Four years ago, speech-language pathologist Ange Knutson knew something had to change. As a program clinical coordinator with Inova Health Systems in Virginia, she saw the Inova Rehabilitation Center at Mount Vernon Hospital fighting an increasingly uphill battle of keeping a full staff of occupational therapists, physical therapists, and SLPs. The center had several positions that had been open for long periods of time as it searched for just the right candidates with the very specific experience and skill sets required to treat acute rehab patients.
"We weren't finding the staff with the right experience, schools weren't graduating as many students, and we were relying more and more on [contract] agency staff," Knutson recalled. "These [open positions] were costing us almost $820,000 a year."
So Knutson took action. In 2006 she devised a plan to transform the center's mentoring program. She proposed to hospital administrators that by spending $500,000 for a half-time position in each of the three disciplines for staff time out of patient care to provide hands-on teaching lab sessions, they would solve the staffing problem and save money in the long term by avoiding agency fees. Unlike the previous mentoring program in which incoming clinicians were assigned a mentor (who was usually too busy to help because of full caseloads), these new mentor positions, called "rehab clinical specialists," would carry only partial caseloads and dedicate the remainder of their time helping their mentees by providing co-treatments, input into treatment plans and patient goals, and ongoing in-service and lab session training.
The administrators agreed; after three years, the rehabilitation center has filled 90% of its open positions and stopped attrition. And although the program was intended primarily for occupational and physical therapy, in which the shortage was most dire, it spread quickly to SLPs as well. Julie Eckles, rehab clinical specialist and SLP at Mount Vernon for 19 years, who was one of the first mentors, calls it a "win-win situation."
"It couldn't have been better conceived," Eckles said. "It targets a lot of different issues—staffing, staff development, retention, excellence in service. This program allowed us to hire young, bright clinicians who didn't have a lot of experience and support them through all stages their development." And the benefits also accrue to the more experienced clinicians.
"Mount Vernon has a culture of teamwork and it doesn't matter if I'm working with a new clinician or one more experienced than I," Eckles said. "We see complex cases and having a second set of eyes and ears facilitates the process of accurately assessing needs as quickly as possible."
Relatively new SLP Lauren Schwabish agrees that the mentoring program has been a huge success. When Schwabish was hired at Mount Vernon four years ago, she had five years of experience working with patients in a sub-acute clinic. But at the Inova Rehab center, she needed more guidance to deal with more acute cases of brain injury. When the mentoring program began a year after she was hired, she came under Eckles' tutelage.
"At first I didn't know how to approach the program—with five years of experience I didn't know why I needed someone looking over my shoulder," Schwabish admitted. "But it wasn't like that at all. It was like having a second set of eyes to validate what you were doing or help you to come up with another avenue if you had a difficult case. Even for cases that seemed routine, you could bring [your mentor] on just to keep you on track. She had in her schedule time to help you craft the perfect plan of care."
In addition to staff's high regard for the program, the financial support from the hospital's administration is a critical nod of approval. Although there are no hard numbers to back up the success of the program, Knutson is sure the hospital administrators agree it has been financially beneficial. Her biggest clue?
"They approved another rehab clinical specialist for outpatients and two more for inpatients," she said triumphantly.