Productivity VS Outcomes
Someone posed the question asking if there had been any research to demonstrate a correlation between productivity and positive patient outcomes. Of the numerous internet searches completed, I find no evidence such a study exists for therapy. However, there are several articles I found regarding productivity VS patient satisfaction outcomes that have been done for the nursing field.
My first thought here is probably the same as yours. If your supervisor is standing over you complaining about productivity, you may tend to get a bit "on edge." Like any job, your supervisor needs a certain amount of work to be completed on a daily basis to keep the business open. Even if your job is working for one of the local fast food places, you would need to cook and serve so many burgers daily, or you'll find yourself on the street without a job.
OK, strange comparison, I know. Just what is the relationship between a fast food restaurant and the therapy clinic? Well, think about what you do when you walk into the local burger joint and the line is forever long because the cook also has to wait on customers. Do you just stand there and wait your turn? Head down the street to the next restaurant? Complain to the management? Any of these are good answers, but it still doesn't make the line move any faster. If the cook isn't able to keep up with the demand, sales suffer and profits decline. If this trend is allowed to continue, pretty soon the restaurant closes.
It's a similar situation in the therapy clinic. If the therapist has to deal with two or more patients at the same time, things slow down, or someone has to wait. Billing minutes for that "waiting" patient is unethical, which in turn will affect your productivity. Low productivity equals decreased profitability. If profits are marginal, your next raise can be affected. And by the same token, if this decrease in productivity continues, soon the company either closes, moves on, or is asked to leave.
The big difference here is that the customers in therapy are our patients. They normally don't have the option to go down the street to the next therapy clinic. They can complain to management, but then we're back to our boss standing over us again complaining about productivity.
Now, I'm not saying that productivity guidelines are good. They are something we have to deal with, like it or not. Business being business, we do have to keep the numbers up or suffer the consequences.
Let's back up here to review a small piece from one of the articles I've read concerning patient outcomes and nursing. Patients do report increased satisfaction when nursing staff are more productive. However, since most nursing staff contact is one on one, is there anyone who wouldn't be happier when your nurse spends more time caring for you? This study seems like a no-brainer.
As far as productivity VS outcomes in therapy, I can only assume that our patients would be happier if we dealt with them one on one. I sincerely doubt that patient satisfaction is the highest when concurrent treatments are the norm. As most of them have little to do all day but sit and wait, waiting for therapy is one thing they shouldn't have to do.
Are there any answers to this problem? I really believe it's going to take a major effort by us, as therapists, to make our elected officials know what's going on. Not from our perspective though, but from our patients point of view. Since we are the advocates for our patients, we need to make the effort to change what has happened. Whether this is voting for the candidates who support positive Medicare change, or writing letters to congressional leaders, we have to show how the quality of patient care has declined due to the compulsory productivity standards.
As far as productivity and positive patient outcomes, I think if someone completed a good study in this area it would give us a place to start.
Hope all your thoughts are good,
Tim