of the staff.
New product lines
The redesign team evaluated the hospital’s product lines and decided how to revamp them to create new teams.
For instance, responsibility for treating post-cardiac bypass and debility patients, which had been split among all the other programs, was assigned to medical rehabilitation. The staff decided to create a specialized spinal cord team because of the hospital’s focus on increasing the spinal cord population.
The staff used historical data and projections for future patient load to determine how many patients they could expect in each diagnostic category.
They created teams to manage between 10 and 12 patients each. There are two teams each in the following groups: brain injury, stroke, medical rehab (which treats debilitation and post-cardiac bypass patients), and mixed muscular skeletal rehab, as well as, one amputee team and one spinal cord injury team.
Of the six department directors whose jobs were eliminated, only two stayed on in newly created positions.
Bryn Mawr hired two team coordinators from outside the hospital because the applicant pool wasn’t big enough, Keating says. Some clinicians chose not to apply for the new jobs because they didn’t feel committed to the new model, he adds.
After the team coordinators and clinical specialists were identified, Bryn Mawr assigned the other team members based on their interests and experience. Staff were asked to select their top three choices for teams. Most staff got their first choice for team assignment, Keating says.
[Coming next month in Rehab Continuum Report: a look at Bryn Mawr’s communication plan and new rehab tech position.
For more information on Bryn Mawr’s re-engineering program, contact Dan Keating at (610) 256-5611.]
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