Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 For those of you with TR departments in your IRF program, do they schedule throughout the day or more evening and weekend activities? Does OT, PT, SP take precedence if patient schedule is tight or sessions need to be rescheduled for any reason? Carol Rehder, PT Manager, Physical Therapy Genesis Medical Center rehder@... A J.D. Power and Associates Distinguished Hospital for providing " An Outstanding Patient Experience " >>> 3/1/2011 8:35 PM >>> Kathy Lovato PT, DPT Direcctor of Therapy Operations Mesa, AZ 1. All of our therapists are salary with assistants being hourly. We have some that work for tens, others traditional 8 2. Earliest start time is 700, latest is finished by 6pm 3. We broke the hospital up into teams of 10 patients by room number each team has a lead PT and OT with speech carrying 20. During conference the assistants are treating but conference time is divided by team so all the therapists are not taken up the entire time waiting their turn. We have one Dr. that does walking team rounds where the patient is in the room the team enters, discusses their care and leaves. Each room takes 6 to 7 minutes, again the teams make the therapist time productive. The RNs conference in the room so it increases their time with the patient. Patients are also not requesting services of nursing knowing rounds iscoming their way therefore no one needs to cover for them. 4. Right now with the doctor who does traditional conference room conferences the charge nurse covers. Please feel free to call with questions IRF question It's probably been asked before but here goes again... for inpatient rehab units--- 1. what are typical work schedules for your OT and PT staff? 2. what's the earliest start time and the latest end time for OT and PT services? 3. when your staff is attending team rounds, do they have others cover their patients or do they schedule around the team meetings? 4. Do your RN's have difficulties leaving the unit to attend team rounds? If yes, how do they overcome them? Do they have other RN's cover their duties while they are in team rounds? Thanks! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@... Be kinder than necessary because everyone you meet is fighting some kind of battle ============================================================================== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 For those of you with TR departments in your IRF program, do they schedule throughout the day or more evening and weekend activities? Does OT, PT, SP take precedence if patient schedule is tight or sessions need to be rescheduled for any reason? Carol Rehder, PT Manager, Physical Therapy Genesis Medical Center rehder@... A J.D. Power and Associates Distinguished Hospital for providing " An Outstanding Patient Experience " >>> 3/1/2011 8:35 PM >>> Kathy Lovato PT, DPT Direcctor of Therapy Operations Mesa, AZ 1. All of our therapists are salary with assistants being hourly. We have some that work for tens, others traditional 8 2. Earliest start time is 700, latest is finished by 6pm 3. We broke the hospital up into teams of 10 patients by room number each team has a lead PT and OT with speech carrying 20. During conference the assistants are treating but conference time is divided by team so all the therapists are not taken up the entire time waiting their turn. We have one Dr. that does walking team rounds where the patient is in the room the team enters, discusses their care and leaves. Each room takes 6 to 7 minutes, again the teams make the therapist time productive. The RNs conference in the room so it increases their time with the patient. Patients are also not requesting services of nursing knowing rounds iscoming their way therefore no one needs to cover for them. 4. Right now with the doctor who does traditional conference room conferences the charge nurse covers. Please feel free to call with questions IRF question It's probably been asked before but here goes again... for inpatient rehab units--- 1. what are typical work schedules for your OT and PT staff? 2. what's the earliest start time and the latest end time for OT and PT services? 3. when your staff is attending team rounds, do they have others cover their patients or do they schedule around the team meetings? 4. Do your RN's have difficulties leaving the unit to attend team rounds? If yes, how do they overcome them? Do they have other RN's cover their duties while they are in team rounds? Thanks! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@... Be kinder than necessary because everyone you meet is fighting some kind of battle ============================================================================== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 We have a TR here and she works every Saturday and 3 afternoons/early evenings...when the schedule is tight PT, OT and ST take priority. Our OTs start at 700 but we are looking at some coming in at 630. PT starts at 0830 and SLP start at 0800. One OT works 10 hours; the other staff all work 8. Our therapists are all hourly which makes scheduling very challenging. We do team conferences 6 days per week and everyone working with the patients being discussed that day including nurse, MD, social work, psychology, therapists attend preconference where 2-3 patients for that day are discussed and then one therapist stays with MD, social work and nurse to present the information from therapies to the patient and family at the conference. Our conferences are 15 min each and our preconference is 15 min. Other therapists who are not attending see patients. The nurses come in and out but we meet on the unit, so they are easily covered for. Feel free to contact me with any other questions. Brownrigg Therapy Manager Acute Care Services & Inpatient Physical Rehabilitation Unit Peace Health St. ph Medical Center 2901 Squalicum Pkwy Bellingham, WA 98225 sbrownrigg@... , ext 2384 our success is in the being, not just in the doing From: PTManager [mailto:PTManager ] On Behalf Of Carol Rehder Sent: Wednesday, March 02, 2011 6:59 AM To: PTManager Subject: Re: IRF question For those of you with TR departments in your IRF program, do they schedule throughout the day or more evening and weekend activities? Does OT, PT, SP take precedence if patient schedule is tight or sessions need to be rescheduled for any reason? Carol Rehder, PT Manager, Physical Therapy Genesis Medical Center rehder@... <mailto:rehder%40genesishealth.com> A J.D. Power and Associates Distinguished Hospital for providing " An Outstanding Patient Experience " >>> <klovato22@... <mailto:klovato22%40aol.com> > 3/1/2011 8:35 PM >>> Kathy Lovato PT, DPT Direcctor of Therapy Operations Mesa, AZ 1. All of our therapists are salary with assistants being hourly. We have some that work for tens, others traditional 8 2. Earliest start time is 700, latest is finished by 6pm 3. We broke the hospital up into teams of 10 patients by room number each team has a lead PT and OT with speech carrying 20. During conference the assistants are treating but conference time is divided by team so all the therapists are not taken up the entire time waiting their turn. We have one Dr. that does walking team rounds where the patient is in the room the team enters, discusses their care and leaves. Each room takes 6 to 7 minutes, again the teams make the therapist time productive. The RNs conference in the room so it increases their time with the patient. Patients are also not requesting services of nursing knowing rounds iscoming their way therefore no one needs to cover for them. 4. Right now with the doctor who does traditional conference room conferences the charge nurse covers. Please feel free to call with questions IRF question It's probably been asked before but here goes again... for inpatient rehab units--- 1. what are typical work schedules for your OT and PT staff? 2. what's the earliest start time and the latest end time for OT and PT services? 3. when your staff is attending team rounds, do they have others cover their patients or do they schedule around the team meetings? 4. Do your RN's have difficulties leaving the unit to attend team rounds? If yes, how do they overcome them? Do they have other RN's cover their duties while they are in team rounds? Thanks! