Multidisciplinary Management Strategies for Speech-Language Pathologists in Post-Acute Settings

Introduction

The nature of rehabilitation in sub-acute and post-acute medical facilities is multidisciplinary. Speech-language pathology, physical therapy, and occupational therapy are typically grouped together as a clinical and logistical entity. Insurers assign treatment time allocations to these disciplines collectively and they are often housed in the same wing, unit, or room of a medical center. Research supports the efficacy of multidisciplinary rehabilitation (Prvu Bettger & Stineman, 2007) and so "rehabilitation" as an entity is supplanting isolated physical therapy, occupational therapy, and speech-language pathology departments. As these departments evolve into multidisciplines, as opposed to isolated ones, managers of these broader and more holistic departments find themselves managing outside their discipline.

Qualities of effective leaders (including managers) include excellence in communication and organization (Catlett & Halper, 1992; Leggat, 2007). These skills are found among the personal skill sets of speech-language pathologists (SLPs). ASHA (2004) recognizes that the ability to develop, communicate, and implement a mission, visions, and goals are essential for managers. Effective interpersonal, mediation, and negotiation skills are also essential for those who manage other SLPs (ASHA). These same skills can be applied to management of various professionals across clinical settings. However, SLPs may find themselves facing unique sets of challenges when moving into multidisciplinary management roles (Swigert, 2008).

Due to the high degree of overlap in the education of anatomy, physiology, functional service delivery, modalities, and treatment planning between occupational therapists (OTs) and physical therapists (PTs), professionals in these disciplines may find themselves initially more comfortable reporting to a manager within these disciplines. Conversely, an SLP who becomes a manager may find himself or herself struggling to fully understand the scope of practice of the OTs and PTs whom they manage because the education, training, and service deliveries do not suggest the same degree of commonality.

SLPs who supervise and manage in multidisciplinary environments must have sensitivity and aggressively pursue the knowledge required to be effective in this role. The ultimate goal of rehabilitation is successful recovery and it is imperative that all professionals advocate for the individual's recovery. But there is additional benefit of improved advocacy for all disciplines when fostered by an effective multidisciplinary manager. In short, an exceptionally run rehabilitation department, led by an effective multidisciplinary manager, can be much greater than the sum of its parts.

Education and Licensure

The first step in understanding the professionals being managed is to understand what they needed to learn in order to be what they are. Although speech-language pathology has required a master's degree or equivalent since 1965 (American Speech-Language-Hearing Association, 2010a), a master's degree is a more recent requirement for occupational and physical therapists (American Occupational Therapy Association, 2009; Nieland & Harris, 2003). It is still possible to find clinical PT or OT professionals who entered the field when bachelor's degrees were the standard of education. Table 1 summarizes the education, license, and continuing education requirements for the three disciplines.

Table 1. Requirements for PTs, OTs, and SLPs