Management course project on going from just neuro to ortho too…

We are in a management course – taken online and taught by an OT across the country. She gave me permission to post some of our group projects more or less in full, since she changes the scenarios every year. In our case, our group of four students had to deal with a primarily neuro-NDT rehab hospital trying to start attracting more orthopedic cases. We had to do a mission statement, a SWOT (strengths weaknesses opportunities threats), plans etc. We also had to do a capital budget and operating budget, with justifications. I didn’t include the Excel spreadsheets cuz um, I don’t think I can. But this is Part 1 and 2 of our project, and part 3 will show up soon after it is graded. I also have a Little People Wellness project to post once we get a graded version back. This is long, but in my opinion, kinda cool to at least skim. 🙂 And yes, I know the charts are totally messed up. Ignore them.

The Robyns-Walderlain Medical Center

Mission Statement

The mission of the Occupational Therapy Department of Robyns-Walderlain Medical Center is to continuously strive for holistic, client-centered care, supported by both evidence-based research and clinical expertise. We value our state-of-the-art facility, in-depth knowledge of surgical and rehabilitative protocols, our strong relationship with medical colleagues, and lifelong learning. We strive to become the premier facility in our community for the comprehensive treatment of orthopedic and neurological patients.

Philosophy Statement

We believe in providing the highest quality of care to our patients. We strive to consistently improve best practice through evidence based research, clinical expertise and continued education. We believe our patients should have access to the best medical equipment as well as highly trained and professional therapists. We work collaboratively with other disciplines in order to help our patients regain functional independence. We believe in a holistic approach when treating our patients.

The Robyns-Walderlain Medical Center is committed to providing the best quality of care to both orthopedic and neurological patients. Our facility uses a hands-on approach used in working with people who have central nervous system injuries that create difficulties in controlling movement (NDT). Our therapists are certified to help those with neurological challenges to become as independent as possible. While in our care we are able to accurately measure and monitor a patient’s ability to perform everyday tasks safely. With this[vls1] data we can provide a “just right challenge” to support and develop further skills. (Cognitive Disabilities) Our therapists work collaboratively with individuals, family, caregivers and physicians to develop comprehensive treatment programs. Our rehabilitation staff also provides the highest quality of care for muscle, bone, and joint health. As occupational therapists we design treatment programs to address the range of motion, strength, and endurance problems related to orthopedic issues (Biomechanical). In all treatments we incorporate occupations, or “meaningful activities”. This allows us to ultimately ensure our patients’ ability to participate in activities of daily life.

Understanding the importance of research and teaching for improving patient care, the occupational therapy department will support, promote and participate in these activities. Continued education is essential to the delivery of quality care and is not only a personal but an organizational responsibility. We are responsible for providing appropriate learning experiences and role models for all students of occupational therapy. We are committed to excellence through continuous evaluation of occupational therapy care and positive modifications to techniques and activities supported by evidence based research. We have an obligation to manage departmental personnel and finances to achieve maximum productivity while providing quality and efficient care. Health is not just the absence of disease but a state of optimum physical, mental and social well-being. We are dedicated to excellence in healthcare through continuous quality improvements in the facilities in which these services are provided.





COTA and multiple OTs

No ADL or kitchen room

Room to expand equipment area as well as ADL/kitchen area

Staff members resistant to change secondary to loyalty to previous manager

Ortho patients have high turnover

No mission statement or philosophy

Budgeting for more OTs and different schedule

Not a lot of experience with orthopedics

Large metro area with plenty of patients

Share a gym with PT

New referrals and new relationships with physicians/surgeons

Work hours may have to include weekends

Large gym with room for expansion

Therapists don’t have a lot of experience with non-NDT/orthopedics

Ability to see more patients at once

Insurance billing may change/need to be learned

Normal work hours

Must buy new orthopedic equipment

Building a mission statement and philosophy to guide our progress

Budgeting may not cover all the new OTs/equipment needed

Highly NDT-trained

Only inpatient

May have an OT shortage or lose OTs in the changeover

No competition

Need to get more OTs

May have difficulty with continuity of care w/o outpatient services

Have sixty beds

Introducing new population to hospital

Amazing new manager!

Not formally certified for thermal modalities (assuming in TN)

Step 5 (Brainstorm)

Weaknesses & Threats:

No ADL or kitchen room

· Look into budget/ask about money to build one

No mission statement or philosophy

· Create them

Share a gym with PT

· Delineate our space somehow, be creative

· Look into building another gym

Internal Marketing only

· Consult with administration about advertising and ask what is going on externally

Must buy orthopedic equipment

· Look for ways to split costs

· Used equipment

· Loans/trades

· Grants

· E-bay, auction, other creative sources

· Look at budget

Need to get more OTs

· Ads in OT magazines

· Newspapers

· Word of mouth

< span style="line-height: 115%;font-family:Symbol;font-size:12;color:black;" >· Referral rewards

· Work on job description

· Talk with HR

· Look into hiring budget

· Work on good benefits/incentives/bonuses

Need to get more OTs

· Look into orthopedic necessities and other places handle it.