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@... <mailto:lstodda1%40hfhs.org> Be kinder than necessary because everyone you meet is fighting some kind of battle ======================================================================== ====== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 We have a TR here and she works every Saturday and 3 afternoons/early evenings...when the schedule is tight PT, OT and ST take priority. Our OTs start at 700 but we are looking at some coming in at 630. PT starts at 0830 and SLP start at 0800. One OT works 10 hours; the other staff all work 8. Our therapists are all hourly which makes scheduling very challenging. We do team conferences 6 days per week and everyone working with the patients being discussed that day including nurse, MD, social work, psychology, therapists attend preconference where 2-3 patients for that day are discussed and then one therapist stays with MD, social work and nurse to present the information from therapies to the patient and family at the conference. Our conferences are 15 min each and our preconference is 15 min. Other therapists who are not attending see patients. The nurses come in and out but we meet on the unit, so they are easily covered for. Feel free to contact me with any other questions. Brownrigg Therapy Manager Acute Care Services & Inpatient Physical Rehabilitation Unit Peace Health St. ph Medical Center 2901 Squalicum Pkwy Bellingham, WA 98225 sbrownrigg@... , ext 2384 our success is in the being, not just in the doing From: PTManager [mailto:PTManager ] On Behalf Of Carol Rehder Sent: Wednesday, March 02, 2011 6:59 AM To: PTManager Subject: Re: IRF question For those of you with TR departments in your IRF program, do they schedule throughout the day or more evening and weekend activities? Does OT, PT, SP take precedence if patient schedule is tight or sessions need to be rescheduled for any reason? Carol Rehder, PT Manager, Physical Therapy Genesis Medical Center rehder@... <mailto:rehder%40genesishealth.com> A J.D. Power and Associates Distinguished Hospital for providing " An Outstanding Patient Experience " >>> <klovato22@... <mailto:klovato22%40aol.com> > 3/1/2011 8:35 PM >>> Kathy Lovato PT, DPT Direcctor of Therapy Operations Mesa, AZ 1. All of our therapists are salary with assistants being hourly. We have some that work for tens, others traditional 8 2. Earliest start time is 700, latest is finished by 6pm 3. We broke the hospital up into teams of 10 patients by room number each team has a lead PT and OT with speech carrying 20. During conference the assistants are treating but conference time is divided by team so all the therapists are not taken up the entire time waiting their turn. We have one Dr. that does walking team rounds where the patient is in the room the team enters, discusses their care and leaves. Each room takes 6 to 7 minutes, again the teams make the therapist time productive. The RNs conference in the room so it increases their time with the patient. Patients are also not requesting services of nursing knowing rounds iscoming their way therefore no one needs to cover for them. 4. Right now with the doctor who does traditional conference room conferences the charge nurse covers. Please feel free to call with questions IRF question It's probably been asked before but here goes again... for inpatient rehab units--- 1. what are typical work schedules for your OT and PT staff? 2. what's the earliest start time and the latest end time for OT and PT services? 3. when your staff is attending team rounds, do they have others cover their patients or do they schedule around the team meetings? 4. Do your RN's have difficulties leaving the unit to attend team rounds? If yes, how do they overcome them? Do they have other RN's cover their duties while they are in team rounds? Thanks! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@... <mailto:lstodda1%40hfhs.org> Be kinder than necessary because everyone you meet is fighting some kind of battle ======================================================================== ====== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 We have a TR here and she works every Saturday and 3 afternoons/early evenings...when the schedule is tight PT, OT and ST take priority. Our OTs start at 700 but we are looking at some coming in at 630. PT starts at 0830 and SLP start at 0800. One OT works 10 hours; the other staff all work 8. Our therapists are all hourly which makes scheduling very challenging. We do team conferences 6 days per week and everyone working with the patients being discussed that day including nurse, MD, social work, psychology, therapists attend preconference where 2-3 patients for that day are discussed and then one therapist stays with MD, social work and nurse to present the information from therapies to the patient and family at the conference. Our conferences are 15 min each and our preconference is 15 min. Other therapists who are not attending see patients. The nurses come in and out but we meet on the unit, so they are easily covered for. Feel free to contact me with any other questions. Brownrigg Therapy Manager Acute Care Services & Inpatient Physical Rehabilitation Unit Peace Health St. ph Medical Center 2901 Squalicum Pkwy Bellingham, WA 98225 sbrownrigg@... , ext 2384 our success is in the being, not just in the doing From: PTManager [mailto:PTManager ] On Behalf Of Carol Rehder Sent: Wednesday, March 02, 2011 6:59 AM To: PTManager Subject: Re: IRF question For those of you with TR departments in your IRF program, do they schedule throughout the day or more evening and weekend activities? Does OT, PT, SP take precedence if patient schedule is tight or sessions need to be rescheduled for any reason? Carol Rehder, PT Manager, Physical Therapy Genesis Medical Center rehder@... <mailto:rehder%40genesishealth.com> A J.D. Power and Associates Distinguished Hospital for providing " An Outstanding Patient Experience " >>> <klovato22@... <mailto:klovato22%40aol.com> > 3/1/2011 8:35 PM >>> Kathy Lovato PT, DPT Direcctor of Therapy Operations Mesa, AZ 1. All of our therapists are salary with assistants being hourly. We have some that work for tens, others traditional 8 2. Earliest start time is 700, latest is finished by 6pm 3. We broke the hospital up into teams of 10 patients by room number each team has a lead PT and OT with speech carrying 20. During conference the assistants are treating but conference time is divided by team so all the therapists are not taken up the entire time waiting their turn. We have one Dr. that does walking team rounds where the patient is in the room the team enters, discusses their care and leaves. Each room takes 6 to 7 minutes, again the teams make the therapist time productive. The RNs conference in the room so it increases their time with the patient. Patients are also not requesting services of nursing knowing rounds iscoming their way therefore no one needs to cover for them. 4. Right now with the doctor who does traditional conference room conferences the charge nurse covers. Please feel free to call with questions IRF question It's probably been asked before but here goes again... for inpatient rehab units--- 1. what are typical work schedules for your OT and PT staff? 2. what's the earliest start time and the latest end time for OT and PT services? 3. when your staff is attending team rounds, do they have others cover their patients or do they schedule around the team meetings? 4. Do your RN's have difficulties leaving the unit to attend team rounds? If yes, how do they overcome them? Do they have other RN's cover their duties while they are in team rounds? Thanks! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@... <mailto:lstodda1%40hfhs.org> Be kinder than necessary because everyone you meet is fighting some kind of battle ======================================================================== ====== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 ABSOLUTELY with the 3 hour and 15 hour rules within first 7 days.... OT , PT and SLP take precedence....:>) E. Lynn MS PT Director of Rehabilitation Marlton Rehabilitation Hospital 92 Brick Rd. Marlton, NJ 08055 ext 4204 From: PTManager [mailto:PTManager ] On Behalf Of Carol Rehder Sent: Wednesday, March 02, 2011 9:59 AM To: PTManager Subject: Re: IRF question For those of you with TR departments in your IRF program, do they schedule throughout the day or more evening and weekend activities? Does OT, PT, SP take precedence if patient schedule is tight or sessions need to be rescheduled for any reason? Carol Rehder, PT Manager, Physical Therapy Genesis Medical Center rehder@...<mailto:rehder%40genesishealth.com> A J.D. Power and Associates Distinguished Hospital for providing " An Outstanding Patient Experience " >>> <klovato22@...<mailto:klovato22%40aol.com>> 3/1/2011 8:35 PM >>> Kathy Lovato PT, DPT Direcctor of Therapy Operations Mesa, AZ 1. All of our therapists are salary with assistants being hourly. We have some that work for tens, others traditional 8 2. Earliest start time is 700, latest is finished by 6pm 3. We broke the hospital up into teams of 10 patients by room number each team has a lead PT and OT with speech carrying 20. During conference the assistants are treating but conference time is divided by team so all the therapists are not taken up the entire time waiting their turn. We have one Dr. that does walking team rounds where the patient is in the room the team enters, discusses their care and leaves. Each room takes 6 to 7 minutes, again the teams make the therapist time productive. The RNs conference in the room so it increases their time with the patient. Patients are also not requesting services of nursing knowing rounds iscoming their way therefore no one needs to cover for them. 4. Right now with the doctor who does traditional conference room conferences the charge nurse covers. Please feel free to call with questions IRF question It's probably been asked before but here goes again... for inpatient rehab units--- 1. what are typical work schedules for your OT and PT staff? 2. what's the earliest start time and the latest end time for OT and PT services? 3. when your staff is attending team rounds, do they have others cover their patients or do they schedule around the team meetings? 4. Do your RN's have difficulties leaving the unit to attend team rounds? If yes, how do they overcome them? Do they have other RN's cover their duties while they are in team rounds? Thanks! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@...<mailto:lstodda1%40hfhs.org> Be kinder than necessary because everyone you meet is fighting some kind of battle ============================================================================== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 ABSOLUTELY with the 3 hour and 15 hour rules within first 7 days.... OT , PT and SLP take precedence....:>) E. Lynn MS PT Director of Rehabilitation Marlton Rehabilitation Hospital 92 Brick Rd. Marlton, NJ 08055 ext 4204 From: PTManager [mailto:PTManager ] On Behalf Of Carol Rehder Sent: Wednesday, March 02, 2011 9:59 AM To: PTManager Subject: Re: IRF question For those of you with TR departments in your IRF program, do they schedule throughout the day or more evening and weekend activities? Does OT, PT, SP take precedence if patient schedule is tight or sessions need to be rescheduled for any reason? Carol Rehder, PT Manager, Physical Therapy Genesis Medical Center rehder@...