The ‘No Productivity’ Scenario
I've recently blogged about the potential closing of the long-term care/skilled nursing facility where I work
. Although there has been no formal announcement from the administration, census continues to slow and hours have been cut from all departments -- for the exception of rehab. Due to the fact that we continue to generate revenue for the facility and are required by state law to provide skilled services to the residents, physical therapy continues to be an important presence in the building, albeit with smaller daily caseload of patients.
Typically I would have seven to eight patients on my daily schedule -- currently, I have four to five. Combined with a contract guaranteeing me a full-time position (at least 32 hours per week), my days are left with a few hours to fill. With the encouragement of my rehab director, I spend a large portion of my days screening patients, auditing wheelchairs and assistive devices, contributing to committee meetings, and providing CNA training for safer transfers. All of these activities are non-billable and although I record the time I've spent with each individual task, do not count toward my "productivity" percentage.
Watching my productivity numbers drop is alarming due to the many years spent in skilled nursing facilities where I chased a mark of 80-90% each day. However, I am just as busy if not quite as stressed. I believe the decreased stress has led me to make better clinical decisions and has given me the opportunity to branch out in my role of a PTA. It makes me speculate about how much better the quality of therapy our patients receive would be if therapists did not have the productivity "noose" around our necks each day. Will this last for my rehab department? Of course not. Eventually, efficiency of the therapy staff will become top priority again as more patients are added to caseload.
In this interim period, though, I will take advantage of the "low-productivity" expectations, with a full understanding that this is a unique opportunity to hone my therapeutic skills and learn more without the pressure of the clock.