· Brainstorm with OT stuff

· Educate staff through professional courses, CE, lunch and learns

· Do inservices

Not certified in Thermal Modalities (necessary in Tennessee)

· Look into budget for hiring consultant to training

· See if anyone already has the certification

· Try to get certified

Lack of experience

· Involve employees in training and developing performance expectations

· Discuss professional evolution and change

· Have employees go through a type of orientation

· Use mentors

· Co-treat

· Do a journal club on orthopedic issues

· Get collections of surgical protocols and rehab protocols

· Do case studies

< p style="margin-left: 45pt; text-indent: -0.25in;">· Inservices by surgeons, visiting OT/PTs

· Observations at an orthopedic clinic

· Watch surgeries

· Focus on importance of lifelong learning, stressed in the mission statement

Staff members resistant to change secondary to loyalty to previous manager

· Interview staff to get to know them better

· Remember team development and its stages regarding group dynamics

· Provide lunch and get-to-know session

· Use rewards and positive reinforcement, such as praise

· Have a mediator come in and talk about shifts of management

· Team loyalty exercises

· Do team trust exercises

Work hours may include weekends

· Use flexible scheduling

Insurance billing may change/need to be learned

· Talk to case managers

· Have inservices, education, training

· Research medicare/medicaid

· Do sample cases

· Have FAQ, Q & A questions

Budgeting may not cover all OTs/equipment needed

· Try for used equipment or splitting costs with physical therapy

· Be creative – look on E-bay

· Ask community, church, friends, etc to make OT kits, like for ADLs

· Use The Recycling Occupational Therapist to get ideas for homemade items

· Use splint material and such sparingly

· See about job-sharing or part-time OTs or more COTAs

· Look at old playground equipment

· Go to auctions, places with closeout sales, wholesale, etc

· Break into the local gym and steal things

· May have an OT shortage or lose OTs in the changeover

· Involve employees in process of performance expectations

· Try to use tactics that promote team unity and cohesiveness

· Advertise aggressively

· Talk with hesitant OTs about their reasons and ways to still meet their needs

· Have difficulty with continuity of care w/o outpatient services

· Talk with the nearby outpatient clinic

· Share protocols

· Emphasize and encourage communication

Step 6 (Plan)

  • Work on creating a balanced budget

  • Increase morale of staff

  • Create a mission statement and philosophy

  • Create space for ADLs

  • Create space for treatment with new ortho equipment

  • Buy ortho equipment

  • Increase knowledge of our new addition to healthcare providers

  • Hire more OTs and COTAs

  • Advertising

  • Have staff certified

  • Staff becoming more knowledgeable with ortho techniques

  • Be familiar with insurance policies

  • Create new schedule

Step 7 (Tactics)

Strategic Goal





Minimize resistance to change

-Have a departmental meeting with everyone on Day 1 to communicate the reasons and the plan for change.

-Have informal interview/lunch with OT # 1 on Day 2, #2 on Day 3, the COTA on Day 4.

Day 5 – Meeting to address what does and does not work within the department as well as concerns of the employees that were obtained during the interviews. Have employees think of solutions over weekend to help prepare them for next weeks Mission Statement development.

-Involve employees in decision making processes so that they do not see the change as a threat.

-Discuss conversion to flexible scheduling when new employee(s) hired

$ for Lunch

OT manager

Week 1

Develop Mission and Philosophy Statement

3 departmental meetings during lunch (provided).

Day 6 – Discuss what both are and begin brainstorming.

Day 8 – Begin developing departmental statements

Day 9 – Review and finalize.

-Other Departmental Statements

-Hospital Statements


-$ for lunch

OT team

Week 2

Develop OT Kitchen and ADL room

Day 7 and 10 Meet with Administration to ensure budgeted dollars available for development

-Discuss the requirements for such a room.

-Provide list of costs for OT specific items to equip the room such as adaptive devices

-evidence supporting use of kitchen and ADL room in treatment.

OT team

Meeting – Week 2 – due to the time it may take to get estimates


Week 8 -including

Electrical and


Restructure layout of gym

-Meet with admin and PT manager to discuss improving the layout of gym area

-Discuss delineation of space

-Discuss impact of equipment purchases on current layout

OT team and PT manager

Week 3

Purchase of orthopedic equipment

-Develop list of equipment that can be shared with PT

-Price equipment that is necessary for department

-Order the equipment

OT and PT manager and admin

Week 3

Implement new layout with new equipment

-Have old equipment moved to new location in gym

-Installation of new equipment


OT and PT manager

Week 9

Allowing time for purchasing and delivery. Timing so that construction is complete within the gym.

