Strategies to improve the completeness of a system of substitute therapist in a rehabilitation center

Abstract

In a rehabilitation center, every patient needs continuous rehabilitation to achieve optimal treatment effect. However, therapists need to take a rest whenever necessary. Therefore, a system of substitute therapist (SST) is required so that patients can acquire high quality of medical treatment service. Furthermore, the organization can operate normally. However, there is no sound SST. The completion rate of SST was 70.1% in April 2017. The objective of this project was to improve the completeness of SST. This project applied the procedure of task achieving quality control (QC) story to develop strategies to solve the issue. The goal setting was to achieve 90% of completion rate of SST. We developed the strategies by brainstorming and literature reviewing. The proposed strategies included: (1) applying labor-saving treatment (robot-assisted therapy, circuit training, interaction group, self-training); (2) applying ISBAR (Introduction-Situation-Background-Assessment-Recommendation) for hand-off report; (3) implementing auditing system of original therapist and substitute therapist. The completion rate of SST was 93.3% after strategy one (July 2017), 94.4% after strategies one and two (August 2017), and 98.4% after strategies one, two and three (September 2017). Furthermore, the patient satisfaction increased form 3.9 points to 4.6 points (maximum is 5 points). All the three strategies were effective. Therefore, all the three strategies were adopted to formulate standard operation procedure (SOP) for SST. This project successfully improved the completeness of SST through task achieving QC story. The three strategies were implemented in sequence. First, the strategy one was to increase number of patients that substitute therapist can treat simultaneously. Then, the strategy two was to improve handoff communication. Finally, the strategy three was to consolidate behavior change of therapists. The strategies proved to be capable of providing solutions for clinical problems.