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RE: Mark's post --

Hear! Hear!

Good insight, Mark!

We must balance professionalism and economic realities.

Dick Hillyer

Hillyer Associates, Inc.

Town & Country PT, Inc.

rwhpt@...

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Lance,

> Consolidate the admin process, 1 head office

>and a questionable organization to run it? Hold on, fun times to come.

Just watching the current mess in Washington every night on the evening news

really gets me all excited about a government-sponsored single payor system.

Oh yeah, bring it on!

Mark Dwyer, MHA, PT

mdwyer1@...

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  • 2 weeks later...

I am the manager of a PT department in an acute care hospital. I also carry

a 50-100% case load. We see both inpatients and outpatients. The

therapists have the opportunity to rotate in each area. In June of '96, the

hospital hired " efficiency experts " to look at our productivity. Their goal

was 100%!!! (8 hours X 4 units /hr). We felt 75% was reasonable. After

much observation, time keeping of all staff actions and charting, we

actually ended up at about 80% over the six month period. For outpatient,

where you can often manage 2-3 patients at a time, productivity still

manages to average 80% per therapist. Since the techs also deliver

modalities under supervision, we track their productivity. This includes

units of service (non-billable) for preparing hotpacks, setting up EMS,

traction and whirlpools, etc. Somebody has to do these things and you need

to account for their time in order to justify staff levels.

Inpatients are a much different matter. There are so many things that can

interfere with efficient delivery of PT services. One-on-one is the minimum

need. Frequently it is 2-3 (staff) on one (patient). We are a Level II

trauma center. For example, to gait a trauma patient with a chest tube,

fractured leg, head injury, 2 or more IV poles can take, say, 3 staff

people. If you do this for 0-15 minutes, you can only bill for one unit of

service, but we had to pay salary for 3 units (3 staff X 1unit of service).

We have to have adequate staff in order to safely deliver patient care! We

track the frequency for each unit of service that takes 1, 2, and 3 or more

staff to deliever it and can come up with staffing levels.

As such, our productivity for inpatients has consistently ranged from 59% -

65% per therapist. It seems that no matter how much we try to be more

efficient, 65% is about tops.

Re: efficiency

>You stated that you expect 25-26 units per PT or PTA. Do you have techs or

aids working with them? Is this in an acute hospital setting, or

outpatient? If you do use techs or aids, do you not include them in your

productivity expectations? We count PT's, PTA's, and Techs in a division

and expect 20 units/day/person in those 3 job classifications, because in

our state, as long as the patient is seen for one of his treatments by the

PT each day, the tech can see them the other time. Therefore, the tech is

accountable for billable units each day, as long as supervisory regs are

being followed. Thanks for your input. It really helps us to compare apples

and apples, and see if we are in the ballpark.

>

>>>> " Mark Dwyer " 09/14 10:54 PM >>>

>Carol,

>

>Your goal of 140 billable 15 minute units per day for 2 PT's and 3 PTA's

(28

>units per therapists = 7 treatment hours per day per therapist) is close to

>what we expect. We allow 6.5 hours per day for patient care and expect

>25-26 units. That may change when we go under PPS, but the fact is that we

>exceed 25 units fairly often. This is the expectation for PT and OT.

>

>Mark Dwyer, MHA, PT

>Kansas City, Kansas

>mdwyer1@...

>

>

>

>

>______________________________________________________________________

>

>

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