Even during normal times, it can be challenging to manage occupational therapy within a healthcare facility, to say the least. Effectively deploying this essential component of healthcare everywhere it’s needed — from rehab facilities to home health virtual visits to, increasingly during Covid-19, hospital ICU units — is enough to keep OT leaders and managers with their hands full.
During a global pandemic that’s brought huge transformations to care delivery in general, it’s even more of a challenge. Yet with recent mandates to expand the practice scope and insurance coverage of occupational therapy, there are also opportunities to make the benefits of OT more readily available to patients. (The CMS has recently expanded coverage of OT delivered via telehealth and home health.)
Amid these changes, how can OT leaders best prepare the delivery of occupational therapy within their facilities during the months and years ahead? And how can we make sure that the OTs and OTAs who deliver these essential services are kept happy, healthy and effective in their work?
As part of Occupational Therapy Month 2021, we’re taking a moment to explore some of the solutions to these questions. At CareerStaff Unlimited, we’ve been in the business of the recruitment of occupational therapists for decades, along with a range of other allied and nursing professionals, and we’re happy to share that direct experience with the nation’s healthcare managers and OT leaders.
4 Strategic Tips for OT Leaders
Tip #1: Show understanding for overworked, stressed-out therapists. It’s never been a more difficult time for the nation’s occupational therapists. During Covid-19, they’ve been meeting their mandate for patient care in new ways, some of which go beyond the scope of their original duties.
Occupational therapists have played a major role in Covid-19 recovery. Building “early mobilization” for critical ICU patients who have sometimes spent weeks in bed and/or on ventilators is a key part of this process. Over the past year, this task has often been carried out by OTs volunteering to work with high-risk patients.
Because occupational therapy has been a critical part of Covid-19 care, OTs are susceptible, like the nurses and doctors on the front lines, to side effects like burnout, compassion fatigue and extreme stress. You can learn more about the signs of compassion fatigue, and how to deal with it, here.
Exercising understanding towards OTs facing these kinds of challenges will go far toward ensuring they deliver the highest-caliber care that they can. Providing extras like time off or family leave with the use of temporary OTs can help keep morale and productivity high. It’s also a good idea from the perspective of preserving mental and physical wellbeing of your team of occupational therapists.
Tip #2: Leverage occupational therapy to extend patient care — carefully. If the Covid-19 pandemic has had any positive effect, it’s in revealing new skills and capacity of versatility for clinicians. Though not the most ideal of conditions to work under, the new challenges and even settings available for OTs will no doubt be critical tools for career development.
For instance, one occupational therapist in Nebraska found that her expertise in lymphedema was of unexpected value for treating Covid-19 patients. As explained by the Fremont Tribune, though she jumped at the chance to help fight Covid-19 by helping ICU patients physically recover from the effects of the virus, she was not completely prepared for the experience.
“To come in, in the morning, and find out that one of your patients that you’ve worked with a lot has passed — and that happened every single day — that is emotionally fatiguing,” she said. “Nurses are trained in school about dealing with death and dying,” she said, “but that was really new to us in the therapy world.”
But though difficult, new experiences of this nature can offer the chance for clinicians to advance their careers in new directions and gain experiences that they might not have otherwise — such as ICU work. Many facilities have also used OTs to help treat other side effects of Covid-19, like the dementia that can sometimes accompany the isolation and intensity of Covid-19o recovery for some patients.
For leaders who need to leverage the skills of their occupational therapists towards other avenues of care, it’s essential to make sure it’s done in a way that’s helpful and clearly communicated. As much as possible, this work should be voluntary and include the chance to engage with therapy and support services. For guidance, you can find out about our own Covid-19 policies and resource system here.
Tip #3: Get ready for more integrated telehealth services. Even as therapists have stepped up to help out in ways that go above and beyond the normal scope of their duties, so too have the uses of OT itself expanded in other ways as a result of the pandemic. Most immediately, the CMS has implemented policy changes to expand insurance payments for occupational therapy delivered via telehealth or virtual technology.
It’s a provision that’s long overdue, according to the American Occupational Therapy Association (AOTA). Even before the pandemic, the group worked “to promote permanent telehealth coverage for other payers, such as commercial insurance, large employers with self-administered insurance plans, and targeted state Medicaid plans,” as the authors of a research article published in the American Journal of Occupational Therapy have pointed out.
In that article, the authors also point out the role OTs are likely to have in helping shape a forward-thinking strategy for how we respond to “future health care crises,” noting that efforts are currently “underway to continue the waivers described earlier that allow occupational therapy personnel to have more flexibility across different settings.”
The current provisions may be emergency measures put in place to help treat Covid-19, but they could well become standard operating procedures to accommodate the shift to remote and virtual therapy. The pandemic has already revealed the need to integrate digital services throughout healthcare organizations, and during OT Month, we should remember that occupational therapy is no exception.
Tip #4: Re-think your strategy with occupational therapy going forward. It isn’t just the parameters around telehealth that’s changing in the management of occupational therapy, but many other aspects of OT delivery, as well.
As the AJOT authors point out, the CARES Act loosened requirements around inpatient admission standards for rehab, allowing for waivers that “gave permission to provide and charge for telehealth occupational therapy in outpatient and institutional settings” and allowed OTs “to open home health cases and conduct the start of care for home health agencies, and granted occupational therapy assistants the ability to perform maintenance therapy in outpatient settings.”
The changes caused by the pandemic present significant opportunities for expanding the use of occupational therapy, which could potentially improve care workflows and even general patient outcomes. They also offer valuable lessons for the future: “Although COVID-19 is the current public health crisis, others will occur in the future,” warn the authors of the study.
What does this all mean in practical terms? Just as for every other type of clinician, the pandemic has forced a re-evaluation of basic safety and efficiency, and other aspects that have gained much greater importance over the past year. To that end, the AJOT authors recommend to revisit the policies and workflows that involve OTs to ensure the best possible delivery of patient care.
To successfully achieve this, the authors recommend that leaders:
- Stay flexible and fluid in your approach to staffing and scheduling.
- Make sure you’re communicating frequently, and that your clinicians understand any updates and changes to policy that affects them.
- Support staff members and give them options to maintain their wellbeing and resiliency in a stressful environment (we have some specific tips for this here).
- Leverage the expertise of OT practice foundations like AOTA to guide best practices (you can find AOTA’s Covid-19 resources here).
Happy Occupational Therapy Month 2021 from CareerStaff
A good first step in meeting the challenges facing OT leaders in the future is finding with the right healthcare managed services provider (MSP). When you partner with a healthcare MSP with a presence across the U.S., you’ll have access to a larger pool of candidates than you might find locally. In addition, you’ll get the chance to hire travel professionals from other cities or states, giving you more opportunities to find — and hire — exactly who you’re looking for.
At CareerStaff, we’re proud to connect the nation’s most qualified occupational therapy professionals with the facilities that need them. Find out how we can help you meet your workforce needs: Contact us today to set up a free consultation.