RE: Documentation Time

[Guest guest]

,

To address your questions in order:

Documentation time: We dictate our notes and I highly encourage the

staff to dictate at the time of treatment. For instance if they are

doing and evaluation while they leave the room after the subjective to

allow the patient to change they dictate that portion of the eval.

Then as the patient is changing after the objective the therapist

dictates that portion. It is fresh in the therapists mind, is over and

done with, and is by far the most time efficient way to dictate and

document. As our PTs/OTs/Speech Paths are salaried they are required to

stay as long as necessary to complete daily documentation so the more

efficient they are the sooner they can get out. Ultimately they can

document when they want to but they know what needs to be completed each

day.

Lunch time: Our lunch has always been non-paid to both hourly and

salaried employees. Thus the 8 -4:30 shift for 8 hour days and 7-5:30

for 10 hour days. Part time and per diem employees have the option of

working through lunch if they choose (but with the inpatients the lunch

serving is over the 12-1:00 time slot and they are usually unavailable

for treatment anyway) but we don't offer this to our full time 32, 36,

or 40 hour employees. Also by hospital policy (and labor law I believe)

we must provide this ½ hour sometime in between their patient schedules

i.e. not at the end of the day.

Hope this helps.

Jeff Brown PT

>>> 08/21/09 8:32 AM >>>

Hi Group,

I work in a multi PT outpatient group. I have 2 groups of questions. I

am not disclosing what we do beucase I don't want to skew your answers.?

We are considering revamping this entire procedure.

GROUP 1

How do you guys allocate doumentation time for the daily teatment??

Do you advice your therapists to do it during the time they are with

the patient, immediately after the patient or at the end of the shift??

I don't mean the typed reports sent to the insurance company or

referring physician. When do you recommend these reports to be done?

GROUP 2

In a 40 hour work week, how do you schedule lunch times. When is the

last patient before the scheduled lunch (1hr, 30 minutes etc?)

Is it paid or unpaid time.?

Do you increase their work week by 2.5 hours for a 30 minutes lunch

every day to 42.5hrs for paid or unpaid time.

Do you give them a choice to skip lunch (eat around canceled patients)

if they want to eat and not extend the hours they work each week?

Thanks for your opinions.

Ivashenko PT DPT OCS CProT

Edison NJ

[Guest guest]

,

To address your questions in order:

Documentation time: We dictate our notes and I highly encourage the

staff to dictate at the time of treatment. For instance if they are

doing and evaluation while they leave the room after the subjective to

allow the patient to change they dictate that portion of the eval.

Then as the patient is changing after the objective the therapist

dictates that portion. It is fresh in the therapists mind, is over and

done with, and is by far the most time efficient way to dictate and

document. As our PTs/OTs/Speech Paths are salaried they are required to

stay as long as necessary to complete daily documentation so the more

efficient they are the sooner they can get out. Ultimately they can

document when they want to but they know what needs to be completed each

day.

Lunch time: Our lunch has always been non-paid to both hourly and

salaried employees. Thus the 8 -4:30 shift for 8 hour days and 7-5:30

for 10 hour days. Part time and per diem employees have the option of

working through lunch if they choose (but with the inpatients the lunch

serving is over the 12-1:00 time slot and they are usually unavailable

for treatment anyway) but we don't offer this to our full time 32, 36,

or 40 hour employees. Also by hospital policy (and labor law I believe)

we must provide this ½ hour sometime in between their patient schedules

i.e. not at the end of the day.

Hope this helps.

Jeff Brown PT

>>> 08/21/09 8:32 AM >>>

Hi Group,

I work in a multi PT outpatient group. I have 2 groups of questions. I

am not disclosing what we do beucase I don't want to skew your answers.?

We are considering revamping this entire procedure.

GROUP 1

How do you guys allocate doumentation time for the daily teatment??

Do you advice your therapists to do it during the time they are with

the patient, immediately after the patient or at the end of the shift??

I don't mean the typed reports sent to the insurance company or

referring physician. When do you recommend these reports to be done?

GROUP 2

In a 40 hour work week, how do you schedule lunch times. When is the

last patient before the scheduled lunch (1hr, 30 minutes etc?)

Is it paid or unpaid time.?

Do you increase their work week by 2.5 hours for a 30 minutes lunch

every day to 42.5hrs for paid or unpaid time.

Do you give them a choice to skip lunch (eat around canceled patients)

if they want to eat and not extend the hours they work each week?

Thanks for your opinions.

Ivashenko PT DPT OCS CProT

Edison NJ

[Guest guest]

,

To address your questions in order:

Documentation time: We dictate our notes and I highly encourage the

staff to dictate at the time of treatment. For instance if they are

doing and evaluation while they leave the room after the subjective to

allow the patient to change they dictate that portion of the eval.

