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Kate Brewer, PT, MBA, GCS
Skills for Rehab Professionals
The Essential Guide
to Therapy Management
The Essential Guide
to Therapy Management
Skills for Rehab Professionals
Kate Brewer, PT, MBA, GCS
The Essential Guide to Therapy Management: Skills for Rehab Professionals is published by HCPro, Inc.
Copyright © 2008 HCPro, Inc.
All rights reserved. Printed in the United States of America.
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received an unauthorized copy.
HCPro, Inc., provides information resources for the healthcare industry.
HCPro, Inc., is not affiliated in any way with The Joint Commission, which owns the JCAHO and Joint
Commission trademarks.
Kate Brewer, PT, MBA, GCS, Author
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iiiThe Essential Guide to Therapy Management
Contents
Introduction.................................................................................................................. vi
Chapter.1:.Leadership.and.management.skills.......................................................... 3
Directional ............................................................................................................................... 5
Coaching .................................................................................................................................. 5
Supportive leadership ............................................................................................................... 5
Delegating................................................................................................................................. 6
Chapter.2:.Time.management.and.delegation..........................................................11
Tools to manage your time ..................................................................................................... 12
Chapter.3:.Strategies.for.effective.communication..................................................19
Potential barriers to effective communication ....................................................................... 19
Techniques to facilitate effective communication .................................................................. 20
Creating an environment of open communication ................................................................ 21
Chapter.4:.Conflict.management...............................................................................25
Identifying sources of conflict ................................................................................................ 25
Resolution strategies .............................................................................................................. 26
Holding all staff accountable ................................................................................................. 27
Summary ................................................................................................................................ 27
Chapter.5:.Conducting.effective.meetings................................................................31
Tips for successful meetings ................................................................................................... 31
Chapter.6:.Ensuring.clinical.excellence....................................................................39
Customer relations ................................................................................................................. 39
Compliance with acceptable treatment techniques................................................................ 42
Mentoring opportunities ........................................................................................................ 42
Professional development and clinical ladders ....................................................................... 42
Tracking clinical outcomes .................................................................................................... 43
iv The Essential Guide to Therapy Management
Chapter.7:.Human.resource.management................................................................47
Identification of need ............................................................................................................. 47
Recruiting ............................................................................................................................... 49
Interviewing ........................................................................................................................... 51
Negotiation ............................................................................................................................. 55
Orientation programs ............................................................................................................. 56
Performance coaching ........................................................................................................... 56
Setting the stage for a coaching session ................................................................................. 57
Performance reviews .............................................................................................................. 58
Annual performance reviews ................................................................................................. 63
Summary ................................................................................................................................ 63
Chapter.8:.Operational.management........................................................................67
Efficiency ................................................................................................................................ 67
Fixing productivity problems ................................................................................................. 68
Getting results ........................................................................................................................ 69
Software .................................................................................................................................. 69
Optimizing revenues ............................................................................................................... 70
Seeing the big picture ............................................................................................................. 71
Chapter.9:.Developing.compliance.programs...........................................................75
Compliance program elements ............................................................................................... 76
Chapter.10:.Marketing.strategies..............................................................................83
Survey the environment ......................................................................................................... 83
Assess your practice ............................................................................................................... 86
Marketing materials ............................................................................................................... 90
Contents
vThe Essential Guide to Therapy Management
Acknowledgments
First, I would like to acknowledge my wonderful and supportive husband, Keith, who is my
rock and my support, helping me stay balanced with my home life and my work life. I would
like to thank my son, Jimmy, for keeping me smiling and busy in every free moment that I
have—you are my sunshine.
I would like to thank Greenfield Rehab Agency and my business partners Michelle Poole and
Nick and Carole Jarich for supporting me and allowing me to lead us forward in our goals. It
is so rewarding to work with a company that does things the right way.
I would like to thank all the managers I have worked with in the past, as they have helped
me develop my thoughts and ideas on management. I have appreciated your willingness to
share your styles and approaches with me in order to help me develop my own. Some of the
best lessons I have learned have come through my own mistakes—thank you for letting me
be human.
