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Leading Change


  • Dr. Ruth Ann Kiefer NP RN CRRN

    Corresponding authorSearch for more papers by this author
    • Ruth Ann Kiefer, DrNp RN CRRN, is a member of the faculty at the Dixon School of Nursing at Abington Memorial Hospital in Abington, PA, and continues to practice as a CRRN in the hospital's rehabilitation unit.


Teamwork remains a big part of a rehabilitation unit's success. What do you do when there is dissension within the ranks and each shift becomes segregated, is resentful of the other, and spends a good part of each day complaining about the inadequacies of the current system? At one facility, patient falls, staff injuries, and workers' compensation cases were on the rise. Work became a chore that few looked forward to. Staff call-out rates increased, which added to the workload of the remaining staff A program was developed that provided a “tag-team” approach to care delivery for rehabilitation patients. Nurses and clinical assistants worked in pairs as they provided care. No single-person positioning and transfers were done when there was a clear need for two people. One staff member was not assigned to complete total care for patients when two staff members could complete the task more safely and efficiently. This “tag-team” approach produced positive outcomes with regard to patient and staff satisfaction.