<mailto:rehder%40genesishealth.com> A J.D. Power and Associates Distinguished Hospital for providing " An Outstanding Patient Experience " >>> <klovato22@...<mailto:klovato22%40aol.com>> 3/1/2011 8:35 PM >>> Kathy Lovato PT, DPT Direcctor of Therapy Operations Mesa, AZ 1. All of our therapists are salary with assistants being hourly. We have some that work for tens, others traditional 8 2. Earliest start time is 700, latest is finished by 6pm 3. We broke the hospital up into teams of 10 patients by room number each team has a lead PT and OT with speech carrying 20. During conference the assistants are treating but conference time is divided by team so all the therapists are not taken up the entire time waiting their turn. We have one Dr. that does walking team rounds where the patient is in the room the team enters, discusses their care and leaves. Each room takes 6 to 7 minutes, again the teams make the therapist time productive. The RNs conference in the room so it increases their time with the patient. Patients are also not requesting services of nursing knowing rounds iscoming their way therefore no one needs to cover for them. 4. Right now with the doctor who does traditional conference room conferences the charge nurse covers. Please feel free to call with questions IRF question It's probably been asked before but here goes again... for inpatient rehab units--- 1. what are typical work schedules for your OT and PT staff? 2. what's the earliest start time and the latest end time for OT and PT services? 3. when your staff is attending team rounds, do they have others cover their patients or do they schedule around the team meetings? 4. Do your RN's have difficulties leaving the unit to attend team rounds? If yes, how do they overcome them? Do they have other RN's cover their duties while they are in team rounds? Thanks! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@...<mailto:lstodda1%40hfhs.org> Be kinder than necessary because everyone you meet is fighting some kind of battle ============================================================================== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 ABSOLUTELY with the 3 hour and 15 hour rules within first 7 days.... OT , PT and SLP take precedence....:>) E. Lynn MS PT Director of Rehabilitation Marlton Rehabilitation Hospital 92 Brick Rd. Marlton, NJ 08055 ext 4204 From: PTManager [mailto:PTManager ] On Behalf Of Carol Rehder Sent: Wednesday, March 02, 2011 9:59 AM To: PTManager Subject: Re: IRF question For those of you with TR departments in your IRF program, do they schedule throughout the day or more evening and weekend activities? Does OT, PT, SP take precedence if patient schedule is tight or sessions need to be rescheduled for any reason? Carol Rehder, PT Manager, Physical Therapy Genesis Medical Center rehder@...<mailto:rehder%40genesishealth.com> A J.D. Power and Associates Distinguished Hospital for providing " An Outstanding Patient Experience " >>> <klovato22@...<mailto:klovato22%40aol.com>> 3/1/2011 8:35 PM >>> Kathy Lovato PT, DPT Direcctor of Therapy Operations Mesa, AZ 1. All of our therapists are salary with assistants being hourly. We have some that work for tens, others traditional 8 2. Earliest start time is 700, latest is finished by 6pm 3. We broke the hospital up into teams of 10 patients by room number each team has a lead PT and OT with speech carrying 20. During conference the assistants are treating but conference time is divided by team so all the therapists are not taken up the entire time waiting their turn. We have one Dr. that does walking team rounds where the patient is in the room the team enters, discusses their care and leaves. Each room takes 6 to 7 minutes, again the teams make the therapist time productive. The RNs conference in the room so it increases their time with the patient. Patients are also not requesting services of nursing knowing rounds iscoming their way therefore no one needs to cover for them. 4. Right now with the doctor who does traditional conference room conferences the charge nurse covers. Please feel free to call with questions IRF question It's probably been asked before but here goes again... for inpatient rehab units--- 1. what are typical work schedules for your OT and PT staff? 2. what's the earliest start time and the latest end time for OT and PT services? 3. when your staff is attending team rounds, do they have others cover their patients or do they schedule around the team meetings? 4. Do your RN's have difficulties leaving the unit to attend team rounds? If yes, how do they overcome them? Do they have other RN's cover their duties while they are in team rounds? Thanks! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@...<mailto:lstodda1%40hfhs.org> Be kinder than necessary because everyone you meet is fighting some kind of battle ============================================================================== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 Our TR is part time for 8-10 patients. The hours are between lunch and dinner 4 days during the week, and also on Sunday when there is usually no other therapy being done. PT, OT and SLP come first for scheduling priority; if a community excursion is planned, the other therapists schedule around that time. Bob Perlson Director, Rehabilitation Rogue Valley Medical Center Medford, Oregon IRF question It's probably been asked before but here goes again... for inpatient rehab units--- 1. what are typical work schedules for your OT and PT staff? 2. what's the earliest start time and the latest end time for OT and PT services? 3. when your staff is attending team rounds, do they have others cover their patients or do they schedule around the team meetings? 4. Do your RN's have difficulties leaving the unit to attend team rounds? If yes, how do they overcome them? Do they have other RN's cover their duties while they are in team rounds? Thanks! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@... Be kinder than necessary because everyone you meet is fighting some kind of battle ======================================================================== ====== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 Our TR is part time for 8-10 patients. The hours are between lunch and dinner 4 days during the week, and also on Sunday when there is usually no other therapy being done. PT, OT and SLP come first for scheduling priority; if a community excursion is planned, the other therapists schedule around that time. Bob Perlson Director, Rehabilitation Rogue Valley Medical Center Medford, Oregon IRF question It's probably been asked before but here goes again... for inpatient rehab units--- 1. what are typical work schedules for your OT and PT staff? 2. what's the earliest start time and the latest end time for OT and PT services? 3. when your staff is attending team rounds, do they have others cover their patients or do they schedule around the team meetings? 4. Do your RN's have difficulties leaving the unit to attend team rounds? If yes, how do they overcome them? Do they have other RN's cover their duties while they are in team rounds? Thanks! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@... Be kinder than necessary because everyone you meet is fighting some kind of battle ======================================================================== ====== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 Our TR is part time for 8-10 patients. The hours are between lunch and dinner 4 days during the week, and also on Sunday when there is usually no other therapy being done. PT, OT and SLP come first for scheduling priority; if a community excursion is planned, the other therapists schedule around that time. Bob Perlson Director, Rehabilitation Rogue Valley Medical Center Medford, Oregon IRF question It's probably been asked before but here goes again... for inpatient rehab units--- 1. what are typical work schedules for your OT and PT staff? 2. what's the earliest start time and the latest end time for OT and PT services? 3. when your staff is attending team rounds, do they have others cover their patients or do they schedule around the team meetings? 4. Do your RN's have difficulties leaving the unit to attend team rounds? If yes, how do they overcome them? Do they have other RN's cover their duties while they are in team rounds? Thanks! