Patients Deserve Rehab Services
Sign Our Petition for Excellent Patient Care
For the last two months, we have been describing how the staffing model and the productivity system used by OHSU’s Rehabilitation Services department affect the therapists who work there. We believe this model and system has resulted in loss of wages and benefits to Rehab Services employees and has possibly resulted in wages/hours law violations by creating conditions that lead to employees working off the clock. Other impacts include the inability of employees to avail themselves of continuing professional education and increased staff-turnover rates due to low morale and provider burnout. No let’s talk about patient care.
Chronic & Systemic Understaffing
Members in Rehab Services tell us that management chronically and systematically understaffs the department. Simply put, there are not enough therapists to provide services to the patients. When members raise concerns and ask for more staff, they are told the budget does not support this because the department does not meet the productivity numbers. Previous posts have discussed how this affects employee benefits and timekeeping. Here are some examples about this this affects patient care:
NICU (intensive-care unit for babies) is staffed with only one therapist per an average 40 patients.
Acute Pediatrics has no occupational-therapy coverage in the hospital on Sundays or holidays. There is often no physical-therapy coverage in the hospital on Sundays.
Adult Acute Occupational Therapy is not available on Sundays or holidays, or in the medical, trauma/surgical or cardiovascular ICUs.
Adult Acute Physical and Occupational Therapy is so understaffed that most therapists are routinely assigned two to three times the number of patients they can see in a day.
Adult Acute Speech-Language Pathology had chronic and severe staffing shortages the past year and only recently achieved staffing at a level appropriate for patient-care needs.
Inpatients and outpatients often receive an evaluation but then have delay in follow-up treatment services. In some acute-care cases, a patient may go several days without services because of too few staff.
Adult Acute Rehab has only one rehab aide (a position essential to assisting therapists for patient care) to provide assistance to the entire department.
Patients Aren’t Receiving Services
The ultimate result of management’s inadequate staffing plan is the daily certainty that many patients who need to be seen by therapists will not receive rehab services. No amount of efficiency, productivity or working off the clock will change that. Patients not being seen is directly related to management’s staffing and budget plan. Employees would like to share specific data that supports these claims, but are fearful of retaliation by OHSU.
What happens when patients who need rehab-therapy services don’t receive them, or receive them late or at suboptimal frequency? Our members have raised concerns that several undesirable outcomes are possible:
Patients may suffer loss of function or suboptimal functional recovery.
Patients may experience a longer length of stay.
Discharge planning may be inadequate or delayed.
Patients may return to the hospital due to not succeeding after discharge.
Patient satisfaction may be lower.
Rehab providers may experience burnout and moral distress.
All of this — longer length of stay, fewer available beds, patient readmissions, poor staff retention — can combine to result in increased costs for OHSU.
What Next?
Rehab Services employees have raised and continue to raise staffing concerns directly with their managers and director. They have raised and continue to raise staffing concerns through OHSU’s employee-engagement surveys. Local 328 has repeatedly raised staffing concerns to OHSU leadership.
Yet the staffing issues in Rehab Services continue. The patient-care concerns continue. The stress on therapists who are trying to accomplish what is literally impossible continues. Fear of retaliation for speaking up about these issues continues.
OHSU leadership needs to address these concerns, with our members and our union, in an atmosphere that is be guaranteed to be free of retaliation.