Putting a Wrench in the Cog: Practical advice for managing productivity (Part One)
Fixing my mistake
I got a little bit of negative feedback on my last blog about productivity. Ok, I got A LOT of negative feedback. And for good reason. The piece was extremely theoretical and made it look like I was writing it from the 98th floor of an ivory tower. And for that I’m sorry. But there’s something important you should know. I did my CF in the SNF setting and spent years there; where productivity levels are at their strictest. It’s where I first developed my practice patterns as an SLP. While I am not held to the same strict productivity standards anymore, years of work in the SNF have left their mark. It’s not fair. It’s not effective. It’s not efficient. Heck, it’s not even “productive” in the true sense of the word. But in many facilities, and most SNFs, it IS the reality. So let’s figure out how to deal with this reality and maybe even turn it into a strength.
Is the productivity requirement fair?
Not all productivity requirements are created equal. Some are relatively fair. Others are not. 95%? Not so fair. Most agree that 80-85% is a more appropriate number. In an eight-hour day, this gives you 72-96 minutes to do everything you have to do outside of the patient’s room. My advice? Manage the heck out of those 72-96 minutes.
Make a list and check it twice (Or seven times)
Try making a list of ALL of the things you do on a given day. Don’t leave ANYTHING out. Spend at least one week and track how much time you spend on each one of those things. Look at the list and separate out the things you can do with the patient and those you can’t. Ask yourself: What are the most time-consuming things I am doing without the patient that can be 1. Dropped completely (i.e. anything that doesn’t achieve your goals for the day) 2. Done with the patient (i.e. point of service documentation) 3. Made more efficient (i.e. templates or smart phrases that decrease documentation time) and/or 4. Allocated to somebody else (i.e. a rehab aide).
For example, after analyzing your time you realize that you spend an average of 18 minutes talking to Chatty Kathy the RN throughout the day. That’s about a quarter of your “non-productive” time. And you admit hearing about her cat’s indigestion hasn’t been entirely useful. What should you do? Avoid Kathy like your patient avoids honey thickened coffee.
How about the phone calls with family members that run almost 20 minutes long and you KNOW they only need about 5 minutes? Plan them for 5 minutes before a meeting you need to run to so you HAVE to get off the phone with them. Even better- take the call in the patient’s room so the patient can provide input as well. Win/win.
“But I’m different”
These examples may not apply to you AT ALL. This is why it’s so important to do your own analysis and figure out where you are spending the most time (as well as creative ways to manage that time better). Searching for patients in the facility? See if an aide can find them for you. Spending an hour creating therapy materials? Don’t reinvent the wheel- See if you can purchase pre-made ones or use a generous somebody’s ideas for free. OR see if you can bring a laptop in the room and create them while your patient is working on some other exercises so you can get their feedback. The point is, there is ALWAYS something that can be done to make your time more efficient. This way, you’ll have more time to focus on the things that matter the most for your patient.
Great for 80-85%, but what about 90% or 95%?!!#
This is all fantastic for the manageable productivity numbers, but what about the insanely high ones? I have found that productivity levels, like all things in life, are negotiable. They can be a general guideline more than a strict law. Next week I’m going to tell you how you can negotiate that productivity to make it more flexible so it can fit an appropriate schedule for you and your patients. Stay tuned.
