Efficiency

Every job has its own way of measuring success and every business has key benchmarks that ensure they actually make some money. After years of working for a non-profit where my monthly salary was "discovered" I'm still working on reaching the major benchmark in the therapy world: efficiency. Medicare, or some other health insurance, pays for all the therapy my patients receive and they reimburse the company I work for according to the amount of time I spend with patients within a certain target range that varies from patient to patient. Ideally all of the therapists end the week at 70-80% efficiency. In other words, we spend 80% of our working time with patients and 20% doing other things: documentation, talking with staff or family, or just getting from one room to the next. In March I was pretty consistently in the 70-80% range so I was feeling good about myself. But then...

Three weeks ago I was moved to the nursing home in Spencer. In many ways it has been a good move. It takes me longer to get there (but gives me the opportunity to catch up on my favorite podcasts), but I'm working with a lot more people who intend to go home and will actually get there. That means there are more things to work on besides making sure they can get dressed and to the bathroom on their own. I've enjoyed the change and the challenge. However, my efficiency has taken a major hit. Instead of having one new patient every couple of weeks, I have 3-5. Today I saw one new person and spent 29 minutes with her. (I bought a watch with a timer on it so it is easy to keep track -- when I remember to push the start button upon entering the room.) It took me at least that long to write up the Plan of Care which includes the goals of what the person needs/wants to be able to do to go home. So about the best I can do with a first visit is 50%. Add in two discharge summaries which can take about as long, an updated plan of care, and finishing two Plans of Care from last week that I had only done the bare minimum on before leaving on Friday, and I was once again below 60% for the day. It will get better since I am getting lots of practice in filling out the paperwork. And maybe I'll get better at tuning out the distractions of the cartoons the resident down the hall likes to watch, co-workers talking to residents or each other, or other staff coming in with the latest update. And for the time being, my supervisor has my back with those higher up in the company. But soon, I will no longer be able to say that I'm doing discharge summaries on people that I only saw once or twice so I have to read all the notes before I can say anything coherent about how far they have come. Until then, I'll keep plugging away even as I take the time to poke my head into a room to see what the resident needs. Today all the woman wanted was for her table to be pulled over close enough to her bed so she could reach her water.