Exercise Therapist - Outpatient Gym

Job Description Summary

Performs cardiac rehabilitation functions to facilitate patient cardiac fitness. Participates in process of assisting the patient with cardiac risk factor reduction.

Job Description

ESSENTIAL FUNCTIONS

Essential functions are those tasks, duties and responsibilities that comprise the means of accomplishing the job's purpose and objectives. Essential functions are critical or fundamental to the performance of the job. They are the major functions that the person in the job is held accountable for. Following are the essential functions of the job.


* Use this to denote if a function does not provide opportunity to perform beyond "Meets Expectations"
1. ADMISSION AND EVALUATION
Conducts Intake Evaluations on a weekly basis as assigned to meet patient needs in accordance with the established standards of care and practice.

CONSISTENTLY EXCEEDS STANDARDS
· Achieves competency with unusual or complex evaluations/ diagnoses/ ages
· Acts as a resource/mentor to new staff/students
· Consistently refers patients to other disciplines/resources as indicated by evaluation findings

CONSISTENTLY MEETS/SOMETIMES EXCEEDS STANDARDS
· Demonstrates expanded evaluation techniques (i.e. special tests)
· Demonstrates willingness to research new diagnoses in order to prepare for an unfamiliar evaluation
· Demonstrates willingness to learn new evaluation techniques
· Able to identify subtle patient problems and incorporate into treatment plan accordingly

CONSISTENTLY MEETS
· After RN’s initial medical record review and 1:1 interview with patient/family, reviews patients medical record prior to conducting orientation session
· Reviews and evaluates results of GXT (when available) and medical data prior to patient admission
· Identifies any orthopedic, neurological or medical problems, which may interfere with patient's successful completion of the program
and notes any of these problems in initial patient admission assessment.
· Plans to accommodate special limitations appearing in patient admission assessment
· Assesses and evaluates the patient's GXT and medical data, and develops a safe and effective exercise prescription for
the patient utilizing the appropriate mode, intensity, duration and frequency of exercise
· Conducts exercise therapist assessment with patient problem list and pulmonary rehabilitation treatment plan,
CAD Risk Reduction Plan and mutual patient/ family goals and documents all according to policy
· Completes admission data input into Qtel Monitoring System as needed
· Assesses patient compliance with risk reduction plan on a weekly basis

DEVELOPMENTAL/NEEDS IMPROVEMENT
· New employee, needs increased guidance/ assistance
· Unfamiliar with work setting/ types of diagnoses on caseload
· Requires frequent supervisory input and guidance to complete any of the above tasks

CONSISTENTLY DOES NOT MEET STANDARDS
· Does not complete admission and evaluations on time
· Does not clearly and accurately complete evaluations
· Uses inappropriate evaluations and techniques
· Goals not measurable, functional or realistic
· Findings inaccurate/incomprehensive



2. TREATMENT
Conducts exercise program with assigned patients according to established treatment plan in accordance with established standards of care and practice.

CONSISTENTLY EXCEEDS STANDARDS
· Acts as a resource/mentor to new staff/students
· Actively and consistently initiates collaboration with other team members when appropriate
· Maximizes use of prepared patient education materials and creative treatment techniques.

CONSISTENTLY MEETS/SOMETIMES EXCEEDS STANDARDS
· Demonstrates creativity in treatment sessions to individualize care and gain maximal benefit from each session
· Seeks additional help to communicate patient care issues that need to be discussed with Medical Director at team meetings.
· Seeks out other team members to discuss patient goals, collaborate treatment plans.
· Demonstrates ability to obtain multiple session data for patients with MD follow-up appointments

