Fox GERI 7 Carnegie Plaza Cherry Hill, NJ 08003

P: 1 877 407 3469 F: 1 877 407 4329 W: foxgeri.org

Real World

Implementation I:

Best Practices in

Staffing, Training &

Certification

Mimi Jacobs, PT, GCS, OCS

Fox GERI

Fox Rehabilitation

STAFFING

FOX REHAB OVERVIEW

Text • Fox GERI partnered with Fox Rehabilitation and CARAH

to translate the ESP

• Fox GERI/Fox Rehabilitation is headquartered in Cherry

Hill, NJ a suburb of Philadelphia

• Fox Rehabilitation is a private practice providing physical,

occupational and speech therapy services to the older adult

in their home, assisted living or adult medical day center

• Fox Rehabilitation currently employs 110 Occupational

Therapists across 5 states in the mid-Atlantic region

STAFFING

THE BIG QUESTION

Text

How do you translate an evidence-

based intervention to 110 OTs across

5 states?

How do you climb Mt. Everest?

STAFFING

OUR ANSWER

Text A PILOT TRANSLATIONAL PHASE

Year 01:

• 15 OTs

• Geographical area immediately surrounding

headquarters

Year 02:

• 15 OTs

• Expanded geographical area within 75 miles of

headquarters

STAFFING

YEAR 01

Text • Began internal marketing as soon as possible

• Request for volunteers sent out to 28 OTs

• 17 responded

• 15 met our established baseline criteria

Employed at Fox Rehabilitation >6 months, baseline

score on internal ongoing quality assurance

measures such as internal documentation chart

audits

• Both novice and experienced clinicians

GROUP PHOTO

YEAR 01

Text

STAFFING

YEAR 02

Text • Of the 15 OTs who participated in Year 01:

• 6 participated in Year 02

• 8 did not participate due to staff turnover, company

promotions, participation in other projects and

medical leave

•Request for volunteers sent out to 30 additional OTs

• 12 responded

• 9 new OTs were added to the project in Year 02

• Both novice and experienced

GROUP PHOTO

YEAR 02

Text

STAFFING

STAFF COMMITMENT

Text

All OTs participating in this project signed a “Commitment

Letter” which outlined:

• Description of the project

• The short term and long term vision of the project

• Responsibilities and expectations of the OT

• Responsibilities and expectations of

Fox Rehabilitation

• Responsibilities and expectations of Fox GERI

• Responsibilities and expectations of CARAH

STAFFING

PILOT PHASE RECAP

Text

Pilot translational phase prior to full implementation to

identify and address:

• Adoption issues

• Sustainability issues

Over 2 years:

• 24 OTs volunteered and received training

• Currently 17 (70%) are continuing its use

• OTs ranged in years of education and clinical

experience

TRAINING

Text • Critical to translation was the development of training,

monitoring, coaching and documentation processes that

balanced company structure, culture and reimbursement

requirements with fidelity to ESP

• While ESP builds on OT skills and knowledge, it is

distinct from traditional practice and requires a minimum of

20 training hours in assessments, protocols and treatment

principles

• To assure success in translating ESP and fidelity to the

original intervention tested, we developed a comprehensive

training program

TRAINING

YEAR 01

Text In the research setting, interventionalists received days of

face-to-face training to deliver ESP

Translational Problem:

As a private practice, this training structure was

unacceptable for financial reasons (lost revenue, salary

costs, etc)

Solution: Modify the training structure

TRAINING

YEAR 01

Text

On their own time:

• OTs repeated the Fox Rehabilitation internal

training “Dementia Module” for all new hires (2 hrs)

• OTs completed selected readings (4 hrs)

Participated in a 2 day(16 hrs )face-to-face training (Fri/Sat)

TRAINING PHOTO

YEAR 01

Text

TRAINING PHOTO

YEAR 01

Text

TRAINING

YEAR 02

Text Based on feedback from Year 01 – the training program

evolved for Year 02

Year 02

• Fox Rehabilitation Dementia Module (2 hrs)

• Selected Readings (4 hrs)

• Self Paced Web Based Training (8 hrs)

• 1 day face-to-face Training Session (8 hrs) (Saturday)

TRAINING PHOTO

YEAR 02

Text

TRAINING PHOTO

YEAR 02

Text

TRAINING

YEAR 02

Text

Ongoing coaching / supervision and fidelity evaluation

occurred via:

• 3 individual call ins over a 5 month period

• 6 monthly group conference calls

○ Discuss new information / updates on project

○ Celebrate success

○ Brainstorm solutions to challenging cases

TRAINING

COMPANY WIDE

Text • Within the geographic territories of trained OTs: all OTs not

participating in project, all PTs and all SLPs received training on

“What is ESP” and “How to identify a patient/caregiver dyad

appropriate for ESP / How to refer a patient/caregiver to receive

ESP”. This was repeated every 6 weeks to reinforce the

material and reach staff new to the practice

• All OTs, PTs and SLPs, company wide, now receive training on

basic concepts of caregiver training

• Administrative teams including customer intake, compliance,

chart auditing, billing, accounts receivable, and marketing all

received training on “What is ESP” and “How it affects my

specific job”. Training repeated every 6 weeks

CERTIFICATION

Text

CARAH is continuing to develop the criteria of ESP

certification. Fox is providing feedback to CARAH on

possible models of the certification process

Text

THANK YOU

Fox GERI 7 Carnegie Plaza Cherry Hill, NJ 08003

P: 1 877 407 3469 F: 1 877 407 4329 W: foxgeri.org