Honoring Excellence
Monday November 23, 2009
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The word excellence is thrown around frequently, but what does it really mean to excel as a physical therapist? Is it helping a patient reach his or her goals? Is it thinking of innovative ways to motivate someone who is having a bad day? Is it supporting patients and caregivers through life-changing transitions?
For today’s PTs and PTAs, it’s all of the above, and more. Some therapists recognize that to practice excellence they need to more closely engage with all aspects of patient care, while others are realizing that to achieve excellence, they also may need to take a more active role in advancing the profession.
Donna Kzielke, MPT, an inpatient therapist on the stroke unit at Marianjoy Rehabilitation Hospital, in Wheaton, Ill., works primarily with a geriatric population and recognizes that part of her job is helping patients cope. “They have undergone a huge change, and I help them adjust and rethink their goals,” she says. “Every patient is someone’s grandmother, father, friend — and I want to feel I have exhausted all my resources to help them.”
Kzielke says working in an inpatient setting allows her to get to know her clients. “You’re in their physical space so much that it becomes a partnership between you and the patient and the family, if they are involved — the patient isn’t just someone coming to you to be made better, you’re working toward that end result together,” she says.
Sally Taylor, PT and allied health manager on the spinal cord injury rehabilitation unit at the Rehabilitation Institute of Chicago, says that when working with patients who have serious traumatic injuries, she must interact with people who are in the middle of massive life changes. “You have to get their buy-in and help them want to get back to society and embrace experiences they had before in a new context,” Taylor says. “It takes a lot of skill.” And it can be the most rewarding part of her day.
But for Taylor, daily personal rewards aren’t enough — as a rehab manager, she has to inspire her staff on a daily basis as well. Taylor encourages a patient-driven approach for her staff of PTs, OTs, and speech-language pathologists.
“One of the main things as a manager is remaining optimistic and reminding the staff that we have to face these challenges together — insurance issues, families who don’t arrive for appointments, patients getting sick ... You have to give the message that we can meet these challenges,” she says, noting that many problems can be solved by listening to a patient’s goals, creatively scheduling, and employing innovative time management skills.
Knowledge Quest
Teamwork can be used to benefit patients on a broader scale, too. After 16 years in the field, Kzielke became inspired to expand her horizons in the quest for excellence.
“I can’t imagine not seeing patients daily,” she says, “but I was ready for new challenges.” Kzielke began exploring the use of body-weight supported treadmill training, but quickly became frustrated by the limited coursework and literature available, especially since most of the studies she found had long protocols — well beyond the amount of time she had to spend with patients. “I wanted to see if people in the acute recovery phase could tolerate treadmill training, and see what would happen if we just did it for two weeks,” she says.
Kzielke is involved in a study using GPS to track stroke survivors to look at how well they reintegrate into their communities. “We ask them to set targets and then track their walking,” she says. “One of my patients had two goals — to get to Cubs games and church. Without relying on self-reporting, we are able to see how often he achieves those goals.”
Such projects give Kzielke and other research clinicians the best of both worlds, as partnering with patients every day drives research efforts that could help whole populations of people they never will meet.
Taylor has moved into the research realm, and she says it is inspiring her entire staff, making her a more effective PT and manager. Her team is working on SCIRehab, a five-year project using clinical practice improvement research methodology to determine how, and to what degree, each rehabilitation component is associated with results. “Working on this project has helped our team take ownership and build evidence for what we do every day,” Taylor says.
She says the study has created a cohesive, supportive team atmosphere in her unit, and that everyone on the team is taking a more inquisitive approach to their treatments. By inspiring her whole team to grow personally while advancing the profession, Taylor is fostering the quest for excellence through her leadership.
Shared Wisdom
Most PTs work intently toward excellence and perfection every day, but both Kzielke and Taylor say looking for inspiration in small victories and staying engaged in learning is important because that idealism can be harder to maintain in the workplace.
“The longer I do this, the more I realize that the time I have with the clients is such a small part of the recovery process,” Kzielke says. “They might be with me for three weeks, and stroke recovery can take three to 12 months. What I do is a small piece, but I can have a significant impact ... For me, part of providing excellent care has been recognizing how small a part I play but how important it is.”
It is such rewards that keep PTs engaged in the daily work of healing and expanding the profession by seeking new techniques through research.
“I never want to get to a point where I am too comfortable or feel I know everything. I don’t want to discount university research, but so many studies are done by people that [are] not treating patients,” Kzielke says. “If we can get real life studies going, even with small numbers, information from these real working conditions could carry weight with clinicians and spark bigger studies.”•
Libby Lowe is a contributing writer for Today in PT.
