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Shifting Rehab Paradigms

Healthcare Management

Published August 19, 2016 12:33 PM by Viktoriya Friedman

The healthcare management world is filled with clinicians. Unlike the corporate environment where most are trained and obtain a management degree in business, the healthcare hierarchy is built on direct care providers. Though direct knowledge of healthcare is a huge asset, most managers, once they transition into this role, do not feel the necessity to grow as leaders. As healthcare is becoming more structured, it is essential for management, including Directors of Rehabilitation and Nursing to be committed to grow as leaders and determined to build effective teams.

The ever-growing requirements of our governing bodies, such as CMS and our professional organization, rarely complement requirements mandated by our organizations. Many times this issue is further exacerbated for Directors of Rehabilitation Services when one works for a contract company with expectations not clearly aligned with in-house policy and procedures.

Most of us have worked for a boss that likes to hear themselves talk, as well as the one that assumes everyone will just self-organize and just “get things done.” As I transitioned from being a staff physical therapist to managing the department, I craved to work for a manager that can also lead. I wanted to learn from that, be inspired and grow as a manager.

Initially, I struggled to find peers in the same positions to bounce ideas off of. Most of them, though great clinicians, were managing therapy minutes and not at all focused on growing and developing employees. I knew how to maximize Resource Utilization Groups (RUG). I really wanted to learn how to lead my team.

With seven successful years under my belt, I would suggest taking the following steps for those managers seeking to train as leaders:

1.      Know thyself. Recognize your weaknesses and have measurable, timely goals to eliminate them. If you know your emotions take over when you strongly disagree with a team member, learn how to minimize the negative effect of adrenaline on your body. In the modern world, some of our most important battles are fought with colleagues and even loved ones. Thus, we need brain power. Not only know what helps you communicate most effectively, but dive into questions such as: “Am a leader or a dictator?” “Do I delegate?” “Do I speak more than I listen?”

2.      Ensure you have great people as your key staff. Know natural instincts of your subordinates and develop them accordingly. Many research-based tests exist, as simple as a work performance questionnaire to Myers-Briggs. Use this set of data to understand your team better.

3.      You must know your stuff.  Just like a project manager for an IT team, DOR and DON must know the specs of their jobs and the jobs of their subordinates. This includes knowing the CMS lingo, guidelines and requirements and knowing how to maximize revenue. If you don’t know, please don’t act as if you do; most of your staff will read through you, and you will spend great effort rebuilding respect.

4.      Have a plan if you want to succeed. What are the goals for your organization, your team, your individual staff members and yourself? Is the goal to start an outpatient clinic in your facility, to reach out to community by providing better resources, to maximize communication between departments? How do you get there?

5.       Focus. Learn to prioritize.

6.      Action is the key to take your achieve your goals. Don’t delay

Ineffective communication among healthcare providers leads to disasters. Studies have shown that lack of effective communication leads to serious mistakes in the healthcare world, yet evidence-based leadership and communication training is hard to find. In fact, The Joint Commission in America has reported that the primary root cause of over 70% of sentinel events was communication failure (1). Moreover, The Department of Veteran’s Affairs (VA) National Center for Patient Safety in America has identified communication failure in healthcare as the primary root cause of 75% of more than 7,000 root cause analyses of adverse events and close calls (2, 3).


In healthcare, effective communication requires a wide range of skills such as assertiveness, active listening, etc.


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