Restructuring of Rehabilitation Services Leslie Burgy LDR-678 Research Practicum August 13th, 2013

Host Organization: St. John Macomb-Oakland Hospital Facts about the hospital: St John Macomb Hospital and St John Oakland Hospital merged in 2007 and are considered one hospital with two campuses. 535 beds 3436 associates 1200 physicians in over 45 specialties

Site Supervisor Laura Cadieux, RN Director of Intermediate Care at St John Hospital and Medical Center East Region Director of Inpatient Rehabilitation Nursing

Overview: As of July 1 st, 2013, the Rehabilitation Department which includes both acute care services and Inpatient Rehabilitation units at St John Hospital and Medical Center and St John Macomb-Oakland Hospital transformed leadership models. Assessment of the project started in April 2013 when the continuum of care team shared their strategic goal of regionalization of Rehab. Services with the ultimate goal being systemization of Rehab. Services.

Objectives: Decrease the variation of practice at St.John Hospital and Medical Center and St John Macomb-Oakland or otherwise known as the East Region. Assessment of various resource alignments Systemization of policies and procedures specific to Rehab Services. This will include Providence and Providence Park Hospitals.

Updated Objectives The East Region of Rehab Services was realigned as of July 1 st, 2013 New responsibilities:  Physical and Occupational Therapy at Macomb and Oakland Hospitals for acute and inpatient rehab.  Audiology services at Macomb  Speech Language Pathology ( though this is a contracted service)

Updated Objectives IPR Midlevel providers in East Region have same responsibilities All the IPR policies and procedures have been reviewed and eliminated as appropriate

Current Status: This practicum started in April 2013 Total accumulated hours:  April =2  May = 4  June=  July = 83  August= 78 Total=

Lessons Learned: “ Aligning an organization is like preparing for a long sailing trip. First select your destination (missions and goals) and your route (strategy). Then you figure out what boat you need (the structure), how to outfit it (the systems) and the crew mix (the skills). Throughout the journey you keep an eye for reefs that are not on the charts” (Watkins, 2003, p. 135)

Lessons Learned: Leadership Organizational Cultural and Communication Finance Systems Management Strategic Planning and Implementation

Next Steps: Final meeting with site supervisor on August 15 th, 2013 to confirm completion of practicum Take completed east region IPR policies to west region for integration so that new system Policy Stat can be used Arrange System Rehab Advisory Committee Meeting Review Acute Care Rehab Policies and procedures with Moross

References: St. John Providence Health System. (2013). Retrieved from Watkins, M.(2003). The first 90 days. Boston, MA. Harvard Business School Publishing.