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@... Be kinder than necessary because everyone you meet is fighting some kind of battle ======================================================================== ====== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 13, 2011 Report Share Posted April 13, 2011 Do you have a defined process for " case finding " ? In other words, do you try to find or identify patients for your inpatient rehab unit or wait for referrals? If yes, who fulfills this role and what is the process? Outside referrals---We have a rehab case manager who goes to other facilities but she doesn't enter the facility unless requested to do so to respond to a referral. Internal referrals---We are targeting our own hospital for more admissions. We really believe that we are missing patients who qualify for IRF. Approx 2-3% of our admissions come from our own hospital. I'm not counting the patients we receive from other hospitals in our System. I heard that the National average is closer to 4-6%. Any insights on this? What percent do you admit from your own hospital? Not counting other hospitals within your " System " . We depend heavily on our acute care PT and OT staff and the acute care social workers to identify patients and to facilitate the referral. Many of the Attending physicians are familiar with IRF and do make referrals. Even with this, we believe we are missing patients. We are in the process of piloting something on our intensive care unit. Our rehab case manager is attending the daily bedside rounds(RN, SW, physician is present) to help identify patients for IRF. So far, we have not received any more referrals or admissions than before we started attending. We will probably stop attending and perhaps go to another general medical floor and attend their rounds. Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@... Be kinder than necessary because everyone you meet is fighting some kind of battle ============================================================================== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 4, 2011 Report Share Posted May 4, 2011 We start OT treatments as early as 6:30 am. We are a 35 bed unit located on 2 separate floors and breakfast is from 6:30-7:30 on one floor and 7:45-8:45 on the other. The O.T.s have staggered start times from ranging from 6 am to 8 am arrival times. PTs start treatments at 9:00. Each patient is handed their schedule for the next day the night before and the next day's schedule is written on the Master schedule board at the Nursing station the night before. Nursing also includes necessary nursing care in the patient schedule book to ensure adequate time for tube feedings/wound vac changes/ bowel programs. This minimizes conflicts. We certainly have challenges with patient readiness, but the preparation with knowing the next day schedule has helped. Kerry Kerry R. Wood, PT, DPT Therapy Manager FAHC IP Rehab Therapies Colchester, VT 05446 Fax: www.fletcherallen.org Life is Precious.....LIVE IT!! Re: IRF question Good morning! We do start as early as 7:30, every evening we provide the nursing staff with next day's schedule, with notes referring to wether the patient will have a feeding session or ADL session, nursing staff (night shift) copy the schedule in each patient's room so they know night before what to expect, patients are consulted on how early they want to have their therapy session, if for any reason a change needs to happen, they are made before 8:00 a.m, and changes are communicated verbally to patients and changes are made on room boards. If we have patients that required to be fed or are low levels, nursing will communicate that during daily rounds and/ or Team conference, so therapists will accommodate for a later appt. We implemented this about 18 months ago, and made a great difference . Hope this information is helpful!! Leonor , R.P.T Manager, Inpatient Rehabilitation Services Pager 317 diazlm@... >>> " Stoddart, Lori " 5/4/2011 9:07 AM >>> Hi Everyone, We are again looking at our scheduling processes and practices to gain more efficiency and to better meet the needs of the patients and of course, to meet the 3 hour rule. Like many facilities, we struggle with patients being " ready " for their therapy appointments and especially for the first appointment of the day. Some facilities have appointments as early as 8:00 a.m. (not including OT ADL). I found that most start at 8:30 a.m. (out of the room appointments). Not including OT ADL at bedside, our first appointments are 9:30 a.m. Years ago, we started at 8:30 a.m. but decided to push it down to 9:30 to give the patients more time to get ready and in a functional manner. Also, to reduce the need to wake them up so early. What we found is that the same reasons that patients weren't ready at 8:30 a.m. are happening at 9:30. We want to move back to 8:30 a.m. but before we do so we need to redesign some processes related to the nursing staff's morning routine and be sure we individualize the schedules according to the patients needs and preferences. The nursing staff is very stressed out about the idea of therapy going back to 8:30. They are having a hard time getting everything done (pass meds, assessments, attend team rounds, wound care, self-care, etc.) for the 9:30 appointments. The patients have a lot of medical needs and some impairments really add to the time it takes for all activities to be completed (eating, self-care, 2 person assist transfer, etc.). My questions to the group: 1. do you follow any criteria for which patients have the earliest appointments (whatever that is for your facility). Currently, we do not. We will reschedule if we find that the patient cannot be ready that early. Our nurses will sometimes put a hold on the patients schedule ( " nursing time " in our scheduling system). 2. do your therapists select their appointment times for patients? Ours do but they frequently make changes based on patients needs/tolerance/preference. Or is it a clerical function? Or a team decision after your evaluations? 3. Do the disciplines (specifically OT and PT) coordinate their appointments? We do not on the front end but will do so as needed to meet the needs of the patient. If yes, what criteria do they use? What is it they are trying accomplish by coordinating them? Typically, our driving force for coordinating is to reduce the back and forth of patients to the unit and the gym (the transportation). 4. Typically, what is the most time (duration) a patient attends appointments? It's not unusual for us to schedule patients for 3 straight hours of therapy. If they can't tolerate it, we change it. Do they have back to back appts? We do. Our usual schedule is PT b.id. (60 min in a.m. and 60 min in p.m.) and OT one hour. 5. Do you have limits on the duration of time a patient attends appts? Only if needed, based on patient's tolerance and preference. 6. As a rule, does your nursing staff have patient's ready for their first appointment of the day? Please define the term " ready " . Does " ready " mean they are bathed, dressed and sitting in the wheelchair ready for transport? Or do the therapists take them as they are? 7. What percent of your OT and PT appts are done at bedside or on the nursing unit? Primarily, only our OT ADL in the morning. As a rule, our patients are transported to the PT/OT department for treatments. Can you share processes and practices that you find helpful with having patients ready for their first appointment of the day. e.g. Nursing schedules, therapy schedules, the role of all staff in contributing to the readiness of patients for appts, does PT staff help with self-care if it's not already completed, how many ADL's are done by OT, etc? We are looking at throwing out our whole scheduling process and starting over!! Not sure what it will look like but we need to do something very different to stop the madness! We can't keep jumping through burning hoops to ensure patients receive 3 hours of therapy, in the most quality manner. And, let's not forget, achieve patient and employee satisfaction too! Sorry, lots of questions--I really value your input and appreciate the time you take to reply to these posts! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@... Be kinder than necessary because everyone you meet is fighting some kind of battle ============================================================================== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 4, 2011 Report Share Posted May 4, 2011 We start OT treatments as early as 6:30 am. We are a 35 bed unit located on 2 separate floors and breakfast is from 6:30-7:30 on one floor and 7:45-8:45 on the other. The O.T.s have staggered start times from ranging from 6 am to 8 am arrival times. PTs start treatments at 9:00. Each patient is handed their schedule for the next day the night before and the next day's schedule is written on the Master schedule board at the Nursing station the night before. Nursing also includes necessary nursing care in the patient schedule book to ensure adequate time for tube feedings/wound vac changes/ bowel programs. This minimizes conflicts. We certainly have challenges with patient readiness, but the preparation with knowing the next day schedule has helped. Kerry Kerry R. Wood, PT, DPT Therapy Manager FAHC IP Rehab Therapies Colchester, VT 05446 Fax: www.fletcherallen.org Life is Precious.....LIVE IT!! Re: IRF question Good morning! We do start as early as 7:30, every evening we provide the nursing staff with next day's schedule, with notes referring to wether the patient will have a feeding session or ADL session, nursing staff (night shift) copy the schedule in each patient's room so they know night before what to expect, patients are consulted on how early they want to have their therapy session, if for any reason a change needs to happen, they are made before 8:00 a.m, and changes are communicated verbally to patients and changes are made on room boards. If we have patients that required to be fed or are low levels, nursing will communicate that during daily rounds and/ or Team conference, so therapists will accommodate for a later appt. We implemented this about 18 months ago, and made a great difference . Hope this information is helpful!! Leonor , R.P.T Manager, Inpatient Rehabilitation Services Pager 317 diazlm@... >>> " Stoddart, Lori " 5/4/2011 9:07 AM >>> Hi Everyone, We are again looking at our scheduling processes and practices to gain more efficiency and to better meet the needs of the patients and of course, to meet the 3 hour