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Toni Talks about PT Today

Productivity Standards

Published July 27, 2011 12:43 PM by Toni Patt

One of the responses to last week's blog made an interesting point. The writer attributed one cause of her job stress to her productivity standard. It was the same standard as her PTAs although she had a heavier caseload. I realized the same thing applies where I work. All PTs and PTAs have the same productivity standard including those working on the rehab unit. The hospital is huge. It's ridiculous to assume we're all going to accomplish the same amount of work.

Therein lies the problem with productivity standards. Someone calculated a number on paper and decided it should apply to everyone. Yes, we should keep busy while we're at work. But some of the things I do aren't billable, while being very necessary. I can't calculate them into my productivity, so it looks like I haven't been working. I can easily lose 15 minutes just waiting on elevators.

I don't think the number should be the same for PTs and PTAs. Yes, I get more units for an evaluation. It also takes longer to write the evaluation. Plus I have to do a chart review. I generally do five to six evaluations a day. That adds up to a lot of time I can't account for on paper. PTAs on the other hand are expected to carry more patients, often requiring the assist of a second person. That second person can be a blessing or a curse depending on what I have planned for my patients.

Different areas also present different challenges. Our orthopedic patients are all on the same floor. The equipment is readily available. Whereas in ICU, the patients are much sicker and require more for treatment. I might spend 40 minutes in a room but only half that time on treatment. There is no way I can make my productivity standard if I spend all day on ICU. Sometimes those patients are too sick to even work with.

Productivity is supposed to be included in our annual evaluations. We're told those who aren't as productive will get a lower evaluation. I wonder if that happens. Some of my coworkers don't seem to be as concerned with being productive as others. Yet, evaluation time comes around and nothing changes. If productivity measurement has a purpose, then it should be used for that purpose. If not, then I would like to know. There are days when the only thing that keeps me going is knowing I haven't met my productivity.

No standard is going to be correct. No matter what the standard is, someone will be unhappy. It would be nice if the standard took into consideration my caseload and what I can reasonably achieve on a daily basis. If an entire staff is being challenged to be productive, there is probably a reason beyond their control. Sometimes there aren't enough patients for everyone to be productive. This usually results in a collective sigh and slowdown as we recover for the next onslaught.



First, I'm not a PT so I can't begin to understand the daily, weekly, monthly, and annual requirements levied on your profession.  I have certainly received care from many PTs and understand the time, dedication, and devotion to your patients that is required to yield positive results.  In fact, without your profession, many of my peers would not be functional today, or able to live what we can seemingly describe as a normal life.

Second, I thank you for your years of service in the health profession that is to me the "miracle worker's profession."  I include all PTs in that salute, but your blog is the venue that enabled me to do so - so thanks again.  After witnessing the horrors of what can happen to the human body, I have also witnessed the miracles of what you do to get that body into a functional state.

Yes, it takes the surgical skill of a doctor and the nurturing care of a nurse, but the real life reconstruction begins with you.  You are the encouragement, the drive, the compassionate soul behind motivating people into healthy, pain free living...or in many cases, just living.  You make people functional again.

Third, I've been reading your site from beginning to end because despite it offering your observations and comments of what you do in your profession, it also has a secondary, perhaps unintended, consequence of delivering good information for family care givers who don't have your education.  I now care for my parents in my home and your insight comes in handy to understand how to deal with some of their issues (stokes, dementia, assisted walking, getting them to do their exercises, etc.).  Do not be alarmed, I responsibly have them looked after by professionals too.

Finally, and more to the point of your blog entry, standards on paper and by regulation always fall short of reality, especially as a metric for compensation, promotion, etc.  Their really is no fair in standards.  In my book, judging by what I've read so far, your incredibly high standards do not need measuring as they should be, and most likely are, self-evident in the good you do for each patient in your care.  For you, I'm assuming, the satisfaction of knowing that you were able to improve somebody's quality of life through your work is the ultimate standard.  Truly God's work if that is in your belief system.

Yes, somebody will be unhappy with the standard, but they should feel happy knowing that people like myself are grateful for the work that you do.  If you have unbillable down time, your productivity can always be reflected upon as the "priceless" help you've given to many.

Again, thank you for all you do...and the is a tremendous resource.

P.S. Are you able to write about some of your cases and best practices?  Especially geriatric treatment and stroke patients.

Vasco September 26, 2011 1:50 PM

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