Kate Brewer, PT, MBA, GCS
The Essential Guide to Therapy Management
vi The Essential Guide to Therapy Management
Introduction
The skill of management must be constantly developed and honed with experience. As many
can attest, plenty of managers need vast improvements in style. The difficulty is that, al-
though management is a skill that can be developed, it is also an art that is influenced heavily
by our own communication styles and attitudes. It is a challenge to change one’s tendencies,
but the first step to doing so is raising awareness. Being aware and taking a personal inven-
tory of how we react in certain situations can help us begin to identify where we can improve.
There are countless theories of management, from academic perspectives to business perspec-
tives. Rehab managers should read and explore these different theories to see whether they
could apply to the rehab business. This book is a practical resource for both the relatively new
rehab manager and to the more seasoned manager who is looking to review how he or she is
running the organization and looking for ways to improve. Because this book is geared toward
such a variety of readers, be sure to adjust suggestions as necessary so that they apply to your
situation.
Success in rehab management
True success in rehab management involves the balance of three main areas: clinical excel-
lence, operational excellence, and personnel management. As this book will illustrate, clini-
cal excellence refers to the product you are selling—quality therapy services—and to ways
of continually growing and developing that aspect. The second area, operational excellence,
refers to how the practice is managed and monitored to ensure efficiency and optimal profit
margins. Finally, the third component is personnel management. Therapists and their team
members are the practice’s most valuable assets. How employees are treated, managed,
coached, and supported directly affects job satisfaction and retention. Because therapy is a
service-based industry, it cannot be provided without licensed therapists. These therapists
need to be treated with value and respect to ensure that they are optimizing their skills, both
for the organization and for their patients.
viiThe Essential Guide to Therapy Management
Managers are pulled in numerous directions over the course of a day, and the guiding princi-
ple for every successful manager is to devote equal attention to clinical excellence, operations,
and personnel management. Overemphasizing one area and neglecting another is a surefire
way to cause more problems. For example, if managers are so caught up with pushing staff
productivity that they ignore a problem with a therapist who is being negative and causing
problems with coworkers, they won’t be able to achieve the success they seek. This lack of
attention to the personnel problem may cause therapists to leave because they don’t feel sup-
ported.
As hard as it may be, a balance of the three principles of management is needed for success
in all three areas: positive patient outcomes, a great bottom line, and a happy, cohesive team.
After all, that’s what we are always striving to achieve.
Introduction
Leadership and management skills
Chapter 1
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As in any position, leadership requires certain knowledge, skills, and abilities (KSA) to make
the performance a success. Some KSAs can be taught through mentoring and teaching, and
some are simply innate. For example, charisma—the talent of generating loyalty and enthu-
siasm through energy, eloquence, and charm—is difficult or impossible to teach effectively.
Usually, it is either present or it’s not.
Leaders tend to emerge from the crowd and set themselves apart by their words and actions.
They have credibility because they have shown that they walk the walk and demonstrate
leadership; they don’t just talk the talk and fail to follow through. By inspiring others and
tapping into their strengths, leaders are able to extend their influence and develop trusting
relationships, thus moving a business forward. Leaders are always looking ahead and pulling
the team in the company’s desired direction.
A leader can be a manager who, instead of looking forward and out, looks down and in to
ensure that current processes are working effectively. The following is a demonstration of how
leadership is different than management:
Leadership Management
Doing the right thing Doing things right
What needs to be done and why Getting things done
Relationships and engaging people to Current systems
move the business and structures forward
Innovation and creativity Consistency and control
Vision and the future The bottom line today
The Essential Guide to Therapy Management
Leadership and management skills
Chapter 1
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Chapter 1
As a rehab manager, you don’t have to be one or the other; you can be both. Depending on its
size, however, a good organization sometimes needs both positions. Nevertheless, it is good to
strive for leadership qualities and to still be able to manage your team effectively.
Strive to embody the following unique, valuable qualities of effective leaders:
Inspire confidence
Show personal attention, concern, and attention
Produce results and quality outcomes
Inspire, gather, and use employee ideas
Lead rather than “boss”
Foster teamwork and a sense of belonging
Are able to show kindness but still be firm
Coach staff to help them reach their full potential
Model a good balance between work and family life
Delegate
Are self-confident without being perceived as arrogant
Are able to make hard decisions
Have strong self awareness (i.e., are aware of their strengths and weaknesses)
Are good at emotional management (i.e., are able to express themselves appropriately
and to control impulsiveness)
Are empathetic, and connect to people (i.e., are able to relate to different kinds of
individuals and bridge the gap between them)
People have many different management styles. An individual often doesn’t just pull from
one category but rather effectively melds and combines different techniques, depending on
the situation. The following broad categories may help rehab managers identify their styles or
help them recognize when one style is more appropriate than another.