rule. Like many facilities, we struggle with patients being " ready " for their therapy appointments and especially for the first appointment of the day. Some facilities have appointments as early as 8:00 a.m. (not including OT ADL). I found that most start at 8:30 a.m. (out of the room appointments). Not including OT ADL at bedside, our first appointments are 9:30 a.m. Years ago, we started at 8:30 a.m. but decided to push it down to 9:30 to give the patients more time to get ready and in a functional manner. Also, to reduce the need to wake them up so early. What we found is that the same reasons that patients weren't ready at 8:30 a.m. are happening at 9:30. We want to move back to 8:30 a.m. but before we do so we need to redesign some processes related to the nursing staff's morning routine and be sure we individualize the schedules according to the patients needs and preferences. The nursing staff is very stressed out about the idea of therapy going back to 8:30. They are having a hard time getting everything done (pass meds, assessments, attend team rounds, wound care, self-care, etc.) for the 9:30 appointments. The patients have a lot of medical needs and some impairments really add to the time it takes for all activities to be completed (eating, self-care, 2 person assist transfer, etc.). My questions to the group: 1. do you follow any criteria for which patients have the earliest appointments (whatever that is for your facility). Currently, we do not. We will reschedule if we find that the patient cannot be ready that early. Our nurses will sometimes put a hold on the patients schedule ( " nursing time " in our scheduling system). 2. do your therapists select their appointment times for patients? Ours do but they frequently make changes based on patients needs/tolerance/preference. Or is it a clerical function? Or a team decision after your evaluations? 3. Do the disciplines (specifically OT and PT) coordinate their appointments? We do not on the front end but will do so as needed to meet the needs of the patient. If yes, what criteria do they use? What is it they are trying accomplish by coordinating them? Typically, our driving force for coordinating is to reduce the back and forth of patients to the unit and the gym (the transportation). 4. Typically, what is the most time (duration) a patient attends appointments? It's not unusual for us to schedule patients for 3 straight hours of therapy. If they can't tolerate it, we change it. Do they have back to back appts? We do. Our usual schedule is PT b.id. (60 min in a.m. and 60 min in p.m.) and OT one hour. 5. Do you have limits on the duration of time a patient attends appts? Only if needed, based on patient's tolerance and preference. 6. As a rule, does your nursing staff have patient's ready for their first appointment of the day? Please define the term " ready " . Does " ready " mean they are bathed, dressed and sitting in the wheelchair ready for transport? Or do the therapists take them as they are? 7. What percent of your OT and PT appts are done at bedside or on the nursing unit? Primarily, only our OT ADL in the morning. As a rule, our patients are transported to the PT/OT department for treatments. Can you share processes and practices that you find helpful with having patients ready for their first appointment of the day. e.g. Nursing schedules, therapy schedules, the role of all staff in contributing to the readiness of patients for appts, does PT staff help with self-care if it's not already completed, how many ADL's are done by OT, etc? We are looking at throwing out our whole scheduling process and starting over!! Not sure what it will look like but we need to do something very different to stop the madness! We can't keep jumping through burning hoops to ensure patients receive 3 hours of therapy, in the most quality manner. And, let's not forget, achieve patient and employee satisfaction too! Sorry, lots of questions--I really value your input and appreciate the time you take to reply to these posts! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@... Be kinder than necessary because everyone you meet is fighting some kind of battle ============================================================================== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 4, 2011 Report Share Posted May 4, 2011 Lori- Below are my answers, for a 13 bed unit. Obviously, the more bed, the more complexity. We aim to begin PT at 830 but it can be earlier or later according to individual patient needs. 1. It's a judgment of the therapist as to what patients go first. We're a small enough team that there's good communication between nurses and therapists. The therapists typically do the scheduling, but nurses can block out time for procedures if necessary. (This will happen for dialysis and so forth in addition to routine nursing care.) Otherwise, typically nurses work around the therapists' schedules. 2. Therapists do the scheduling but our Unit Secretary can make changes to reflect nursing or diagnostic needs. We have an electronic schedule board that is basically an Excel worksheet that converts to an HTML document and displays around the unit on flat screen monitors. Once the schedule is " published " it can be changed and updated on the fly as situations change. It is also what our Respiratory and Wound Care depts. refer to when they need to schedule time with our patients without interrupting the therapies. I always explain to the nurses and other department that achieving therapy time is basically a compliance and reimbursement issue. When people understand that there's very little pushback on who takes precedence in scheduling. 3. Yes, our therapy disciplines have " huddles " to work out the schedule. Usually the schedule doesn't change on subsequent days, so it usually takes just a few minutes to coordinate every day. 4. The schedules are individualized. It's probably more common to have a break between therapy sessions. 5. See #4. 90 minutes is a common duration. 6. We have CNAs on the unit and their shift starts at 6 a.m. (RNs at 7 a.m.) CNAs get patients' vitals and morning needs met, assist in preparing them to go to the dining room for 8 a.m. meal. After the meal in most cases the patients are ready to go for therapy. 7. It varies, but it's fair to say we do relatively little bedside therapy. However, our gym and other therapy areas are right on the unit in the midst of the patient rooms, so transport is not an issue. Bob Perlson Director, Rehabilitation Rogue Valley Medical Center Medford, Oregon IRF question Hi Everyone, We are again looking at our scheduling processes and practices to gain more efficiency and to better meet the needs of the patients and of course, to meet the 3 hour rule. Like many facilities, we struggle with patients being " ready " for their therapy appointments and especially for the first appointment of the day. Some facilities have appointments as early as 8:00 a.m. (not including OT ADL). I found that most start at 8:30 a.m. (out of the room appointments). Not including OT ADL at bedside, our first appointments are 9:30 a.m. Years ago, we started at 8:30 a.m. but decided to push it down to 9:30 to give the patients more time to get ready and in a functional manner. Also, to reduce the need to wake them up so early. What we found is that the same reasons that patients weren't ready at 8:30 a.m. are happening at 9:30. We want to move back to 8:30 a.m. but before we do so we need to redesign some processes related to the nursing staff's morning routine and be sure we individualize the schedules according to the patients needs and preferences. The nursing staff is very stressed out about the idea of therapy going back to 8:30. They are having a hard time getting everything done (pass meds, assessments, attend team rounds, wound care, self-care, etc.) for the 9:30 appointments. The patients have a lot of medical needs and some impairments really add to the time it takes for all activities to be completed (eating, self-care, 2 person assist transfer, etc.). My questions to the group: 1. do you follow any criteria for which patients have the earliest appointments (whatever that is for your facility). Currently, we do not. We will reschedule if we find that the patient cannot be ready that early. Our nurses will sometimes put a hold on the patients schedule ( " nursing time " in our scheduling system). 2. do your therapists select their appointment times for patients? Ours do but they frequently make changes based on patients needs/tolerance/preference. Or is it a clerical function? Or a team decision after your evaluations? 3. Do the disciplines (specifically OT and PT) coordinate their appointments? We do not on the front end but will do so as needed to meet the needs of the patient. If yes, what criteria do they use? What is it they are trying accomplish by coordinating them? Typically, our driving force for coordinating is to reduce the back and forth of patients to the unit and the gym (the transportation). 4. Typically, what is the most time (duration) a patient attends appointments? It's not unusual for us to schedule patients for 3 straight hours of therapy. If they can't tolerate it, we change it. Do they have back to back appts? We do. Our usual schedule is PT b.id. (60 min in a.m. and 60 min in p.m.) and OT one hour. 5. Do you have limits on the duration of time a patient attends appts? Only if needed, based on patient's tolerance and preference. 