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We are in an acute care teaching hospital. Our state practice act has some

very stringent guidelines for use of technicians. This has made us unable

to have them " treat " in the acute care setting. Our " productivity "

expectation is 19-20 units/PT or PTA. IT is a level we have had to defend,

but have found it a realistic level when we look at our other

responsbilities including student training, oreintation, staff education

etc....

> 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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Carol and Moira:

I am currently teaching (at a PTA program) the differenciation in

task/responsiblilites/deleagtion of PT/PTA/ and aide. What states do you

practice in, and would it be possible to send me the wording from your state

practice act/rules so the class can discuss it?

Sheri Bjork

______________________________________________________________________

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Our state also has very stringent regulations. The tech is not responsible for

the treatment, he/she is assisting the PT by providing delegated treatment

activities. It can only be billed as PT as long as the therapist has direct

involvement with the patient each day.

>>> " Mulligan, Moira A. " 09/15 2:25 PM >>>

We are in an acute care teaching hospital. Our state practice act has some

very stringent guidelines for use of technicians. This has made us unable

to have them " treat " in the acute care setting. Our " productivity "

expectation is 19-20 units/PT or PTA. IT is a level we have had to defend,

but have found it a realistic level when we look at our other

responsbilities including student training, oreintation, staff education

etc....

> 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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I'd be interested in what the difference between the aid/PTA would be

> and their responsibilities and what they are accountable for. I'm an an

> Allied Health Admissions Rep in which I counsel prospective PTA's.

>

> Thanks,

>

> Anne Harrington

>

> >From ptmanager-return-405-anneh=hotmail.comegroups Tue Sep 15

> 17:32:34 1998

> >Received: (qmail 22561 invoked by uid 505); 16 Sep 1998 00:33:30 -0000

> >Mailing-List: contact ptmanager-owneregroups

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> >

> >To: <ptmanageregroups>

> >Date: Tue, 15 Sep 1998 19:32:53 -0000

> >MIME-Version: 1.0

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> > charset= " iso-8859-1 "

> >Content-Transfer-Encoding: 7bit

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> >X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3110.3

> >Subject: Re: RE: efficiency

> >

> >Carol and Moira:

> >

> >I am currently teaching (at a PTA program) the differenciation in

> >task/responsiblilites/deleagtion of PT/PTA/ and aide. What states do

> you

> >practice in, and would it be possible to send me the wording from your

> state

> >practice act/rules so the class can discuss it?

> >

> >Sheri Bjork

> >

> >

> >

> >______________________________________________________________________

> >

> >

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I'd be interested in what the difference between the aid/PTA would be

> > and their responsibilities and what they are accountable for. I'm an an

> > Allied Health Admissions Rep in which I counsel prospective PTA's.

> >

> > Thanks,

> >

> > Anne Harrington

> >

> > >From ptmanager-return-405-anneh=hotmail.comegroups Tue Sep 15

> > 17:32:34 1998

> > >Received: (qmail 22561 invoked by uid 505); 16 Sep 1998 00:33:30 -0000

> > >Mailing-List: contact ptmanager-owneregroups

> > >Precedence: list

> > >X-URL: /list/ptmanager/

> > >X-Mailing-List: ptmanageregroups

> > >Reply-To: ptmanageregroups

> > >Delivered-To: listsaver-egroups-ptmanageregroups

> > >Received: (qmail 8779 invoked by uid 7770); 16 Sep 1998 00:32:28 -0000

> > >Received: from e-tex.com (206.25.36.2)

> > > by vault.findmail.com with SMTP; 16 Sep 1998 00:32:28 -0000

> > >Received: (qmail 6472 invoked from network); 16 Sep 1998 00:31:30 -0000

> > >Received: from r3m24.e-tex.com (HELO default) (206.25.37.88)

> > > by e-tex.com with SMTP; 16 Sep 1998 00:31:30 -0000

> > >Message-ID: <001e01bde0df$a2ff2180$582519ce@default>

> > >

> > >To: <ptmanageregroups>

> > >Date: Tue, 15 Sep 1998 19:32:53 -0000

> > >MIME-Version: 1.0

> > >Content-Type: text/plain;

> > > charset= " iso-8859-1 "

> > >Content-Transfer-Encoding: 7bit

> > >X-Priority: 3

> > >X-MSMail-Priority: Normal

> > >X-Mailer: Microsoft Outlook Express 4.72.3110.1

> > >X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3110.3

> > >Subject: Re: RE: efficiency

> > >

> > >Carol and Moira:

> > >

> > >I am currently teaching (at a PTA program) the differenciation in

> > >task/responsiblilites/deleagtion of PT/PTA/ and aide. What states do

> > you

> > >practice in, and would it be possible to send me the wording from your

> > state

> > >practice act/rules so the class can discuss it?

> > >

> > >Sheri Bjork

> > >

> > >

> > >

> > >______________________________________________________________________

> > >

> > >

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  • 2 weeks later...

No, they weren't. The person assigned to my department was a nurse, with a

background as a nurse supervisor of rehab services. She spent 13 weeks in

the department. Initially, I had to come up with guestimates of time spent

on every aspect of patient care. Units of service (0-15 minutes) didn't

matter. She wanted down to the minute times. So if you did a 10 minute

ultrasound and billed 1 unit (0-15 minutes), how did we account for the

other 5 minutes of our time? Charting, phone call, bathroom? Got to be a

real nightmare trying to account for every minute of your time. Trying to

do this with inpatient services was worse. As I said, productivity is much

worse here because of waiting for the patient, reviewing charts (finding

charts!!) Dr. visits, patient with other ancillary services, (you know,

they'll just be a minute - 10 minutes later).

Then we looked at total units of service delivered over the previous 6

months and got an average and divided by paid staff hours over the same time

to get units of service per hour. The company had a computerized

productivity and staffing program that we were to use as " our efficiency

tool " . Plug the numbers in and it will tell you how many FTE's you will

need. So, based on todays total output, we can plan for tomorrows needs. We

then trialed the program for about 6 weeks, trying to tweak the numbers as

it became apparant some of my time guestimates were way off. Came up with a

number that says each unit of service, on average, takes 32 minutes of our

time (includes chart time, telephone calls, modality set up and take down,

etc. Keep in mind that this was time based on averages for outpatient and

inpatient services.

Never worked. Not even close. What happens when you use the plan to staff

for 50 inpatient visits the next day and you get 10-15 new patients. Or you

get a few acute back pain patients from the ER. Their ludicrus answer, call

that therapist sitting at home waiting by the phone. Nursing does this all

the time. At that point, I knew this person had no clue. They had their

canned staff productivity software program, one that they use for other

ancillary services, and instead of tailoring it to meet our needs, tried to

shoehorn us into their system.

Unfortunately, they sold administration on this flawed productivity measure,

despite my numbers (worked out on my own) showing the glaring errors and

flawed design and we had to cut 1 FTE PT and 1.5 FTE Techs. Six months

after the fallout, I was able to convince administration (with MY numbers)

that we were in need of additional staff. Definitely a colossal waist of

time and money. Two years later, staff level is back to where it was before

the " Time of Trouble " .

Sorry for leaving you hanging for a moment. Had to watch Sammy Sosa hit

#63.

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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