For today’s PTs and PTAs, it’s all of the above, and more. Some therapists recognize that to practice excellence they need to more closely engage with all aspects of patient care, while others are realizing that to achieve excellence, they also may need to take a more active role in advancing the profession.
Donna Kzielke, MPT, an inpatient therapist on the stroke unit at Marianjoy Rehabilitation Hospital, in Wheaton, Ill., works primarily with a geriatric population and recognizes that part of her job is helping patients cope. “They have undergone a huge change, and I help them adjust and rethink their goals,” she says. “Every patient is someone’s grandmother, father, friend — and I want to feel I have exhausted all my resources to help them.”
Kzielke says working in an inpatient setting allows her to get to know her clients. “You’re in their physical space so much that it becomes a partnership between you and the patient and the family, if they are involved — the patient isn’t just someone coming to you to be made better, you’re working toward that end result together,” she says.
Sally Taylor, PT and allied health manager on the spinal cord injury rehabilitation unit at the Rehabilitation Institute of Chicago, says that when working with patients who have serious traumatic injuries, she must interact with people who are in the middle of massive life changes. “You have to get their buy-in and help them want to get back to society and embrace experiences they had before in a new context,” Taylor says. “It takes a lot of skill.” And it can be the most rewarding part of her day.
But for Taylor, daily personal rewards aren’t enough — as a rehab manager, she has to inspire her staff on a daily basis as well. Taylor encourages a patient-driven approach for her staff of PTs, OTs, and speech-language pathologists.
“One of the main things as a manager is remaining optimistic and reminding the staff that we have to face these challenges together — insurance issues, families who don’t arrive for appointments, patients getting sick ... You have to give the message that we can meet these challenges,” she says, noting that many problems can be solved by listening to a patient’s goals, creatively scheduling, and employing innovative time management skills.
Knowledge Quest
Teamwork can be used to benefit patients on a broader scale, too. After 16 years in the field, Kzielke became inspired to expand her horizons in the quest for excellence.
“I can’t imagine not seeing patients daily,” she says, “but I was ready for new challenges.” Kzielke began exploring the use of body-weight supported treadmill training, but quickly became frustrated by the limited coursework and literature available, especially since most of the studies she found had long protocols — well beyond the amount of time she had to spend with patients. “I wanted to see if people in the acute recovery phase could tolerate treadmill training, and see what would happen if we just did it for two weeks,” she says.
Kzielke is involved in a study using GPS to track stroke survivors to look at how well they reintegrate into their communities. “We ask them to set targets and then track their walking,” she says. “One of my patients had two goals — to get to Cubs games and church. Without relying on self-reporting, we are able to see how often he achieves those goals.”
Such projects give Kzielke and other research clinicians the best of both worlds, as partnering with patients every day drives research efforts that could help whole populations of people they never will meet.
Taylor has moved into the research realm, and she says it is inspiring her entire staff, making her a more effective PT and manager. Her team is working on SCIRehab, a five-year project using clinical practice improvement research methodology to determine how, and to what degree, each rehabilitation component is associated with results. “Working on this project has helped our team take ownership and build evidence for what we do every day,” Taylor says.
She says the study has created a cohesive, supportive team atmosphere in her unit, and that everyone on the team is taking a more inquisitive approach to their treatments. By inspiring her whole team to grow personally while advancing the profession, Taylor is fostering the quest for excellence through her leadership.
Shared Wisdom
Most PTs work intently toward excellence and perfection every day, but both Kzielke and Taylor say looking for inspiration in small victories and staying engaged in learning is important because that idealism can be harder to maintain in the workplace.
“The longer I do this, the more I realize that the time I have with the clients is such a small part of the recovery process,” Kzielke says. “They might be with me for three weeks, and stroke recovery can take three to 12 months. What I do is a small piece, but I can have a significant impact ... For me, part of providing excellent care has been recognizing how small a part I play but how important it is.”
It is such rewards that keep PTs engaged in the daily work of healing and expanding the profession by seeking new techniques through research.
“I never want to get to a point where I am too comfortable or feel I know everything. I don’t want to discount university research, but so many studies are done by people that [are] not treating patients,” Kzielke says. “If we can get real life studies going, even with small numbers, information from these real working conditions could carry weight with clinicians and spark bigger studies.”•
Libby Lowe is a contributing writer for Today in PT.
To comment, e-mail pteditor@gannetthg.com.
Monday November 23, 2009