6. As a rule, does your nursing staff have patient's ready for their first appointment of the day? Please define the term " ready " . Does " ready " mean they are bathed, dressed and sitting in the wheelchair ready for transport? Or do the therapists take them as they are? 7. What percent of your OT and PT appts are done at bedside or on the nursing unit? Primarily, only our OT ADL in the morning. As a rule, our patients are transported to the PT/OT department for treatments. Can you share processes and practices that you find helpful with having patients ready for their first appointment of the day. e.g. Nursing schedules, therapy schedules, the role of all staff in contributing to the readiness of patients for appts, does PT staff help with self-care if it's not already completed, how many ADL's are done by OT, etc? We are looking at throwing out our whole scheduling process and starting over!! Not sure what it will look like but we need to do something very different to stop the madness! We can't keep jumping through burning hoops to ensure patients receive 3 hours of therapy, in the most quality manner. And, let's not forget, achieve patient and employee satisfaction too! Sorry, lots of questions--I really value your input and appreciate the time you take to reply to these posts! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@... Be kinder than necessary because everyone you meet is fighting some kind of battle ======================================================================== ====== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 4, 2011 Report Share Posted May 4, 2011 Lori- Below are my answers, for a 13 bed unit. Obviously, the more bed, the more complexity. We aim to begin PT at 830 but it can be earlier or later according to individual patient needs. 1. It's a judgment of the therapist as to what patients go first. We're a small enough team that there's good communication between nurses and therapists. The therapists typically do the scheduling, but nurses can block out time for procedures if necessary. (This will happen for dialysis and so forth in addition to routine nursing care.) Otherwise, typically nurses work around the therapists' schedules. 2. Therapists do the scheduling but our Unit Secretary can make changes to reflect nursing or diagnostic needs. We have an electronic schedule board that is basically an Excel worksheet that converts to an HTML document and displays around the unit on flat screen monitors. Once the schedule is " published " it can be changed and updated on the fly as situations change. It is also what our Respiratory and Wound Care depts. refer to when they need to schedule time with our patients without interrupting the therapies. I always explain to the nurses and other department that achieving therapy time is basically a compliance and reimbursement issue. When people understand that there's very little pushback on who takes precedence in scheduling. 3. Yes, our therapy disciplines have " huddles " to work out the schedule. Usually the schedule doesn't change on subsequent days, so it usually takes just a few minutes to coordinate every day. 4. The schedules are individualized. It's probably more common to have a break between therapy sessions. 5. See #4. 90 minutes is a common duration. 6. We have CNAs on the unit and their shift starts at 6 a.m. (RNs at 7 a.m.) CNAs get patients' vitals and morning needs met, assist in preparing them to go to the dining room for 8 a.m. meal. After the meal in most cases the patients are ready to go for therapy. 7. It varies, but it's fair to say we do relatively little bedside therapy. However, our gym and other therapy areas are right on the unit in the midst of the patient rooms, so transport is not an issue. Bob Perlson Director, Rehabilitation Rogue Valley Medical Center Medford, Oregon IRF question Hi Everyone, We are again looking at our scheduling processes and practices to gain more efficiency and to better meet the needs of the patients and of course, to meet the 3 hour rule. Like many facilities, we struggle with patients being " ready " for their therapy appointments and especially for the first appointment of the day. Some facilities have appointments as early as 8:00 a.m. (not including OT ADL). I found that most start at 8:30 a.m. (out of the room appointments). Not including OT ADL at bedside, our first appointments are 9:30 a.m. Years ago, we started at 8:30 a.m. but decided to push it down to 9:30 to give the patients more time to get ready and in a functional manner. Also, to reduce the need to wake them up so early. What we found is that the same reasons that patients weren't ready at 8:30 a.m. are happening at 9:30. We want to move back to 8:30 a.m. but before we do so we need to redesign some processes related to the nursing staff's morning routine and be sure we individualize the schedules according to the patients needs and preferences. The nursing staff is very stressed out about the idea of therapy going back to 8:30. They are having a hard time getting everything done (pass meds, assessments, attend team rounds, wound care, self-care, etc.) for the 9:30 appointments. The patients have a lot of medical needs and some impairments really add to the time it takes for all activities to be completed (eating, self-care, 2 person assist transfer, etc.). My questions to the group: 1. do you follow any criteria for which patients have the earliest appointments (whatever that is for your facility). Currently, we do not. We will reschedule if we find that the patient cannot be ready that early. Our nurses will sometimes put a hold on the patients schedule ( " nursing time " in our scheduling system). 2. do your therapists select their appointment times for patients? Ours do but they frequently make changes based on patients needs/tolerance/preference. Or is it a clerical function? Or a team decision after your evaluations? 3. Do the disciplines (specifically OT and PT) coordinate their appointments? We do not on the front end but will do so as needed to meet the needs of the patient. If yes, what criteria do they use? What is it they are trying accomplish by coordinating them? Typically, our driving force for coordinating is to reduce the back and forth of patients to the unit and the gym (the transportation). 4. Typically, what is the most time (duration) a patient attends appointments? It's not unusual for us to schedule patients for 3 straight hours of therapy. If they can't tolerate it, we change it. Do they have back to back appts? We do. Our usual schedule is PT b.id. (60 min in a.m. and 60 min in p.m.) and OT one hour. 5. Do you have limits on the duration of time a patient attends appts? Only if needed, based on patient's tolerance and preference. 6. As a rule, does your nursing staff have patient's ready for their first appointment of the day? Please define the term " ready " . Does " ready " mean they are bathed, dressed and sitting in the wheelchair ready for transport? Or do the therapists take them as they are? 7. What percent of your OT and PT appts are done at bedside or on the nursing unit? Primarily, only our OT ADL in the morning. As a rule, our patients are transported to the PT/OT department for treatments. Can you share processes and practices that you find helpful with having patients ready for their first appointment of the day. e.g. Nursing schedules, therapy schedules, the role of all staff in contributing to the readiness of patients for appts, does PT staff help with self-care if it's not already completed, how many ADL's are done by OT, etc? We are looking at throwing out our whole scheduling process and starting over!! Not sure what it will look like but we need to do something very different to stop the madness! We can't keep jumping through burning hoops to ensure patients receive 3 hours of therapy, in the most quality manner. And, let's not forget, achieve patient and employee satisfaction too! Sorry, lots of questions--I really value your input and appreciate the time you take to reply to these posts! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@... Be kinder than necessary because everyone you meet is fighting some kind of battle ======================================================================== ====== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 4, 2011 Report Share Posted May 4, 2011 Lori- Below are my answers, for a 13 bed unit. Obviously, the more bed, the more complexity. We aim to begin PT at 830 but it can be earlier or later according to individual patient needs. 1. It's a judgment of the therapist as to what patients go first. We're a small enough team that there's good communication between nurses and therapists. The therapists typically do the scheduling, but nurses can block out time for procedures if necessary. (This will happen for dialysis and so forth in addition to routine nursing care.) Otherwise, typically nurses work around the therapists' schedules. 2. Therapists do the scheduling but our Unit Secretary can make changes to reflect nursing or diagnostic needs. We have an electronic schedule board that is basically an Excel worksheet that converts to an HTML document and displays around the unit on flat screen monitors. Once the schedule is " published " it can be changed and updated on the fly as situations change. It is also what our Respiratory and Wound Care depts. refer to when they need to schedule time with our patients without interrupting the therapies. I always explain to the nurses and other department that achieving therapy time is basically a compliance and reimbursement issue. When people understand that there's very little pushback on who takes precedence in scheduling. 3. Yes, our therapy disciplines have " huddles " to work out the schedule. Usually the schedule doesn't change on subsequent days, so it usually takes just a few minutes to coordinate every day. 4. The schedules are individualized. It's probably more common to have a break between therapy sessions. 