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by Curtis A. Merring, DOR, Wellington Place, Temple TX –

Professionals and administrators in any rehabilitation setting need intrinsic motivation to pursue evidence-based treatment strategies to stay ahead of market adjustments and reimbursement trends. In our current healthcare system of cost-cutting and cost-saving payers such as Medicare (the lifeline of skilled nursing facilities), it is only a matter of time before regulators request from facilities quantifiable results of treatments. Active participation in this process, including preemptively taking these steps, will put any organization or facility at an advantage.

In my experience as a therapist, it has been rare to witness therapists who review current research when planning their treatment strategies, and current trends show no remarkable change in their approach. This is problematic for both established therapists and new graduates entering the field. Therapists in the field are used to the status quo of not integrating research or evidence. New graduates, equipped with the newest evidence- based treatment strategies and the know-how for obtaining this information, come into a field that is dominated with non-evidence-based practice. As clinicians with the least experience, they are challenged with implementing research-based treatment among the norms of existing therapists, not to mention many superiors who have routinely practiced non-evidence-based practice. Shifting the paradigm will require a change in our culture.

At Wellington Place Living and Rehabilitation, our staff has accepted the challenge of integrating evidence into our practice. The rehabilitation department actively engages in addressing the above stated challenges in the following ways. First, all disciplines have at least one evidence-based outcome measure they are responsible for using, tracking and reporting on to objectively measure progress in addition to and in support of less objective functional level measurements (e.g., Min A, Mod A). Next, a relationship has been established with Texas State University through my current collaboration and consistent, open dialogue regarding new treatment strategies and proven innovations in practice. Also, all therapists are encouraged to attend courses with strong evidence-based, progressive topics and present on them to the whole staff upon completing the course. Applying these steps in order to increase evidence-based practice in our department has increased accountability for both the staff and me. In return, we have been able to provide a better service rooted in proven rehabilitation strategies.

by Jessie Dees, DOR, Willow Bend Nursing and Rehab, Mesquite, TX –

For months now, I have wanted to sit down and type up this article to share my thoughts and reflections on Willow Bend’s Rehab Department. I have been here for 15 months, and looking back, we have come so far. I walked into a department that was struggling to maintain a caseload and keep current on paperwork, while also considering an addition to the building that was a concrete slab and wood studs. Today, our department is quickly growing with team-oriented therapists and techs. Our long-term, short-term and outpatient caseloads continue to expand faster than any of us ever imagined. The timeliness of paperwork completion is much improved through numerous systems we have developed, implemented, and continue to modify. We have improved our presence within the building and in the community.

On January12 of this year, we accepted our first patient into “The Lodge,” our newly renovated Rehab space. We were all excited at the future possibilities and secretly anxious about the unknown. The Lodge has been a great learning experience filled with indescribable opportunities and lots of “growing pains.” As a physical therapist and a Director of Rehab, this opportunity is a dream come true. I am truly grateful to be able to work with a staff that is team-focused and willing to go above and beyond to provide quality treatment to patients. The facility is likewise a therapist’s dream and allows us to expand our creative therapy minds to focus on individualized care. Our therapy courtyard is both functional and provides entertainment and serenity for our patients. The state-of-the-art gym and equipment are exciting for both patients and therapists. The Lodge also has a full-functioning ADL apartment. It provides a great opportunity for patients to perform home tasks in a safe environment and to allow therapists to assess that the tasks are safe and that the patient is truly ready for a safe discharge home.

We accepted our first outpatient this past week with hopes of developing a truly successful outpatient department, not merely a SNF that offers outpatient care. I know that there will be challenges in the development of this program, but I am looking forward to continuing to grow with my team as we forge on into this new area.

It is important to acknowledge and thank all of the other departments at Willow Bend. They have supported the rehab department and have grown with us. Kevin has been nothing but supportive of our department from Day One. We tackle “bumps in the road” together, and while we might not always see eye-to-eye, we are always passionate about our patients and the care we provide.

I am truly excited about our future as a facility and a department. I know there will be long days ahead, some filled with headaches and others with laughter. I am confident that we will continue down the path together, keeping our patients’ best interests at the center of our thoughts, driven by our desire to continue to provide excellent service to our patients, their families, our employees and the community. If you ever find yourself in the Dallas area, please stop by and visit us. We would love to meet you and show you around!

by Jesus Rodriguez, OT, Grand Terrace Rehab and Healthcare, McAllen, TX –

Getting an education can be a challenging experience for many. Imagine adding other factors to the equation, such as family and full-time employment. This can make it difficult for those who work and attend college to be successful in achieving that goal. In addition, many believe that the traditional route of getting an education going from high school straight through college still exists. However, this is not true. Many students are now obligated or choose to work in order to pay for school or to avoid loans. Furthermore, not everyone chooses to go to college after high school or complete a higher education at once. This is true for me.

My road to getting an education has been a journey. I graduated from an occupational therapy assistant program in May 1999 and initiated my practice shortly thereafter. After a few years off, I received a second associate’s degree in interdisciplinary studies in 2004. I took some time off to allow my wife to attend college and get her degree, and then I started school again on a part-time basis, wanting to continue my education but not knowing in what discipline. I finally chose to go back to OT school and earned a Bachelor’s Degree in Health Service Technologies in 2008. In 2009, I initiated the COTA to MOT bridge program at Texas Woman’s University in Denton. I am graduating this year and with great feelings of relief.

The process of continuing your education can be a tedious and challenging one, but it’s well worth it. It starts by ensuring that you have the self-discipline, self-motivation and determination to start and finish what you undertake. It also takes much planning with your family in order to ensure that all the finances, roles and family responsibilities fit in with this venture, and that everyone is willing to sacrifice themselves and understands what is about to happen. Remember, you are not doing this alone if you’re married and have kids; your family does it with you.

After you’ve finalized your decision of going to school, the second step is to gather the information needed to apply to the program such as requirements for application, the application process, and information on the process of completing the educational and clinical coursework. Thereafter, once you are accepted into the program, take time to organize your work, family and school life and prioritize the times allotted for each in order to succeed in the different roles you will have to assume. As for me, after many years of hard work, long work hours, late nights, sports practices and games, white hairs, and four kids later, I am finally DONE!

By Eileen Smith, DOR, Paramount Health & Rehabilitation

This past September, Milestone had an opportunity that was the first of its kind in Utah. The University of Milwaukee sponsored a 5-day lymphedema course in Salt Lake City, UT. In this course, we learned about the lymphatic system, different methods of wrapping and “Massage for Lymphatic Drainage” (MLD). As we all know, the lymphatic system is a complicated but delicate system that can be obstructed by a simple injury, certain diagnoses or surgery of any type. Through this course, we were able to problem-solve and learn different techniques to address these issues from start to finish, beginning with MLD, to lymphedema wraps, down to a compression stocking that will assist in increasing the patient’s quality of life. Along with our course instructor, we were able to learn from our own Milestone member, Mary Egbert, DOR, Draper Rehabilitation, the different techniques and problem-solving she has experienced from taking this same course a few years earlier. After 5 days and an intense case study presentation, we were all certified in lymphedema.

The training did not end there! We had participants from seven of our facilities (Draper, Provo, Orem, Copper Ridge, Paramount, St Joseph, and Arlington Hills) that included therapists, our Wound Nurses, and our Wound Physician who supports several of our facilities. We also had several community therapists participate, which provided a great opportunity for us to intermingle. After the course, we exchanged emails, etc., and have all kept in touch to either assist in problem solving different methods or ideas on patient care or share success stories.