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The Essential Guide to Therapy Management
Leadership and management skills
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Directional
Directional leaders assign tasks and supervise their completion. This communication
style is very much one-directional, with leaders telling the team what they want, where
and how to get it, and when they expect it. The directional leader monitors the assigned
tasks to ensure that they are being completed to the identified specifications. This ap-
proach is effective when:
A quick decision needs to be made
The team is inexperienced or lacks the initiative to follow through
The team lacks organization, structure, and accountability
Because this approach borders on micromanagement and can be received negatively by those
who function more autonomously, it is most appropriate for a relatively new staff or for a staff
in the beginning stages of development.
Coaching
A coaching leadership style can be used when the team demonstrates a decent amount of ac-
countability and is able to work through some basic problem-solving. In this leadership style,
the leader gives the team guidance and performance feedback. The leader gives the team the
opportunity to execute a task and then works with them to help them become more effective
in their performance. This approach is a great way to help a team build confidence by encour-
aging and helping the members continuously improve through feedback. The coaching style
is most effective with groups who:
Have an existing sense of their goal but need guidance on how to get there
Have their basic skills intact but just need some guidance to bring a project to execution
Supportive leadership
Supportive leadership relies on a staff to be proficient and responsible in their roles. In this
style, the leader pulls in the team players to discuss and buy into the action plan. Instead of
telling the group what to do, the supportive leader tries to help the group arrive at a conclu-
sion. For example, instead of telling the group how you want to market the new service line,
you ask the group for their ideas.
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The Essential Guide to Therapy Management
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Chapter 1
The Essential Guide to Therapy Management
Another example is, when an employee comes to you with a question, you ask, “What do you
think you should do?” Have the employee suggest plans of action, say which he or she thinks
is best, and then provide feedback to help form a decision-making process to use if the situa-
tion arises again. This process is sometimes referred to “teaching them how to fish” instead of
putting fish on their hooks for them. In the long run, the organization will benefit from better-
developed employees who make good decisions rather than from an overwhelmed manager
who has to solve all the problems.
This style works best with:
Experienced staff who know the workings of an organization in your practice envi-
ronment
A task force or work group specifically identified to address a certain task
Staff who have identified a particular project or new service line and are invested in
its success
Delegating
In the delegating style, the leader assigns a task or the day-to-day problem-solving to another
individual. The selection of the identified person is essential to ensure that the task will be
carried out. For example, a leader may recognize that he or she cannot effectively oversee two
clinics at one time. He or she could identify an on-site manager or lead clinician for the other
clinic to help manage the day-to-day activities, and the leader could trust that person to keep
him or her informed when the need arises.
To select an appropriate person for delegation, look for a seasoned staff member who:
Is aware of your policies and procedures
Approaches this job with enthusiasm and sound professional ethics
Is emotionally and professionally mature enough to handle more stressful variances
in the workday, such as schedule issues and staff conflicts
Has a strong commitment to the core values of the business and can act as an exten-
sion of you
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Leadership and management skills
�The Essential Guide to Therapy Management
Is able to triage issues, bring you in when needed, and prioritize routine issues sensi-
bly, in a manner that is best for the business
A rehab manager can use many different strategies to lead and manage their teams effectively.
There is not a right way and a wrong way to manage, and in fact many different approaches
can be used at many different times throughout the same day. As rehab managers mature and
gain more experience, they may end up forming management approaches unique to them.
Many influences help shape a management style.
Regardless of the approach used, a rehab manager must maintain a daily balance of man-
aging the operations of the business, treating personnel with respect and consistency and
helping them develop, and ensuring that the organization provides services with consistent
clinical excellence and produces a superior product. If the manager pays less attention to one
of these areas, the practice will suffer.
If the rehab manager pays attention to these three areas, however, the practice will be on
track to grow and thrive. To keep your own development progressing for success, commit to
personal growth and to expanding your management skills through reading books and ar-
ticles, through mentoring, and through exchanging ideas with other managers.
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