Validate

When correcting an employee's actions or asking him/her to do something different with procedures, correct briefly and validate the other strengths the employee demonstrates. So if I have an employee that leaves early without telling me, my response to him/her would be something like "Hey Diane I need to speak with you. You left early yesterday and didn't let me know...Helen could've used your help because she was overloaded. I know that is unusual for you as you are always so thorough with everything you do - I admire that". Or it might sound something like this: "John you left early yesterday and didn't tell me - don't let it happen again.... hey I like what you did with Henry today...what a difference!!" I don't use the word "but...." because it just erases anything positive that you just said. I also don't lead with the compliment and follow with the correction because he/she will remember the last thing you said longer than the first thing you said. Correct quickly/briefly.. and then validate strengths.

Bottom Line

Don't be too wordy when answering your staff. Use brief and to the point instructions/ answers. When you become too verbose, the person you're speaking to is thinking "I get it all ready" :) A coach doesn't use a lot of words, he gives you what is important and he expects you to use logic/ reasoning skills to figure out the rest. A good director is a good coach... you're leading a team not teaching a classroom. Lead like this and you will earn your team's respect... and you will generate top revenues.

Productivity

Many directors try to hammer the point of productivity into their team members only to find that their financials start decreasing even worse. When you try to "force productivity" you actually kill the mood in the department and instead of using low productivity as an educational opportunity - you've now told your therapists that the only thing important to the company is how much he/she bills. Instead I approach a low productivity therapist with a question.... "I see you busy all day...it's difficulty for me to believe that you're sitting in a chair 4 hours a day doing nothing, yet that's what your numbers are saying". Then sit back and listen to them agree with you giving you the opportunity to help them find the areas they are under billing or ways that they can become better time managers. They walk away feeling good about your view of them as busy workers and a pocket full of ideas to implement that will improve their numbers.

Refusals

Often therapists try educational approaches and ultimately try sending in the business office or administrator to reason with a patient that is refusing. Most of the time refusals are a symptom of executive dysfunctions and should be handled by an OTR or SLP. A therapist must establish rapport before treating a patient with early Dementia or executive dysfunctions. This time of establishing rapport can be documented as "Skilled graded approach to engage patient participation in full therapy plan of treatment". Another goal might read as "Patient will participate in environmental engagement activities 80% of opportunities indep". Those activities that you use to establish rapport can include something as simple as getting the patient his/her favorite soda or something else that is important to the patient. Sometimes you can interact with someone else at the patient's meal table to demonstrate you are trustworthy. Another way is to join him/her at activities and allow the patient to teach you how to do it. Allowing the patient to be the expert in one area, will go a long way to build trust so the patient will be willing to allow you to be the expert in another area. It's about building trust.

Observations and Analysis

I'm always astonished at how little time therapists spend observing and analyzing the carry-over of learned therapy techniques and the strength/flexibility they are working on with the patient. I hear frequently from therapists about how busy they are and how little planning time they feel they have. When I ask them if they spend time during their sessions observing the patient as he/she walks and participates in other activities...all the time analyzing what needs to change in his/her program/goals...the therapist always stares at me blankly. Sometimes we forget that our most important skill is our ability to analyze abilities and plan a skilled treatment plan.

Let's Share Information

With all of the many changes in the Sub-Acute therapy setting, everyday duties can appear overwhelming at times and confusing. Feel free to ask questions, give advice, and hopefully as we share information our jobs will become easier. This blog is for therapists, directors of rehab, MDS Coordinators, and anyone else that is involved in therapy in the SNF setting. Welcome!

Introduction

I am a Speech-Language Pathologist with over 20 years of experience. I work for an amazing company; Transitions Rehab as a Clinical Educator. I have worked in nearly every facet of the Sub-Acute Rehab world and still learning something new everyday. I've worked all over the country and the therapy world is smaller than you might think. We all have similar frustrations, but fortunately we all have different strengths which we can share to make our careers more successful and less challenging.