It has been over a year since I was reminded of my failure to meet productivity expectations weekly and sometimes daily. Even though I am not reminded of productivity regularly, I still think about productivity often.
The years I worked with productivity pressures resulted in thinking about billable time during every activity at work. I still find myself talking to a nurse or a family member (patient not present) and silencing the voice telling me what I’m doing isn’t productive. Heck, that voice has at times pipes up when I’m talking to my boss.
Productivity was a foe to me. Unrealistic productivity/billable time expectations caused me so much stress, which negatively impacted my health. I focused on trying to meet productivity expectations in a system that wasn’t set up for my success. I spent more creative energy playing the numbers game than patient care, which in turn made me a less successful therapist.
After a year, the voice is still there; however, I’m slowly but surely changing the voice from “Is this billable?” to “Is this valuable?”. I still analyze how I spent my time at work, but I focus on being a good steward of time rather than fear of reprimand.
So productivity expectations are a foe?
Not quite. Productivity expectations can be a great business tool. Billable time is reimbursed time, and reimbursement keeps the business going. Having productivity expectations allow for forecasting and planning. I think productivity expectations are fine, as long as resources and systems are set in place and the right expectation is targeted.
I believe rehab teams should be looking at the processes they have in place (or lack of processes in place) and make improvements to increase their effectiveness. This activity shouldn’t have an end goal of increasing reimbursement for the sake of reimbursement; rather the goal should be focused on effectiveness.
If the therapy department helps with new employee training on fall prevention and communicating with people with cognitive and/or communication impairment, this does not increase reimbursement. However, this training does improve effectiveness of our community’s ability to provide the best care for patients, which might improve compliance, reduce falls, improve quality of life (for everyone), reduce use of antipsychotics, and a whole host of benefits.
We can also refine processes to smooth patient admission and evaluation (e.g. what could we do to reduce 5 people looking for the same pieces of information at 5 different times?), which would save time. By analyzing the system and current processes, rehab teams and buildings will know what their system can support. When we better understand what our system can support, appropriate productivity expectations can be established.
Check back on Thursday for a guest post about how one therapist has streamlined her daily tasks to eliminate wasted time.
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