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Submitted by Jon Anderson, DPT, Therapy Resource
“KO Let’s Go, Let’s Go KO!” This is the rally cry at Keller Oaks in Keller, Texas, and it is a commonly heard anthem when you visit the facility. In a year that has been difficult at best in healthcare, the culture has done nothing but improve at Keller Oaks. When you look deeper to see what is in the air at Keller Oaks, it goes far beyond COVID.

Kristin Ryther, the therapy program manager at Keller, has been a breath of fresh air in a very trying year at a facility that has been hit hard by COVID on multiple occasions. We asked her to share a bit of her best practices and were blown away by what is developing there.

Starting with onboarding, Keller embraces culture by conducting group interviews and hiring only those people who the team agrees can be grown into great leaders. They agree on all hires and then make sure that the process does not stop there. According to Kristin, “Love is in the details.” She ensures that the new employee is greeted with everything that they need to be successful. She has their log-ins ready, an itinerary for their first day, and a team member assigned to them as a mentor. Kristin provides them with a bit of “swag” and has a ready-made reference form entitled “KO NEED TO KNOW” that includes everything from door codes to restroom locations to documentation tips and PCC locations of interest.

Culture at KO does not stop at onboarding. The team meetings incorporate music and moments of gratitude. Kristin has become a champion of championing others. She works to identify strengths in each of her team members and then assigns responsibilities appropriately. Each member has a strength; slow down and find it! It may be that they have special attention to individual treatments; they may be strong at scheduling, growing programs, or even leading the infection control of the gym. List them out and recognize them.

Ensure that you are communicating everything to your team. Utilize dry erase boards, address at team meetings, keep up-to-date information in binders. Use all means necessary to ensure that your team members have the communication they need to do their best work! Don’t forget to prioritize individual communication. Get to know your therapists and be transparent as well as approachable. Don’t be afraid to just listen and allow them to be heard.

Set clear goals and expectations. Kristin sets goals for “2 week sprints.” Some programs are short projects. She assigns a leader and assists with facilitation but allows for teamwork so they meet their goals. She posts the sprints on the communication board, writes about it, takes pictures and then celebrates it. Short-term goals like this make it manageable, and then the challenge is less likely to be pushed off down the road.

Celebrate the wins! Find the team member who loves to do this and assign it to them. Celebrate the day-to-day achievements and find 10 positives for every negative. Make sure the team feels appreciated and celebrated.

That is not to say that there will not be challenges. There will always be hurdles. When that happens, keep your positive vibes on! Start with yourself, and look in the mirror. Stay consistent. Be transparent. Don’t expect others to do something you wouldn’t do yourself. Hold them accountable after you have asked yourself, “Did I educate? Did I communicate? Did I reinforce?” Maintain accountability and expectations, but never be afraid to give each other grace. Most importantly, be yourself! Your team will recognize the authenticity and appreciate the transparency. Let them know it is okay to enjoy your work and have fun while you are doing it!

By Patrick Amar, DOR/PT, Mountain View Rehabilitation & Care, Marysville, WA
Here at Mountain View, we’ve experienced close to 100% facility staff vaccinations, and attribute our success to a couple of key reasons: the scars left on our minds and hearts as we reflect back over the past 13 months that we never want to repeat again, and communication, communication, communication. Looking back, we never thought the virus would hit so close to home. We heard about it in the news from China, but that’s a world away. We were taken by surprise when the first case of COVID-19 in the United States happened here in our backyard in January 2020. Shortly after, the first outbreak also happened in our area; it was just across the county line. Suddenly we were thrust into the epicenter of the virus, and it seemed the whole world was watching how we managed.

We quickly saw the virus spread in a nearby facility, then in another facility, and then in our community, like an uncontrollable wildfire. In June of that year, it finally came on our doorstep. We knew it was just a matter of time. I think the only positive thing about this pandemic is that it brought our team together even closer. We’ve seen the impact that the virus has had on our patients — their health, their emotions, their psyche and not just them, the family members, too, and the staff. This was the main reason why our staff was so determined to do something about this pandemic by way of getting vaccinated.