Market internally

– Meet with Doctors, Nurses, PT, Speech etc. to discuss plan.

-Meet with director of marketing to discuss new Mission Statement.

OT manager

Week 4

Develop new OT positions

-Develop new job description

-Budget money for positions

OT manager

Week 5

Advertise new OT positions

-Submit ad to OT magazines

-Post position on national and state website

-discuss with HR the new position

OT manager


Professional Development

-Discuss with team the importance of Professional Development

-Coordinate Continued Education. Focus on Orthopedics

-Establish relations with regional MOT programs to develop facility as Level 2 FW site.

-Hire consultant to train staff in thermal modalities

OT team

-Week 6

-Week 8

-Week 9

Increase the experience of current staff

-Begin bi-weekly lunch and learns (Begin Journal Club)

-Rotate Co-treating an orthopedic patient with the current staff

-Demonstrate an evaluation to the staff on an actual client

-OT staff

-OT manager

-Begin week 3

-Begin week 4

Increase awareness of insurance and billing changes

Schedule a case manager to present to the staff information regarding the differences.

OT manager

Week 7

Hire new staff

-Review incoming applications

-Begin Interviewing

-Make hiring decision

OT manager



Week 7

Week 8

Week 10

Orient new employee(s)

-Send letter of welcome

-Meet with employee(s) then have them report to H

-Give employee(s) a tour of the facilities.

-Assign a fellow employee to work with the new hire to answer questions.

-Have all employees meet for lunch to discuss the impending conversion plan.

-Meet individually at end of each week to discuss concerns

OT team

Week 11

Convert to Flexible scheduling

Week 12

Begin Ortho Treatment

OT team

Week 12

Part 2:

Operating Budget Justifications[vls2]

Salary: The salary listed is the standard salary in this area, as found on

Vacation: Two weeks is standard vacation time given to experienced therapists. It will cost this amount to pay for someone to come in and replace each one of the employees for 2 weeks.

Sick time: Five days of sick time is the standard.

Benefits: Standard is 25%, which will pay for employee benefits on top of salary.

Purchase services: Most items are under warranty, but equipment breaks down frequently, and wheelchair items are lost regularly by patients.

Service contracts: It will cost $120 a month for the all seven employees to have a pager, in order to be easily found during a problem and to communicate more efficiently and rapidly.

Minor equipment: This encompasses basic items used frequently in rehabilitation that has the potential for needing regular replacements, such as replacement heads for the ultrasound machine, used to help with pain. Other items such as the toaster are accessories used in the kitchen and bathroom to simulate real life experiences.

Equipment (leases/rental): Both regular and bariatric wheelchairs are needed regularly by patients, and are typically leased through a contractor. The amount shown is the amount needed to lease the chairs for twelve months.

Medical supplies: Necessary to replace supplies such as theraputty, hot pack covers, paraffin oils and ultrasound gel that are used on a daily basis to help patients with their rehabilitation experience.

Dues/Subscriptions: Our mission statement states that we promote life-long learning. We believe in being a part of the national American Occupational Therapy Association, which provides us with regular information on learning opportunities as well as insurance issues. Our support also ensures the AOTA can continue to advocate for the needs of occupational therapy. Our major magazine subscriptions are then free through AOTA membership.

Office supplies: Standard office supplies such as staplers, paper, and pens, to be provided to the therapists to complete their job successfully.

Education/training: The annual AOTA Conference Price is $415 per therapist, and it is typically where many therapists receive many of their required continuing education credits. However, it is not possible to get all credits at this conference. To be competitive, we will offer each therapist $1000 for continuing education credits.

Travel/business meetings: The cost of flying to the conferences averages at around $300. Hotel rooms are typically $200 a night for two nights.

Capital Budget[vls3]

Bathroom, kitchen justification:

Occupational therapists use kitchens and bathrooms to mimic the conditions the patient may meet when returning back to their residence. This allows patients the most natural environment possible to practice necessary skills needed for activities of daily life. The bathroom includes modifications that make it friendly for people with handicaps, including wheelchair access.


All the gym material listed will be used to help patients regain strength, endurance, and/or balance. The tumble form wedges, E-stem/ultrasound, and muscle stimulation machine will all be used to provide comfort and relief to a patient in pain, and/or to prevent the patient from becoming uncomfortable while in common positions used in rehabilitation protocols.

Mar 10, 2008 | Category: Occupational Therapy | Comments: none

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