Growing a Program
It's not like you can plant some therapists in a gym and suddenly the department is busy. To adequately have a therapy program develop into the future, the way business is conducted today has to change. When looking at more cuts in reimbursements, hiring another person doesn't seem logical, but it is.
A good PT aide will get patients up and ready and will have the patient in the gym as you walk through the door and clock in for the day. If therapists are scheduled to come in a half hour apart, the PT aide will have the first person ready to work as the next therapist walks in the door.
And each successive patient will be promptly ready to participate while the therapists waste no time in the gym. If all goes according to plan, therapist productivity will increase because they won't have to locate the patient, get multiple refusals, talk to three nurses to medicate each patient, and locate linen and clothing items.
To grow a program, you also have to let some people go. One therapist can deflate the morale of the whole department with negativity. Letting the person go is a difficult decision; however, if a therapist is negative maybe the place he is now is not the best setting for him. By freeing him to explore other options, maybe he can become happier.
If a facility is actively involved with all things therapeutic, there should be no end to referrals from nursing staff. OT and ST referrals should be apparent with dressing, bathing, eating and swallowing pills on a daily basis. Nursing staff should be addressing these issues and asking for orders if a patient has any apparent change in status. For PT, every fall should get a referral. Every patient who has ended up on the floor, whether from a staffing error or an attempted self-transfer, should be seen by the movement specialists, us.
If there hasn't been a referral from nursing in a week, something is wrong. In a SNF there are numerous missed opportunities for therapy to intervene to prevent falls and improve ADLs, thus helping nursing reduce the amount of assistance needed to transfer patients and get them ready for the day. Not every referral will be appropriate but that's why we are paid so well, to make clinical decisions based on a patient's functional limitations.