“There is nothing wrong with change, if it is in the right direction.” -Winston Churchill
Without a doubt, we are in a season of significant change in the post-acute care profession. Naturally change unearths fears and can create distrust, but it can also bring about great opportunity. The clinicians and colleagues I interacted with at ASHA 2019 (American Speech-Language Hearing Association) were hopeful about these opportunities. They are engaged. They are seeking to continuously improve. They are interested in putting more tools in their tool belt to help them navigate PDPM and PDGM.
On a national level many are embracing these changes but are afraid of what their futures may look like or feel uncomfortable with the lack of input in they might have in care planning for patients. Some are encountering schedules or non-patient centered decisions which have caused them some ethical concerns. Some SLPs in home health are being asked to expand the services provided in their visits with patients to include unfamiliar tasks that may be outside of what they see as their clinical scope. Providers, from contract therapy companies to skilled nursing facilities, need to listen to clinician’s concerns and celebrate their successes.
Here are a few ways in which you can support the speech language pathologists in your organization:
- Create opportunities for interdisciplinary collaboration to capture the full value speech language pathology could be for the patient.
- Ask staff how they are experiencing these changes. What do they need and what do they need to know in order to be successful in their job?
- Ensure that approaches to change and service delivery are aligned with the values and culture of your organization.
- Validate that the message reaching your care delivery team matches your approach. Can they articulate your message?
- Provide transparent and ongoing evidence and trends gathered for best practices.
ASHA 2019 offered some incredible resources for staff regarding evidence-based practice for interventions for behaviors related to dementia and mental health issues. We know that with the initiative to decrease anti-psychotic medications that we must work as a team on non-pharmacological interventions. We know that Medicare patients are coming to us more and more with these types of diagnoses and it was incredible to see ASHA supporting speech language pathologists role with this difficult and often under-served population.
We are less than 2 months into PDPM, and less than 2 months away from PDGM. It’s all new. We planned, we practiced, we projected. But, now we are in it.
So, What Should We Do Now?
- We should ask.
- We should listen.
- We should learn.
- We should assess.
- We should model.
I know operators have been very focused on downward communication and education as we have prepared for payment changes. That will need to continue but we also need to be sure to listen. Listen to our teams. Help them problem solve. There are prominent voices that are sharing fears about practice change. We need to hear those voices and help provide answers that support our clinical interventions. They can call attention to our issues and our opportunities to improve. We also need to hear the quiet whispers of those in trenches that are working hard and can give us equally or even more valuable feedback and incredible ideas and solutions. They are the heart in what we do. They will move us through these changes in payment and bring excellent outcomes to the people they treat and the organizations they represent.
Change is difficult. However, during this season we need to ensure that our focus does not stray from serving our customer – which includes our patients, our associates and our business partners.
We would love for you to share with us some ways that you are working with your facility partner and associates to provide value and outcomes-based care. We are most successful when we work together!