5. See #4. 90 minutes is a common duration. 6. We have CNAs on the unit and their shift starts at 6 a.m. (RNs at 7 a.m.) CNAs get patients' vitals and morning needs met, assist in preparing them to go to the dining room for 8 a.m. meal. After the meal in most cases the patients are ready to go for therapy. 7. It varies, but it's fair to say we do relatively little bedside therapy. However, our gym and other therapy areas are right on the unit in the midst of the patient rooms, so transport is not an issue. Bob Perlson Director, Rehabilitation Rogue Valley Medical Center Medford, Oregon IRF question Hi Everyone, We are again looking at our scheduling processes and practices to gain more efficiency and to better meet the needs of the patients and of course, to meet the 3 hour rule. Like many facilities, we struggle with patients being " ready " for their therapy appointments and especially for the first appointment of the day. Some facilities have appointments as early as 8:00 a.m. (not including OT ADL). I found that most start at 8:30 a.m. (out of the room appointments). Not including OT ADL at bedside, our first appointments are 9:30 a.m. Years ago, we started at 8:30 a.m. but decided to push it down to 9:30 to give the patients more time to get ready and in a functional manner. Also, to reduce the need to wake them up so early. What we found is that the same reasons that patients weren't ready at 8:30 a.m. are happening at 9:30. We want to move back to 8:30 a.m. but before we do so we need to redesign some processes related to the nursing staff's morning routine and be sure we individualize the schedules according to the patients needs and preferences. The nursing staff is very stressed out about the idea of therapy going back to 8:30. They are having a hard time getting everything done (pass meds, assessments, attend team rounds, wound care, self-care, etc.) for the 9:30 appointments. The patients have a lot of medical needs and some impairments really add to the time it takes for all activities to be completed (eating, self-care, 2 person assist transfer, etc.). My questions to the group: 1. do you follow any criteria for which patients have the earliest appointments (whatever that is for your facility). Currently, we do not. We will reschedule if we find that the patient cannot be ready that early. Our nurses will sometimes put a hold on the patients schedule ( " nursing time " in our scheduling system). 2. do your therapists select their appointment times for patients? Ours do but they frequently make changes based on patients needs/tolerance/preference. Or is it a clerical function? Or a team decision after your evaluations? 3. Do the disciplines (specifically OT and PT) coordinate their appointments? We do not on the front end but will do so as needed to meet the needs of the patient. If yes, what criteria do they use? What is it they are trying accomplish by coordinating them? Typically, our driving force for coordinating is to reduce the back and forth of patients to the unit and the gym (the transportation). 4. Typically, what is the most time (duration) a patient attends appointments? It's not unusual for us to schedule patients for 3 straight hours of therapy. If they can't tolerate it, we change it. Do they have back to back appts? We do. Our usual schedule is PT b.id. (60 min in a.m. and 60 min in p.m.) and OT one hour. 5. Do you have limits on the duration of time a patient attends appts? Only if needed, based on patient's tolerance and preference. 6. As a rule, does your nursing staff have patient's ready for their first appointment of the day? Please define the term " ready " . Does " ready " mean they are bathed, dressed and sitting in the wheelchair ready for transport? Or do the therapists take them as they are? 7. What percent of your OT and PT appts are done at bedside or on the nursing unit? Primarily, only our OT ADL in the morning. As a rule, our patients are transported to the PT/OT department for treatments. Can you share processes and practices that you find helpful with having patients ready for their first appointment of the day. e.g. Nursing schedules, therapy schedules, the role of all staff in contributing to the readiness of patients for appts, does PT staff help with self-care if it's not already completed, how many ADL's are done by OT, etc? We are looking at throwing out our whole scheduling process and starting over!! Not sure what it will look like but we need to do something very different to stop the madness! We can't keep jumping through burning hoops to ensure patients receive 3 hours of therapy, in the most quality manner. And, let's not forget, achieve patient and employee satisfaction too! Sorry, lots of questions--I really value your input and appreciate the time you take to reply to these posts! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@... Be kinder than necessary because everyone you meet is fighting some kind of battle ======================================================================== ====== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 6, 2011 Report Share Posted May 6, 2011 Hello Kerry, Just curious about when/ where you schedule your SLP care... Do you run breakfast groups, lunch or dinner care? What times do these professionals start? I manage a 49 bed IRF and can always use suggestions.... Thank you . E. Lynn MS PT Director of Rehabilitation Marlton Rehabilitation Hospital 92 Brick Rd. Marlton, NJ 08055 ext 4204 From: PTManager [mailto:PTManager ] On Behalf Of Wood, Kerry R. Sent: Wednesday, May 04, 2011 2:30 PM To: 'PTManager ' Subject: RE: IRF question We start OT treatments as early as 6:30 am. We are a 35 bed unit located on 2 separate floors and breakfast is from 6:30-7:30 on one floor and 7:45-8:45 on the other. The O.T.s have staggered start times from ranging from 6 am to 8 am arrival times. PTs start treatments at 9:00. Each patient is handed their schedule for the next day the night before and the next day's schedule is written on the Master schedule board at the Nursing station the night before. Nursing also includes necessary nursing care in the patient schedule book to ensure adequate time for tube feedings/wound vac changes/ bowel programs. This minimizes conflicts. We certainly have challenges with patient readiness, but the preparation with knowing the next day schedule has helped. Kerry Kerry R. Wood, PT, DPT Therapy Manager FAHC IP Rehab Therapies Colchester, VT 05446 Fax: www.fletcherallen.org Life is Precious.....LIVE IT!! Re: IRF question Good morning! We do start as early as 7:30, every evening we provide the nursing staff with next day's schedule, with notes referring to wether the patient will have a feeding session or ADL session, nursing staff (night shift) copy the schedule in each patient's room so they know night before what to expect, patients are consulted on how early they want to have their therapy session, if for any reason a change needs to happen, they are made before 8:00 a.m, and changes are communicated verbally to patients and changes are made on room boards. If we have patients that required to be fed or are low levels, nursing will communicate that during daily rounds and/ or Team conference, so therapists will accommodate for a later appt. We implemented this about 18 months ago, and made a great difference . Hope this information is helpful!! Leonor , R.P.T Manager, Inpatient Rehabilitation Services Pager 317 diazlm@...<mailto:diazlm%40wmmcpo.ah.org> >>> " Stoddart, Lori " <lstodda1@...<mailto:lstodda1%40hfhs.org>> 5/4/2011 9:07 AM >>> Hi Everyone, We are again looking at our scheduling processes and practices to gain more efficiency and to better meet the needs of the patients and of course, to meet the 3 hour rule. Like many facilities, we struggle with patients being " ready " for their therapy appointments and especially for the first appointment of the day. Some facilities have appointments as early as 8:00 a.m. (not including OT ADL). I found that most start at 8:30 a.m. (out of the room appointments). Not including OT ADL at bedside, our first appointments are 9:30 a.m. Years ago, we started at 8:30 a.m. but decided to push it down to 9:30 to give the patients more time to get ready and in a functional manner. Also, to reduce the need to wake them up so early. What we found is that the same reasons that patients weren't ready at 8:30 a.m. are happening at 9:30. We want to move back to 8:30 a.m. but before we do so we need to redesign some processes related to the nursing staff's morning routine and be sure we individualize the schedules according to the patients needs and preferences. The nursing staff is very stressed out about the idea of therapy going back to 8:30. They are having a hard time getting everything done (pass meds, assessments, attend team rounds, wound care, self-care, etc.) for the 9:30 appointments. The patients have a lot of medical needs and some impairments really add to the time it takes for all activities to be completed (eating, self-care, 2 person assist transfer, etc.). My questions to the group: 1. do you follow any criteria for which patients have the earliest appointments (whatever that is for your facility). Currently, we do not. We will reschedule if we find that the patient cannot be ready that early. Our nurses will sometimes put a hold on the patients schedule ( " nursing time " in our scheduling system). 2. do your therapists select their appointment times for patients? Ours do but they frequently make changes based on patients needs/tolerance/preference. Or is it a clerical function? Or a team decision after your evaluations? 