CONSISTENTLY MEETS
· Demonstrates appropriate clinical decision making skills in reporting of signs and symptoms by patient to supervising RN.
· Conducts exercise orientation session with patient which includes: interpretation of exercise prescription, guidelines for safety, and overview of program.
· Calculates patient's target heart rate before first exercise session and documents on patient's exercise record
· Instructs patient to monitor heart rate and perceived exertion during exercise and documents in patient record
· Prepares patients for telemetry, takes blood pressure and monitors heart rate, RPE when necessary
· Within first week of the program,
o Conducts pre-program patient measurement
o Explains principles of exercise prescription, safety guidelines and overview of program at first exercise session
o Reviews orientation equipment safety checklist with patient
o Reviews patient's goal for exercise
· Leads appropriate stretching, warm-up and cool-down exercises at each session
· Instructs and supervises patients on use of various exercise modes at each session
· Presents classes related on principles of exercise
· Monitors patient progress with increasing activity tolerance and advances exercise prescriptions based on patient’s THR, RPE and medical condition
· Alerts nursing staff to problems with exercise routine, responds appropriately and makes adaptations as needed
· Provides patient support with behavior modification and risk reduction plan and through weekly review of home exercise program
· Demonstrates ability to manage their assigned patient exercise groups on Qtel Monitoring system and complete all functions
required to enter and update patient’s data input.
· Provides updates on assigned patients to the Medical Director via MD progress note form
· Participates in team meetings and/or communicates patient care issues to nurse manager that need to be discussed with
Medical Director at team meetings.
· Conducts Community Maintenance exercise groups (cardiac, pulmonary, diabetes, and/or general population, including:
o Maintains updated group enrollment logs,
o Maintains cash journals for each group,
o Directly supervising exercise groups,
o B/P assessment,
o Developing exercise workloads, updating as needed
· Anticipates need for repair of equipment and orders maintenance parts.

DEVELOPMENTAL/NEEDS IMPROVEMENT
· Needs assist/guidance in selecting and implementing therapeutic techniques safely and accurately
· New employee, needs increased guidance/ assistance
· Requires frequent supervisory input and guidance to complete any of the above tasks
· Needs encouragement/guidance to collaborate with other members of the team
· Unfamiliar with work setting/ types of diagnoses

CONSISTENTLY DOES NOT MEET STANDARDS
· Uses inappropriate treatment techniques
· Performs treatment techniques in an unsafe manner (non-compliance with safety standards/policies)
· Unable to develop therapeutic rapport

3. DOCUMENTATION
Completes all documentation of services per department standards

CONSISTENTLY EXCEEDS STANDARDS
· Consistently and independently writes clear and concise documentation including measurable, customized and realistic
goals with clear discharge recommendations for other team members
· Mentors new staff and students in documentation process
· Identifies ways to improve documentation process
· Documentation is beyond the basic expectations, within reason.

CONSISTENTLY MEETS, SOMETIMES EXCEEDS STANDARDS
· Consistently documents all aspects of team communication, specialized assessments and patient response in notes
· Documents relevant information between patient visits (i.e. phone conversations, interactions with patient family, caregivers)

CONSISTENTLY MEETS
· Follow–through for plans, patient progress and home exercise program review are acknowledged in patient progress notes on a weekly basis
· Documents exercise prescriptions on the patient exercise record considering target heart rate and patient’s perceived exertion
· Documents all teaching in the Patient/Family education record
· Is responsible to independently write clear, concise, relevant and inclusive documentation that facilitates communication
of the patient’s status and ongoing needs
· Adheres to all hospital and departmental procedures and documentation standards
· Documents response to inpatient Pulmonary Rehab referrals in PCS system according to hospital guidelines
· Provides updates on assigned patients to the Medical Director via MD progress note form.
· Takes responsibility to provide coverage information on all patients for whom they have primary responsibility when absent
· Requests change for physician’s orders as needed
· Appropriately records patient attendance at program for billing purposes

DEVELOPMENTAL/ NEEDS IMPROVEMENT
· New employee, needs increased guidance/ assistance
· Requires frequent supervisory input and guidance to complete any of the above tasks
· Has required 4-6 verbal redirections for incomplete or unclear documentation.

