Recharging the Rehab Team: Strategies to Improve Team Care and Patient Outcomes #3207

INSTRUCTIONAL COURSE DETAIL

SUN, 25 OCT: 8:00 AM – 12:00 PM

SPEAKERS

Dale C. Strasser MD; Professor, Depart of Rehabilitation Medicine; Emory University Medical School; Atlanta, GA

Jay M. Uomoto PhD; Neuropsychology Postdoctoral Residency Program; VA Northern California Health Care System; Martinez, CA

Suzanne Penna, PhD; Neuropsychologist at Emory University, Atlanta, GA

Barbara Bates MD; Associate Professor, Department Rehabilitation Medcine; State University of New York - Albany NY; Albany Veterans Administration Medical Center.

DIAGNOSIS

Brain Injury, Stroke, Technology

FOCUS

Training/instruction in new knowledge/skills (attendees will develop new competencies that can be applied in practice or research)

DESCRIPTION

This course teaches participants to analyze rehabilitation team functioning (TF) and to utilize these insights to develop site-specific action plans to improve team services and patient outcomes. After an introduction to the Team Effectiveness Model and Research Program, participants working in small groups will analyze the underlying TF issues of common problematic situations such as poor carry-over of therapy skills to the nursing unit, splitting of staff by a patient or family member, and a physician with suboptimal engagement with the team approach. The course builds on TF and skills training research by the faculty.

ABSTRACT BODY

Inpatient rehabilitation services are experiencing unrelenting threats – funding, staffing, documentation burdens, and restrictions on lengths of stay and admission criterion. These issues distract from direct patient care and the work of the interdisciplinary team. In this workshop we reexamine the interdisciplinary team with the purpose of understanding and improving rehabilitation team functioning and hence patient outcomes. Participants in this course learn how to analyze team functioning and to utilize these skills to develop your own site-specific action plans to improve team services and patient outcomes. In more general terms, this course strives to be a “back to basics” forum to recharge rehabilitation providers on the team approach and provide participants with skills to improve team effectiveness.

Through our careers, most of us experience an array of its’ teams. Some teams are more effective than others, and some teams are better in particular circumstances than others. We know good teams when we see them, but lack standardized ways to optimize team care. This workshop builds on our experience in the VA Rehabilitation Teams Project (Merit Review Grants B2367R, 03225R) and related work to engage participants in the evaluation of common problematic situations on an IRF team and to development site specific action plans.

The course is divided into three sections. We begin the first section with a brief description of clinical vignettes and a review of the literature in team care and patient outcomes.   The four vignettes illustrate common challenges in team care such bladder management program, splitting of staff by a patient or family member, poor carry-over of therapy skills to the nursing unit, and a physician with suboptimal engagement with the team approach. A systems model of rehabilitation services, the Team Effectiveness Model (TEM), is offered as a tool to evaluate team functioning and structure interventions to improve services.   In the second part, participants work in small groups to evaluate vignettes and develop action plans to improve team functioning. The findings are presented to the larger group for further discussion. In the third part, participants have the opportunity to present their own vignettes for analysis and development of process improvement plan.

Participants are invited to submit specific questions and challenging situations beforehand, and these will be incorporated into workshop.

LEARNING OBJECTIVES

  1. Critique evidence linking Rehabilitation Team Functioning (TF) to patient outcomes.
  2. Analyze the dimensions of TF in problematic clinical scenarios.
  3. Critique the utility of the �¢ï¿½ï¿½diamond�¢ï¿½ï¿½ (and the domains of Leadership, Managerial Practices, Social Climate, and Professional Networks) to analyze clinical situations.
  4. Develop action plans to address specific clinical issues with respect to TF.
  5. Discuss the measurement of TF as part of rehabilitation QI.

BIO SKETCHES

Drs. Strasser, Uomoto, and Stevens developed and implemented the team training intervention as part of a successful cluster randomized clinical trial in process improvement in stroke rehabilitation funded by the VA Rehabilitation Research and Development Merit Review Program. The core of the intervention in this trial was a staff skills training workshop. The course described here builds on this workshop. In addition, Drs Strasser and Uomoto have adapted the material to other settings including workshops for Kaiser Permanante (2012), the National UDS Conference (2013), and the Albany VA Medical Center (2013). The larger research project has shown that rehabilitation teams can be modelled and studied, that measures of team functioning (TF) are valid and reliable; that TF measures predict team cohesiveness and key rehabilitation outcomes; and that such measures can guide a successful team training intervention which correlated with improved patient outcomes. Currently, we are examining the utility of team functioning measures as process indicators in rehabilitation QI. We recently published an exploratory analysis from the national clinical trial data that TF measures tracked patient outcomes over a one year period of time. Issues of the role of teams, team functioning, and TF measures in contemporary rehabilitation will be discussed in context of the specific issues in this course.

Dr. Bates is a senior clinician and clinical researcher with the Albany VA Medical Center. She has participated in multiple workshops with Drs. Strasser and Uomoto. She will serve as a group facilitator and provide expert commentary.

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One full day of Instructional Courses $195 Three full days $395

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*Although significant changes are not anticipated, all schedules, sessions, and presenters posted on this website are subject to change.

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