Diagnostic competencies develop special skills
Diagnostic competencies develop special skills
Interdisciplinary competency programs for special diagnostic populations ensure everyone on the rehab staff at Cedars Sinai Medical Center has the basic skills and knowledge to treat special populations as soon as patients arrive on the unit.
"Therapists and other staff may not have specialized knowledge in every single diagnosis. We needed a faster, systematic way for staff to have access to the resources they need to treat these patients," says Pam Roberts, OTR, MSHA, supervisor at the Los Angeles facility.
Staff have developed a competency program for spinal cord injury and are working on similar programs for stroke, traumatic brain injury, amputation, and chronic pain. "It will allow the staff to start treating patients quicker. In today's health care environment, we have no choice," she says.
Staff at the 32-bed rehab unit are divided into three treatment teams, each of which treats a mix of patients. With the new competency program, when a new spinal cord patient comes to the treatment team, members don't have to scramble for resources. They use the manual to determine needed core information. For instance, the man -ual contains sample letters to insurers to justify wheelchairs. "This is something the therapists didn't have to know a few years ago, but now it's the norm. Now they have a sample that shows the information they need to provide," she says.
The competencies have three components: a self-study guide, divided into specific learning modules; a written test; and a practical competency. Staff are expected to demonstrate each practical skill for their supervisor or mentor then perform it on a set number of patients, depending on skill level. After they've completed the competencies, the supervisor or mentor signs off on that section of the competency checklist.
The competencies were designed as self-study so staff can pace their learning, Roberts says. The time required will vary with experience and skill level. The hospital allots four hours during work time for staff to work on the competencies; they may put in extra hours on their own. Staff must score at least 80% to pass the written test. Those who don't may retake it in two weeks. Staff rotate through the competencies based on their background and the type of patients their team will be expected to treat. An employee whose team typically treats traumatic brain injury patients must go through the TBI competency, for instance.
"We try to make sure all therapists have a basic level of knowledge. That way, if the experienced staff members aren't available, those who are treating the patient have some information and a resource available to them," Roberts says.
To develop the competencies, Roberts and colleagues assembled an interdisciplinary team that determined the needs and goals and best way to attain them. The group met at lunchtime. Partici pation was voluntary and included all staff levels.
"We included people who had little experience treating each diagnosis as well as the experts on the staff. Those who weren't familiar with the diagnosis gave us excellent input on what we needed to teach them," she says.
Creating the curriculum took about six months. "First, we agreed on a format that would be used for all the competencies. We also decided to limit the amount of information. It's not everything you wanted to know about a particular diagnosis, it's the foundation for the treatment of each diagnosis."
[Pam Roberts can be reached at (310) 855-6660.]
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