The pandemic changed everything for many aspects of long-term care. When it collided with the new Patient Driven Payment Model, it affected few departments as significantly as rehab therapy. But over the last two-plus years, rehab experts have learned how to roll with many changes. Their observations and advice for success appear here.
1. A key to emerging strong is acknowledging and learning the pandemic’s lessons.
The pandemic showed the therapy team how “to be more creative and intentional, to think beyond our normal equipment and treatment settings, and provide encouragement to find purpose,” says Valerie Waugh, OTD, OTRL, RAC-CT, Detroit 2 regional vice president for Encore Rehabilitation.
The pandemic also highlighted skills and resource gaps, as well as the need to better manage the pressure of working with higher acuity patients in more stressful care settings, adds Hilary Forman, chief clinical strategies officer at HealthPRO Heritage.
“For long-term-care therapists facing an ever-evolving disease process, this means practicing at the top of our license with every patient encounter and staying current with updated national care standards,” says Peggy Gourgues, chief operating officer for Reliant Rehabilitation.
2. Staying resilient in the face of change has never been greater than during the COVID-19 pandemic.
The need for adapting highlights the importance of trying new things, says Kathy Claypool, vice president of clinical services with Encore Rehabilitation.
“It was important for us to explore innovation,” she says. “We are in completely uncharted territory, where no idea is too new, too crazy, too out there to at least discuss.”
To Gourgues, adapting means “practicing in an environment that provides access to a depth of fellow clinicians, education, research and technical capabilities,” and not being confined to being “siloed” to a relatively small team in a home facility.
3. Exploiting tech innovation has been vital.
Therapists have traditionally sought out tech as a valuable rehab tool, and the pandemic is no exception.
Jessica Niederkorn, a director at Encore Rehabilitation, says her company used remote monitoring software to learn about fall risks, virtual reality enhancing social experiences, and telehealth.
“Zoom or Teams have been lifesavers when we can’t easily be together in person,” adds Whalen.
“Technology can create a pathway to improved outcomes, communication, and consistent, clinically appropriate documentation,” says Gourgues.
4. Encourage nursing home staff and management — the entire team — to take part in positive outcomes.
“The team-based care approach is crucial to ensure things are covered, as we found out with ‘here one day, out for the next 10’ following a positive test,” Waugh says. “The entire team has to be responsible and accountable for patient outcomes to ensure follow up and no missing pieces happen as a result of anyone’s absence.”
Forman notes that her therapy company encourages collaboration with management teams and staff to facilitate success and positive outcomes via a proprietary approach of customizing strategic work plans.
Sharing therapists’ performance and comparing outcomes is important.
“Setting clear goals and standards, facilitating communication, removing barriers to care, and consistent acknowledgement of all team members are vital to positive outcomes,” agrees Gourgues.
5. Make adjustments on the fly. Being nimble with staff is a key to success.
“Top-down, we have all had to learn to be flexible,” says Waugh. “And then, have a plan B and C. But prioritizing the needs of the patients will always help to ensure the priorities stay in the right place.”
“We encourage our clients to be flexible, think outside the box, and realize there are many qualified people who may not fit the traditional mold for certain positions,” adds Forman.
“I really feel like nursing shortages happened quite early after the pandemic started, but to me, therapy is really facing them now,” says Kristy Wikum, MS, CCC-SLP, president and CEO of Centrex Rehab. “This is something that I have never faced in my 30-plus years of being in the therapy world. It has been and will continue to be a challenging time.”