When speaking of efficiency, we are often told, "Don't work hard; work smarter." Most rehabilitation companies require an average of 80% productivity or above; this means that only 20% of a therapist's day can be devoted to non-billable services. This sounds pretty clear-cut on paper, but the reality of managing managing direct treatment and other duties can be trickier.
When we do not meet our expected efficiency rate as therapists, we are often told that we are "giving away minutes." It seems obvious that if we work an eight hour day, but only treat patients for four hours, an efficiency rate of 50% is not going to be acceptable to our employer. That, of course, is an extreme example and could probably only occur in the rarest of circumstances; it's the little actions - ten minutes here and five minutes there - that add up to lower our productivity. In many cases, therapists are being "nice" or "helpful" when we give away minutes throughout the day. If I have ten patients to treat in a day, and I spend only five minutes with each patient on non-therapy related activities, I am "giving away" fifty minutes that day.
It's not as easy as it sounds sometimes. A patient needs a blanket, or a family member stops in to ask questions after a therapy session is completed, and the minutes add up. Some simple ways to start improving efficiency are:
● If families and nursing staff want to discuss progress, invite them to do it during the next session, with the patient present. Focus your time on you patients and, unless it is an emergency, direct patients to use call lights to alert staff that they need help. You should always let staff know when a resident needs help, but as a skilled clinician, it is not your job to fetch blankets or snacks, and it is not appropriate for you to feed, position, physically assist, or transfer any patient unless you have a physician's order to treat that patient.
● Avoid giving advice or recommendations about patients who are not on your caseload, even if you have treated them previously. Nursing staff should be able to access your discharge recommendations, and if they have new concerns, a referral for evaluation is in order.
● Avoid meetings that do not pertain to a specific patient, unless you have made prior arrangements with management. The patient must be present for meetings and education to count as billable time.
● Avoid lengthy screens; if it is longer than ten minutes or so, it is an evaluation and you should document it as that.
● Well meaning families often like to be friendly and chat. Let nursing staff and families know that you have a schedule. Simply stating that you have a patient waiting can help you to avoid conversations that are more like socializing than work, without seeming rude. Have a system for communicating with the dietary manager at the beginning of the day. I find that everyone appreciates knowing about trials meals and snacks earlier rather than later, and it saves trips to the kitchen.
● If you have multiple orders to write in charts, make a list and visit the nurse's once rather than five times.