Have we lost our connection to what's important?
Shelly Mesure, MS, OTR/L
I was recently talking with a colleague about commonly used phrases and the topic led to a deeper discussion about the meaning of the words. For example, I have commonly used the phrase, “to improve the highest level of functional potential,” or “continue to improve maximum level of…”
I assume a core value that we all share is “to improve the lives of our patients” or “maximize independence for our patients." But have we lost our connection to these words? Do they still hold meaning, and if so, how strongly?
These words are important because it reflects how we act with our patients, as well as how we represent ourselves professionally in the documentation. Is it time to find a new way to say the same thing?
I'd like to propose a challenge: Can you find a new way to say your standard phrases? I think the process of rethinking our phrases also will help us reconnect with our words again. If we can reconnect with our words, it will help us reconnect with our core values.
When you work with your patients, do you always address them at eye level? Do you try to get to know them as a person so you can learn about meaningful activities and events in their lives?
When we use phrases such as “highest level of functional potential,” we should be individualizing this message. What is the highest level? Based on statistical data or evidence-based outcomes? Do you have objective measurements to demonstrate a highest level?
What about the part describing function? What is functional to one patient may or may not be functional to the next patient. And, last but not least, “potential”? How do we measure potential? If you can't measure this, how do you know when someone has achieved it?
The only part of this common phrase that I have not mentioned is how it ends — “at this time.” This part is always important to mention because “at this time” indicates a moment in time. As we know very well, “at this time” can very quickly change from day-to-day. But it also can provide us with the justification for our findings at the time we write the status updates.
This is also important with the claim reviewers because it is often called into question if we need to evaluate or re-evaluate the same patient at a different period of time and develop a new plan of care. “At this time” helps to justify each treatment decision on a day-by-day basis, as well as each spell of wellness and/or new plans of care.
Good luck with the challenge. We must really try to examine the phrases we are using so we can incorporate our personal, professional and company-based core values into everything we express.
Shelly Mesure ("measure"), MS, OTR/L, is the senior vice president of Orchestrall Rehab Solutions and owner of A Mesured Solution Inc., a rehabilitation management consultancy with clients nationwide. A former corporate and program director for major long-term care providers, she is a veteran speaker and writer on therapy and reimbursement issues.