Another factor in the success of our vaccine rollout was having good education and communication from the get-go. Once the news of the vaccine was even hinted at, Clayton, our ED, was already preparing the staff for its arrival. Information quickly disseminated from the IDT to floor staff. We knew people would have questions, concerns and even doubts. Educational efforts ensued in huddles, staff meetings and therapy meetings. Even our medical director was involved in the education.

I’d also like to thank our clinical partners for the research and the materials provided for our educational efforts. It helped, too, to hear support for the vaccine not just from us, the IDT, but also from other specialists and healthcare providers who are experts in their field. Questions were welcomed freely and answered objectively. I really believe that our staff understood the common goal. The communication and education, coupled with what we’ve been through, were the driving factors of this success — for our patients, our families and our community.

By April Trammell, SLP, DOR, Beacon Harbor Health & Rehabilitation, Rowlett, TX
Jimmy arrived at Beacon Harbor on April 13, 2020. He was in a very devastated state following a spinal fusion, which was compromised, leaving him with hemiparesis from the chest down. Because he was unable to feel his legs and feet, he was having frequent falls, required a hospital bed with assist rails in order to maneuver in and out of bed, and was wheelchair-bound. “I was brought to Beacon Harbor for my last days on earth to be comfortable and to give my wife Dianne a respite.”

Plans for Jimmy were to transition here to Beacon Harbor long-term care. But Jimmy had other plans in mind. He was successfully determined to wean off of all pain medication. “Then I started doing therapy — that wore me out — but I had it in my head that I wanted to recover.” Jimmy and his team of therapists were determined to help him gain his independence. “Day after day, week after week, I started improving not just a little bit — a lot! No explanation ‘why’ except my therapy and my willingness to do what is asked of me. They have challenged me on so many things, and they are holding me up, allowing me to improve.” He progressed to being able to transfer independently in and out of bed, and to be able to complete basic self-care such as dressing, bathing and toileting independently. “I feel like I am being rebuilt. There’s something about this place that draws it out of you.”

Jimmy and his therapists continued to focus on neuro re-education, and he slowly began to regain full sensation in his body. “I am able to feel hot water and take a hot shower for the first time in over 35 years!” He did not give up; Jimmy continued to thrive in therapy and began walking with a walker for the first time in 10 years. “I started taking control of my life slow, but every day it was a very hard road to walk down — for myself, for my wife and family. I would say Beacon Harbor is just one of the best rehab centers that I’ve ever been in in this nation, and I have been in quite a few from state to state over the years. The bottom line, Beacon Harbor: You have an amazing PT, OT, ST and Nursing staff. I’m getting ready for my second phase of taking my life back. I’m going to move into assisted living, and from there, back home. Thank you for a second chance at life.”

By Paula Voorhis, PTA, DOR, Englewood Post Acute & Rehabilitation, Englewood, CO

In recent weeks, Englewood Post-Acute and Rehab has been handling the COVID outbreak with as much grace as possible. I just wanted to take a moment to share some photos of our celebrations of success.

This is our first group treatment since October, which is when we went into full lock-down, outbreak mode. It was organized by two of the most compassionate therapists I know, Emily White, PTA, and Wendy Garrison, OTA. The residents had a blast!

This is Ron; he was in a catastrophic car accident in 2019, which brought him to us. He received prosthetic training and was set to go home in early November, when he tested positive for COVID. Plans to DC home were postponed, but he made it, and has made it back home to Nebraska.

This is Jessica, the Clinical lead and head cheerleader for team Ron. We all cried like babies when he finally went home.

 

 

 

As a compromised patient, Glenna should not have survived, according to all our knowledge of the virus, but she did. What a happy day it was to move her off of the COVID wing back to her own room.

