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Productivity doesn't have to be a dirty word

Rehab Regs, October 1, 2004

How your facility can establish a rate that works for everyone

Your supervisor wants maximum staff productivity to meet the bottom line. Your patients don't want to be rushed out the door. You want to have enough time to help your patients, complete the necessary documentation, and maybe even have time for lunch. Here are some tips to help you try to please everyone.

Rehab facilities establish productivity rates that range from 50% to 100%, according to Ann W. Kummer, PhD, CCC-SLP, director of the speech pathology department at Cincinnati Children's Hospital Medical Center.

Usually, the larger the facility, the higher the productivity rate because clinicians can focus solely on providing therapy services rather than doing double duty as business office staff. Consequently, many supervisors expect these therapists to meet consistently higher productivity rates.

The American Speech-Language-Hearing Association (ASHA) conducted a survey of speech-language pathologists (SLP) working in healthcare in 2002 and found that almost half of the respondents spent 70% or more of their time in actual patient care.

"The amount of paperwork [an SLP] does in a normal day varies by setting," says Janet Brown, MA, CCC-SLP, director of healthcare services in speech-language pathology for ASHA.

By determining factors like this at your facility, you can come up with an effective productivity level.

"Productivity is a factor that you can evaluate," says Brown. "And it can ensure equity among your staff by setting a performance standard."

Productivity rates can vary greatly from facility to facility based on a variety of factors, says Rebecca Byerley, PT, director of physical medicine at Central Peninsula General Hospital in Soldontna, AK.

"The acuity of the patients and the demands of their treatment will affect a therapist's productivity rate," says Byerley. "It is an accepted practice that our therapists will see between eight and 10 patients a day."

This rate is based on a therapist who works an eight-hour shift each day for five days each week. Put another way, each therapist is expected to log 32 to 40 units of time each day with patients. Each unit is 15 minutes long.

To account for time spent completing paperwork, Byerley's facility has streamlined the documentation process so therapists can complete flowsheets while working with their patients.

If you treat two or more patients at once, you should factor that into your productivity rate. At Kummer's facility, therapists use the following format:

Under these scenarios, conducting group therapy with two patients would amount to the same credited time as one, but an hour of group therapy with four patients would double a therapist's credited time.

"[Group therapy], when appropriate, is a good way to increase productivity," says Kummer.

To meet the productivity rate at your facility, you likely have to overbook to make up for cancelled appointments and no-shows.

Because habitual no-shows can consistently alter a therapist's productivity rate, Byerley's facility has a three-appointment limit on no-shows. Patients who do not attend their therapy appointments are discharged to make space for others who need the therapist's services.

All therapists are not the same, and facilities may need to alter their productivity rates to accommodate employees who have additional tasks to complete.

Byerley's facility encourages public education and may periodically cut down on a therapist's productivity rate. Other tasks may include public relations, program development, care coordination with families, and physician visits.

Experts say to remember these three factors when determining the right productivity level at your facility:

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