CONSISTENTLY DOES NOT MEET STANDARDS
· Requires frequent direction/redirection for completion of documentation within department standards without significant improvement


4. DISCHARGE
Demonstrates timely discharge from treatment with appropriate documentation

CONSISTENTLY EXCEEDS STANDARDS
· Efficiently manages treatment program to achieve goals for discharge within parameters provided (i.e. insurance approval period or length of stay)

CONSISTENTLY MEETS/SOMETIMES EXCEEDS STANDARDS
· Collaborates with patient and documents discussion of preparation for discharge
· Anticipates and prepares patient for discharge well before anticipated discharge date

CONSISTENTLY MEETS STANDARDS:
· Collaborates with nursing staff at various intervals to assess patient's progress towards discharge
· Prepares discharge instructions and schedules discharge meeting with patient to finalize status of goal achievement and
formulate discharge plan in collaboration with nurse
· Conducts post-program patient measurements during last week of patient’s program
· Accurately completes Qprogress discharge reports on the Qtel monitoring system and send copy to MD
· Assesses/determines length of program participation appropriate for patient to meet projected goals.
· Collaborates with RN during discharge meeting with patient to finalize status and formulate post discharge plan
· Provides information for continuum of care after discharge including plans for exercise maintenance program and continued risk reduction plan
· Discharged charts are consistently completed according to department policy within 2 weeks of discharge date

DEVELOPMENTAL/NEEDS IMPROVEMENT
· New employee, needs increased guidance/ assistance
· Requires frequent supervisory input and guidance to complete any of the above tasks
· Most but not all charts are prepared according to D/C process within 2 weeks of discharge date

CONSISTENTLY DOES NOT MEET STANDARDS
· Patients are consistently unprepared for discharge despite verbal counseling.
· Less than 50% of all charts are prepared according to D/C process within 2 weeks of discharge date


5. BILLING
Enters daily charges in a timely and accurate manner

CONSISTENTLY EXCEEDS STANDARDS
· On average, has less than 1 billing errors per month including all aspects of the billing process as delineated
· Independently demonstrates proficiency in correcting errors accurately
to perform the billing reconciliation process accurately
· Acts as a resource for other staff in clarifying billing questions accurately
· Acts as a resource for other staff in accurately teaching all aspects of the Meditech ITS process including but not limited to
entering bills, use of Medicare modifiers, process to correct bills, selecting correct account, etc.
· Anticipates potential insurance issues and takes pro-active measures to resolve

CONSISTENTLY MEETS/SOMETIMES EXCEEDS STANDARDS
· On average, has less than 1-2 billing error per month including all aspects of the billing process as delineated
· Acts as a resource for other staff in accurately teaching all aspects of the Meditech ITS process including but not limited to
entering bills, process to correct bills, selecting correct account, etc.


CONSISTENTLY MEETS STANDARDS:
· Enters daily charges accurately into Meditech for each patient seen by the end of their shift.
· daily documentation accurately reflects charges that are entered
· Adheres to insurance authorizations and guidelines such that denied charges are avoided.
· Accurately completes billing sheet that is reflective of entered and/or rendered charges by the end of their shift.
Indicates Cancelled and No Shows on billing sheet.
· Changes appointment status for No show and Cancelled patients by the end of their shift
· Demonstrates ability to select the correct account for billing services
· On average, has no more than 3 billing errors per month including all aspects of the billing process as delineated above

DEVELOPMENTAL/NEEDS IMPROVEMENT
· New employee who is gaining familiarity with the billing system
· Requires frequent supervisory input and guidance to complete any of the above tasks
· On average, has 4 to 8 billing errors per month including all aspects of the billing process as delineated above with steady improvement noted

CONSISTENTLY DOES NOT MEET STANDARDS
· Charges are consistently not entered
· On average, has more than 8 billing errors per month including all aspects of the billing process as delineated above with no significant improvement

6. PRODUCTIVITY
Demonstrates behaviors supportive of departmental standards for productivity

CONSISTENTLY EXCEEDS STANDARDS
· Consistently exceeds productivity standard for primary area(s) averaged over the year.
· Takes initiative to meet/exceed productivity standard,
· Demonstrates an appreciation for financial status of department and the relationship between treatments and reimbursement

CONSISTENTLY MEETS/SOMETIMES EXCEEDS STANDARDS
· Consistently meets and sometimes exceeds productivity standard for primary area(s) averaged over the year.

