Re: 7 day coverage

April 25, 1999

My inpatient acute area has had 7 day coverage for the entire 10 years I've been

with this organization. I've always considered it a very basic patient care

issue. Our weekend/holiday coverage has generally been half day with the intent

of seeing all of the acute care patients once. The clinical need is definitely

there. We do a lot of joint replacements on Tuesdays and Thursdays (who are

typically ready for discharge on Saturday and Monday). All of our routine

post-acute referral agencies (rehab, subacute, home care) are all prepared to

admit new patients 7 days a week, so the structures are all in place whenever

the patient is ready.

Staffing is done entirely with regular department staff (including both the

normal inpatient and outpatient therapists) and everyone works one weekend every

4. My normal staffing is 2 PTs on the inpatient side and 5 PTs in the

outpatient area. That makes a total of 8 available PTs (including myself) to

rotate two at a time through the weekends. After working a half day Saturday

and a half day Sunday, the therapist will take a day off during the following

week. The outpatient therapists usually just schedule their patient

appointments around that day when they work the weekend, and coverage for a

regular inpatient therapist on those days off is usually provided by me.

No special incentives are provided for weekend coverage, since it is a basic

expectation of the job and applies equally to every PT in the department from

myself on down. Everyone was hired knowing that this was an expectation of the

position, regardless of whether they were hired primarily for the inpatient or

outpatient areas.

Hope that helps...

Ken Tuley, PT

Rehab Services Manager

Cape Canaveral Hospital

>>> 04/22/99 09:20PM >>>

Another topic! PT Managers, I need your help. We are an inpatient

acute/rehab facility, now in a position to be able to hire enough per diem

and part time help to be able to reasonably provide some degree of 7 day a

week coverage. (This of course, has been a long time request of Ortho docs.)

Unfortunately, I have some concerns, after meeting with staff, about dept.

morale, etc. once this is implemented, (tenatively 7/1/99). Some legitimate

concerns of our staff are:

1. Are we doing this for purely financial reasons?

2.Is patient satisfaction and insurer concerns, (i.e, idle time on

Sundays/holidays legitimate reasons for pursuing this additional staffing?)

3. Are the docs really going to follow through with getting these patients

discharged on Sat / Sunday, when PT recommends they are ready, or have d/c'd

them from therapy? (in order to help reduce LOS to HOME.) Or are we simply

increasing hospitalization costs by providing more intensive services,

without seeing a justifiable decrease in LOS, due to lack of participation in

this initiative, on the part of the physicians. What has been your

experience in this regard?

Please provide me with the following information:

1. Are you currently providing some type of coverage to acute Ortho, and

hospital based skilled unit patients on Sundays and/or holidays?

2. If so, are you seeing all of them or are you using a prioritization

system? If prioritizing, what is your prioritization design and rationale

for same?

3. If you are providing Sunday and / or holiday coverage, what type of

continuity of care issues have you encountered, and how have you dealt with

them? (Primary concern is our Rehab unit, where, because of comp time

issues, therapist attendance at patient staffings, which are conducted by

physician, could be impacted, because team members usually attend portions

of staffings several days a week to accomodate all physicians.)

4. As managers, are you participating in weekend coverage along with your

staff in order to address the morale issue? If so, how frequently?

5. What is the average number of weekends your staff are working, if

providing Sat. and Sunday coverage?

6. Are you utilizing any types of pay incentives, etc. for weekend coverage?

I really appreciate your input! Thanks in advance......(By the way, at the

present time, we work a full day Saturday, see Rehab, Ortho, Skilled, all new

evals, some acute neuro, and wound care. Do hi priority wound care on Sun.

and holidays 1 x dly.)

------------------------------------------------------------------------

April 27, 1999

wrote:

Original Article: /list/ptmanager/?start=5034

> My inpatient acute area has had 7 day coverage for the entire 10 years I've

been with this organization. I've always considered it a very basic patient

care issue. Our weekend/holiday coverage has generally been half day with the

intent of seeing all of the acute care patients once. The clinical need is

definitely there. We do a lot of joint replacements on Tuesdays and Thursdays

(who are typically ready for discharge on Saturday and Monday). All of our

routine post-acute referral agencies (rehab, subacute, home care) are all

prepared to admit new patients 7 days a week, so the structures are all in place

whenever the patient is ready.

>

> Staffing is done entirely with regular department staff (including both the