This was our very first survivor. She didn’t even know she was sick and was happily confused about all the fuss we were making over her. We are all truly thankful for the opportunity to celebrate with her. (photo of thankful I beat COVID)

While we all have the heartbreaking stories we carry in our hearts about those who didn’t make it, and the effects of long-term isolation and burnout as we care for our people, it remains good practice to reflect on joy and the many successes we all share to move forward. It is powerful medicine for the wounded and heart-sick amongst us.

By Paul Emerson L. Baloy OTD, OTR/L , DOR, The Hills Post Acute Care, Santa Ana, CA

Denise Del Cano, COTA, ADOR, has dedicated her career in The Hills Post Acute. An alumnus of Santa Ana College, she earned her associate’s degree in Occupational Therapy Assistant 12 years ago and has been with the facility since then. She was promoted to Assistant Director of Rehab last year and completed the DORITO program this year. Denise did her internship here at The Hills. She was supervised by Vonda Gaier, COTA, who then became her colleague. She is a Filipino American born in Los Angeles, California, the eldest of five and a loving mother to her 16-year-old daughter, Elizabeth. Interestingly, Denise was introduced to the field of therapy when her daughter received therapy for several years. Denise saw the importance and relevance of Occupational Therapy and has been an advocate ever since.

Customer Second: Residents approach her knowing that she will listen and immediately respond to their requests. She will ask any of our facility staff how well each one is doing and how she can assist them to make their day better.

Accountability: She assists her supervisor in creating daily schedules and follows up on department needs and requests.

Passion for Learning: She is seeking ways of learning new things, being receptive to new information and understanding, and embracing the Hills Post-Acute way of doing things.

Love One Another: She genuinely cares for the staff. She will hand you a cookie or any treat to perk up your day.
Intelligent Risk Taking She will listen and learn our new way of doing things. Willing to unlearn past habits, think outside the box and develop better and efficient new systems.

Celebration: She will bring in breakfast or lunch to celebrate the day’s hard work, keeping each one’s morale in check and in good shape. She will celebrate birthdays or becoming a new member of the team.

Ownership: She demonstrates ownership by making everything personal because she believes in her heart that this is her second home and that her co-workers are her family.

By JB Chua, DOR, Summerfield Healthcare, Santa Rosa, CA
October 9, 2017, and September 28, 2020 two dates that are significant to Summerfield Healthcare Center. These are the days that we, the Summerfield family, had to evacuate our patients out of our facility and send them temporarily to another place that is not their home. Their limited choices were either in a relative’s home, another skilled nursing facility and worst, evacuation centers. These were definitely one of the most stressful events that Summerfield had experienced. Staff worried about their homes, patients worried about their safety and patients’ families worried about their loved ones. The sky seemed to empathize with the situation with its gloomy hue and the air felt like a snake coiling around your body making it so hard to breath and the smoky air threatens to cut off your oxygen. Definitely not something anyone wants to experience during their lifetime.

As we received the orders to evacuate, text messages and phone calls started to flood my phone. Messages that even I, who holds my team to a very high standard, was surprised to receive… “I’m on my way and Schuyler (my OT’s boyfriend) also wants to know if he can help.”… “Michael (my PT’s fiancée) and I will be there in a little bit.” and many more similar messages, there were some of my staff who were evacuated, on vacation and have younger children who came in to help. Literally, all hands on deck. As the evacuation progressed, each and every patient was assisted in getting dressed and back up on their wheelchairs, we served them breakfast and helped some residents eat, some helped them back to their room to use the bathroom, the therapy room was converted into a calming room where we played soothing music on our phones (power was down so we were not able to use our therapy music player) and some staff were trying to re-assure our residents that everything is going to be fine, even though there were some doubts if it really was going to be. When the transport arrived, we started to roll our patients out towards a safer place. Even with worried hearts and uncertainty, the staff continued to re-assure our patients, waved them good bye and told them that they were going to see them again when everything was all over.