CONSISTENTLY MEETS STANDARDS
· Meets 96-100%of productivity standard for primary area(s) averaged over the year. (department standard is managing 9 exercise groups/week)

DEVELOPMENTAL/NEEDS IMPROVEMENT
· New employee or transfer employee gaining familiarity with work area
· Established employee who meets 80-95% of productivity standard for primary area(s) averaged over the year.

CONSISTENTLY DOES NOT MEET STANDARDS
· Meets less than 80% of productivity standard for primary area(s) averaged over the year.


7. Embraces technological solutions to work processes and practices

Performance Standards:
CONSISTENTLY EXCEEDS STANDARDS: performance meets all areas from Consistently Meets and Consistently Meets/Sometimes Exceeds and clinician demonstrates the following behavior:
o Presents and initiates new technological processes, applications and/or practices to improve department
performance

CONSISTENTLY MEETS/SOMETIMES EXCEEDS STANDARDS performance meets all areas from Consistently Meets and clinician demonstrates a majority of the following behaviors:
o Offers suggestions for changes to improve department work processes and practices
o Consistently access Lotus Notes and other computer applications to facilitate job performance and
department processes beyond basic s, ie: Work Requisitions, Forms Drawer , SSH Portal Research options,
MSDS, as applicable to role in Rehab.
o Participates in ongoing development and enhancement of computerized documentation model
o Demonstrates and utilizes computer skills such as Powerpoint, Excel, or computer based programs ie:
PTEX, Boardmaker, to enhance job tasks, provide education, facilitate department processes and/or improve
clinical treatments
o Acts as a mentor for other staff with technological applications

CONSISTENTLY MEETS STANDARDS:
o Consistently and accurately uses all Meditech/PCS and Qtel Monitoring System Applications required in the department
o Learns and applies new applications in a timely manner
o Is aware of and follows computer downtime procedures as needed
o Consistently accesses Lotus Notes for e-mail, Learning Management and other resources, as applicable to
role in Rehab.
o Accountable to respond to pagers/email according to department standards
o Accurately uses TimePC and SSH Portal applications as needed for job performance
o Accepts changing treatment environment as technology advances and is willing to learn new techniques
and equipment applications
o Receptive to changes in department work processes and practices
o Seeks appropriate guidance for new techniques

DEVELOPMENTAL/NEEDS IMPROVEMENT: Performance is below par; employee needs guidance/ assistance to improve skills in technological applications and/or acceptance of technological changes and is demonstrating steady improvement.
o Demonstrates hesitancy or difficulty attaining new technological skills as required for departmental or
hospital work processes and practices
o Requires cueing to respond to emails and pages within acceptable time limits as defined in department
standards.
o Requires cuing for accurate and consistent use of computer applications such as Lotus Notes mail and
Learning Management icon, TimePC and SSH Portal

CONSISTENTLY DOES NOT MEET STANDARDS: Performance below par and is not improving despite supervisor’s interventions
o Has received verbal counseling for response to emails and pages, yet continues to not meet standards
o Does not use computer applications needed for role in Rehab, ie: Lotus Notes Workspace icons, TimePC,
SSH Portal
o Resistant to learning or applying new technological skills as required for departmental or hospital work
processes and practices



ESSENTIAL FUNCTIONS (Cont.)

I. Technology and Learning
a. Participates in continued learning and possess a willingness and ability to learn and utilize new technology and procedures that continue to develop in their role and throughout the organization.


b. Embraces technological advances that allow us to communicate information effectively and efficiently based on role.


BLS - Basic Life Support. Knowledge and experience in techniques of Cardiac Rehabilitation. Knowledge in exercise physiology, exercise testing, exercise prescription, group leadership, and monitoring techniques.