3. Do the disciplines (specifically OT and PT) coordinate their appointments? We do not on the front end but will do so as needed to meet the needs of the patient. If yes, what criteria do they use? What is it they are trying accomplish by coordinating them? Typically, our driving force for coordinating is to reduce the back and forth of patients to the unit and the gym (the transportation). 4. Typically, what is the most time (duration) a patient attends appointments? It's not unusual for us to schedule patients for 3 straight hours of therapy. If they can't tolerate it, we change it. Do they have back to back appts? We do. Our usual schedule is PT b.id. (60 min in a.m. and 60 min in p.m.) and OT one hour. 5. Do you have limits on the duration of time a patient attends appts? Only if needed, based on patient's tolerance and preference. 6. As a rule, does your nursing staff have patient's ready for their first appointment of the day? Please define the term " ready " . Does " ready " mean they are bathed, dressed and sitting in the wheelchair ready for transport? Or do the therapists take them as they are? 7. What percent of your OT and PT appts are done at bedside or on the nursing unit? Primarily, only our OT ADL in the morning. As a rule, our patients are transported to the PT/OT department for treatments. Can you share processes and practices that you find helpful with having patients ready for their first appointment of the day. e.g. Nursing schedules, therapy schedules, the role of all staff in contributing to the readiness of patients for appts, does PT staff help with self-care if it's not already completed, how many ADL's are done by OT, etc? We are looking at throwing out our whole scheduling process and starting over!! Not sure what it will look like but we need to do something very different to stop the madness! We can't keep jumping through burning hoops to ensure patients receive 3 hours of therapy, in the most quality manner. And, let's not forget, achieve patient and employee satisfaction too! Sorry, lots of questions--I really value your input and appreciate the time you take to reply to these posts! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@...<mailto:lstodda1%40hfhs.org> Be kinder than necessary because everyone you meet is fighting some kind of battle ============================================================================== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 6, 2011 Report Share Posted May 6, 2011 Hello Kerry, Just curious about when/ where you schedule your SLP care... Do you run breakfast groups, lunch or dinner care? What times do these professionals start? I manage a 49 bed IRF and can always use suggestions.... Thank you . E. Lynn MS PT Director of Rehabilitation Marlton Rehabilitation Hospital 92 Brick Rd. Marlton, NJ 08055 ext 4204 From: PTManager [mailto:PTManager ] On Behalf Of Wood, Kerry R. Sent: Wednesday, May 04, 2011 2:30 PM To: 'PTManager ' Subject: RE: IRF question We start OT treatments as early as 6:30 am. We are a 35 bed unit located on 2 separate floors and breakfast is from 6:30-7:30 on one floor and 7:45-8:45 on the other. The O.T.s have staggered start times from ranging from 6 am to 8 am arrival times. PTs start treatments at 9:00. Each patient is handed their schedule for the next day the night before and the next day's schedule is written on the Master schedule board at the Nursing station the night before. Nursing also includes necessary nursing care in the patient schedule book to ensure adequate time for tube feedings/wound vac changes/ bowel programs. This minimizes conflicts. We certainly have challenges with patient readiness, but the preparation with knowing the next day schedule has helped. Kerry Kerry R. Wood, PT, DPT Therapy Manager FAHC IP Rehab Therapies Colchester, VT 05446 Fax: www.fletcherallen.org Life is Precious.....LIVE IT!! Re: IRF question Good morning! We do start as early as 7:30, every evening we provide the nursing staff with next day's schedule, with notes referring to wether the patient will have a feeding session or ADL session, nursing staff (night shift) copy the schedule in each patient's room so they know night before what to expect, patients are consulted on how early they want to have their therapy session, if for any reason a change needs to happen, they are made before 8:00 a.m, and changes are communicated verbally to patients and changes are made on room boards. If we have patients that required to be fed or are low levels, nursing will communicate that during daily rounds and/ or Team conference, so therapists will accommodate for a later appt. We implemented this about 18 months ago, and made a great difference . Hope this information is helpful!! Leonor , R.P.T Manager, Inpatient Rehabilitation Services Pager 317 diazlm@...<mailto:diazlm%40wmmcpo.ah.org> >>> " Stoddart, Lori " <lstodda1@...<mailto:lstodda1%40hfhs.org>> 5/4/2011 9:07 AM >>> Hi Everyone, We are again looking at our scheduling processes and practices to gain more efficiency and to better meet the needs of the patients and of course, to meet the 3 hour rule. Like many facilities, we struggle with patients being " ready " for their therapy appointments and especially for the first appointment of the day. Some facilities have appointments as early as 8:00 a.m. (not including OT ADL). I found that most start at 8:30 a.m. (out of the room appointments). Not including OT ADL at bedside, our first appointments are 9:30 a.m. Years ago, we started at 8:30 a.m. but decided to push it down to 9:30 to give the patients more time to get ready and in a functional manner. Also, to reduce the need to wake them up so early. What we found is that the same reasons that patients weren't ready at 8:30 a.m. are happening at 9:30. We want to move back to 8:30 a.m. but before we do so we need to redesign some processes related to the nursing staff's morning routine and be sure we individualize the schedules according to the patients needs and preferences. The nursing staff is very stressed out about the idea of therapy going back to 8:30. They are having a hard time getting everything done (pass meds, assessments, attend team rounds, wound care, self-care, etc.) for the 9:30 appointments. The patients have a lot of medical needs and some impairments really add to the time it takes for all activities to be completed (eating, self-care, 2 person assist transfer, etc.). My questions to the group: 1. do you follow any criteria for which patients have the earliest appointments (whatever that is for your facility). Currently, we do not. We will reschedule if we find that the patient cannot be ready that early. Our nurses will sometimes put a hold on the patients schedule ( " nursing time " in our scheduling system). 2. do your therapists select their appointment times for patients? Ours do but they frequently make changes based on patients needs/tolerance/preference. Or is it a clerical function? Or a team decision after your evaluations? 3. Do the disciplines (specifically OT and PT) coordinate their appointments? We do not on the front end but will do so as needed to meet the needs of the patient. If yes, what criteria do they use? What is it they are trying accomplish by coordinating them? Typically, our driving force for coordinating is to reduce the back and forth of patients to the unit and the gym (the transportation). 4. Typically, what is the most time (duration) a patient attends appointments? It's not unusual for us to schedule patients for 3 straight hours of therapy. If they can't tolerate it, we change it. Do they have back to back appts? We do. Our usual schedule is PT b.id. (60 min in a.m. and 60 min in p.m.) and OT one hour. 5. Do you have limits on the duration of time a patient attends appts? Only if needed, based on patient's tolerance and preference. 6. As a rule, does your nursing staff have patient's ready for their first appointment of the day? Please define the term " ready " . Does " ready " mean they are bathed, dressed and sitting in the wheelchair ready for transport? Or do the therapists take them as they are? 7. What percent of your OT and PT appts are done at bedside or on the nursing unit? Primarily, only our OT ADL in the morning. As a rule, our patients are transported to the PT/OT department for treatments. Can you share processes and practices that you find helpful with having patients ready for their first appointment of the day. e.g. Nursing schedules, therapy schedules, the role of all staff in contributing to the readiness of patients for appts, does PT staff help with self-care if it's not already completed, how many ADL's are done by OT, etc? We are looking at throwing out our whole scheduling process and starting over!! Not sure what it will look like but we need to do something very different to stop the madness! We can't keep jumping through burning hoops to ensure patients receive 3 hours of therapy, in the most quality manner. And, let's not forget, achieve patient and employee satisfaction too! Sorry, lots of questions--I really value your input and appreciate the time you take to reply to these posts! Lori Stoddart, OTR/L Inpatient Therapy Manager Physical Rehabilitation Services Henry Ford Wyandotte Hospital 2333 Biddle Avenue Wyandotte, MI 48192 734/246-8963 lstodda1@...<mailto:lstodda1%40hfhs.org> Be kinder than necessary because everyone you meet is fighting some kind of battle ============================================================================== Quote Link to comment Share on other sites More sharing options...
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