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Continuous Improvement in Hand Therapy & Beyond

I never envisioned myself being in a leadership position but 10 years into my career I needed a challenge. I was practicing in hand therapy, but not in an exciting, buzzing orthopedic clinic and I was feeling stagnant. So, the new challenge became obtaining my post professional doctorate in occupational therapy. At the time the decision to do this was simply to fill a need for professional growth, but I didn’t feel it would change the trajectory of my career.

To my surprise, however, obtaining my clinical doctorate helped to define a career trajectory and achieve professional goals I never imagined I would be capable of, namely in the realm of leadership. I know that people can achieve great success without formal education, but I attribute much of the richness of my life to my education, along with my faith. While it’s my faith that gives me an empowering lens to interpret life events, it’s my education that gave me the tools to utilize them in a way that moved me towards continued professional and personal development.

So, what does Continuous Improvement have to do with all this?

The concept of Continuous Improvement has its origins leadership and management strategies.

It’s simply a systematic and scientific habit to break through barriers in order to achieve goals (Rother, 2010). Acquiring a physical disability at twenty-one made continuous improvement a necessity for me, but it has translated into an understanding that all barriers can be broken or navigated.

No matter whether we are talking about achieving hand therapy goals in collaboration with patients, or our own professional or personal goals, Continuous Improvement invites a process of inquiry and reflection, and most importantly, an action for change.

I’ve applied Continuous Improvement as a clinician to ensure that the interventions I am utilizing are effectively moving patients towards established goals, as well as to illustrate how patient participation impacts the therapy process. But it can virtually be applied to all contexts with an identifiable goal.

Here’s an example of the continuous improvement process for an aspiring hand therapist:

1. Define your goal

I want to be a CHT

2. Identify your starting position

I’ve been in pediatrics for 2 years

3. Identify the obstacles to achieving your goal

I know nothing about hand therapy

4. Identify strategies you will implement

I will enroll in a hand therapy fellowship, or a post professional upper quarter and hand therapy certificate program. I’ll join American Society of Hand Therapists and read the Journal of Hand Therapy, and so forth.

5. What are the results?

Evaluate the effectiveness of the steps you’ve taken as evidenced in learning outcomes, the breadth and depth of knowledge you have gained, your effectiveness clinically, your confidence and ability to seek out employment in hand therapy, and ultimately, your ability to pass the CHT exam.

The key is in the last step, the evaluative process, to determine whether the steps we’re taking are working and doing this regularly, so that if needed, we can immediately change our approach.

While having a Continuous Improvement mindset (Rother, 2010) is a habit towards adaptiveness and breaking through barriers that helps you achieve personal and professional goals, it’s also is a great tool to assess the effectiveness of clinical strategies you’ve implemented, and to efficiently change course if needed. It can also be a tool that enables your patients to appreciate their own ability to effect change towards their goals and motivate them to maintain an active role in doing so.


Mike Rother, Toyota Kata, Mc Graw Hill; 2010.



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