October 19, 2017 and October 4, 2020 two more dates that will be remembered as well, not because of any tragic event, but because of what these dates unconsciously signify to each and every individual at Summerfield Healthcare Center. It signified opportunity, growth and most importantly hope. Opportunity for each one of us to hit the reset button and start anew. The building was deep cleaned by the staff members, from therapists, nursing, administration, you name it, and you got it. Each and every single one looked for opportunity rather than focusing on the misfortunes and tragic events. Growth was experienced from overcoming challenges such as having to go to another facility to help out with our residents, finding new ways so that we can still provide for our residents and staff even when our resources were not as readily available during normal times and finding a new homes for those who had lost theirs. Lastly, hope; hope that everything we had gone through this year was fully addressed so that we will be better prepared both physically and mentally should these type of events happen again.

As I write this article, there are multiple times that I have had to hold back my tears, not because of sadness but because of how I was humbled with what I had seen and lived through. It reminded me of a saying about how a person’s character will really show up during tough times. On behalf of the therapy team I observed my therapists showing great devotion to our patients and to our facility. They were there from evacuation, helping other facilities, cleaning up the facility and welcoming our patients back. During these difficult times I was mostly impressed with the support they gave each other. I have read a lot of success and inspiring stories that gave me chills as I read them. Having to experience one, is quite overwhelming and humbling. Every now and then, even before this experience, I would send a message to my therapists that I am proud to be a part of our team. As I sent another message to them, after we received the announcement that we can get our patients back in our facility, those same words felt insufficient to really express how I felt. I know deep in my heart, that if the same thing happens in the future, Summerfield Healthcare Center will rise to the occasion once again, because that’s who we are.

By Milena Milenkovic, OT/DOR, Park View Post Acute, Santa Rosa, CA
I was at home, in my pajamas, when I got the text message from our DON on Sunday 9/27 at 11pm, “We need all hands on deck to prepare packets for the potential evacuation.” I slowly jumped out of my bed and headed straight for the espresso machine while my partner read Twitter and Nixel alerts aloud regarding the location of the fires, direction of the winds, and latest evacuations orders.

When I arrived to Park View around 12:30am, the power was off, the building was running on a generator, several members of our leadership team were already busily doing various prep work while the rest of the building was quiet, patients and residents sleeping, nurses and CNAs attending to their tasks. While making copies of patient’s charts in our long-term section, I heard various residents snore, some waking up from sleep, asking for help, and hearing CNAs quickly attending to the resident, comforting them from a bad dream, helping them fall back asleep.

Soon enough, it was nearly 4am and I found myself taking a quick nap in the middle of the therapy gym, listening to the NOC shift sounds of med carts, occasional call lights, and staff’s footsteps. I anxiously napped, waiting for 5am so that I can send a text to my therapists. I worried about what to say to them, worried about those that had to evacuate, worried that many may not show up, that this is just too much, and that we may not have enough support in the morning if we had to evacuate. As 7am rolled-around, the shift-change happened, all my therapists showed up (some much earlier than usual), more staff rolled-in, and our building came to life. As our sister facility, Summerfield, started evacuating, it was our turn to continue “cold-calling” all SNFs within the Bay Area to ask them to accept our patients in the case of evacuation. Ash was falling from the sky as we secured beds for all of our patients. We were ready.

By 2:30pm on Monday 9/28 (32+ hours of being awake), after a near fall from exhaustion and pizza for breakfast, I knew it was time to go home and sleep. The sight of so many alert, awake, kind, calm, and composed Park View staff showing up in the morning brought the comfort, sense of security, and sense of overwhelming connection that we would OK, no matter what. Everyone became a leader by supporting one another, one hour at a time.

During these times, it has been so difficult for many of us who are unable to see our families and close friends. Some of our families and friends live in places that we cannot travel to, some are part of the vulnerable population, and some are no longer with us on this Earth. While napping in the middle of the gym, listening for evacuation alerts, hearing the flow of the NOC shift, I felt a sense of gratitude and acceptance that this, Park View and its staff and what we do as a team, is my family and this is where I am meant to be. That moment of exhaustion combined with team unity, trust in others, and the sight of our staff leading with patience and love is what I always look back on when I need a reason to continue fighting through the challenges that continue coming our way. Together, one day at time.