Then as the patient is changing after the objective the therapist

dictates that portion. It is fresh in the therapists mind, is over and

done with, and is by far the most time efficient way to dictate and

document. As our PTs/OTs/Speech Paths are salaried they are required to

stay as long as necessary to complete daily documentation so the more

efficient they are the sooner they can get out. Ultimately they can

document when they want to but they know what needs to be completed each

day.

Lunch time: Our lunch has always been non-paid to both hourly and

salaried employees. Thus the 8 -4:30 shift for 8 hour days and 7-5:30

for 10 hour days. Part time and per diem employees have the option of

working through lunch if they choose (but with the inpatients the lunch

serving is over the 12-1:00 time slot and they are usually unavailable

for treatment anyway) but we don't offer this to our full time 32, 36,

or 40 hour employees. Also by hospital policy (and labor law I believe)

we must provide this ½ hour sometime in between their patient schedules

i.e. not at the end of the day.

Hope this helps.

Jeff Brown PT

>>> 08/21/09 8:32 AM >>>

Hi Group,

I work in a multi PT outpatient group. I have 2 groups of questions. I

am not disclosing what we do beucase I don't want to skew your answers.?

We are considering revamping this entire procedure.

GROUP 1

How do you guys allocate doumentation time for the daily teatment??

Do you advice your therapists to do it during the time they are with

the patient, immediately after the patient or at the end of the shift??

I don't mean the typed reports sent to the insurance company or

referring physician. When do you recommend these reports to be done?

GROUP 2

In a 40 hour work week, how do you schedule lunch times. When is the

last patient before the scheduled lunch (1hr, 30 minutes etc?)

Is it paid or unpaid time.?

Do you increase their work week by 2.5 hours for a 30 minutes lunch

every day to 42.5hrs for paid or unpaid time.

Do you give them a choice to skip lunch (eat around canceled patients)

if they want to eat and not extend the hours they work each week?

Thanks for your opinions.

Ivashenko PT DPT OCS CProT

Edison NJ

[Guest guest]

To: The Group;

I am a private practise owner and I have the same question as .

In the past I have give a paid 1/2 hour after lunch to get caught up with chart

notes.

I have my front office person typing MD reports.

Any comments or ideas others have?

Hiten Dave' PT

Documentation Time

 

Hi Group,

I work in a multi PT outpatient group. I have 2 groups of questions. I am not

disclosing what we do beucase I don't want to skew your answers.? We are

considering revamping this entire procedure.

GROUP 1

How do you guys allocate doumentation time for the daily teatment??

Do you advice your therapists to do it during the time they are with the

patient, immediately after the patient or at the end of the shift??

I don't mean the typed reports sent to the insurance company or referring

physician. When do you recommend these reports to be done?

GROUP 2

In a 40 hour work week, how do you schedule lunch times. When is the last

patient before the scheduled lunch (1hr, 30 minutes etc?)

Is it paid or unpaid time.?

Do you increase their work week by 2.5 hours for a 30 minutes lunch every day to

42.5hrs for paid or unpaid time.

Do you give them a choice to skip lunch (eat around canceled patients) if they

want to eat and not extend the hours they work each week?

Thanks for your opinions.

Ivashenko PT DPT OCS CProT

Edison NJ

[Guest guest]

To: The Group;

I am a private practise owner and I have the same question as .

In the past I have give a paid 1/2 hour after lunch to get caught up with chart

notes.

I have my front office person typing MD reports.

Any comments or ideas others have?

Hiten Dave' PT

Documentation Time

 

Hi Group,

I work in a multi PT outpatient group. I have 2 groups of questions. I am not

disclosing what we do beucase I don't want to skew your answers.? We are

considering revamping this entire procedure.

GROUP 1

How do you guys allocate doumentation time for the daily teatment??

Do you advice your therapists to do it during the time they are with the

patient, immediately after the patient or at the end of the shift??

I don't mean the typed reports sent to the insurance company or referring

physician. When do you recommend these reports to be done?

GROUP 2

In a 40 hour work week, how do you schedule lunch times. When is the last

patient before the scheduled lunch (1hr, 30 minutes etc?)

Is it paid or unpaid time.?

Do you increase their work week by 2.5 hours for a 30 minutes lunch every day to

42.5hrs for paid or unpaid time.

Do you give them a choice to skip lunch (eat around canceled patients) if they

want to eat and not extend the hours they work each week?

Thanks for your opinions.

Ivashenko PT DPT OCS CProT

Edison NJ

[Guest guest]

To: The Group;

I am a private practise owner and I have the same question as .

In the past I have give a paid 1/2 hour after lunch to get caught up with chart

notes.

I have my front office person typing MD reports.

Any comments or ideas others have?

Hiten Dave' PT

Documentation Time

 

Hi Group,

I work in a multi PT outpatient group. I have 2 groups of questions. I am not

disclosing what we do beucase I don't want to skew your answers.? We are

considering revamping this entire procedure.

GROUP 1

How do you guys allocate doumentation time for the daily teatment??

Do you advice your therapists to do it during the time they are with the

patient, immediately after the patient or at the end of the shift??

I don't mean the typed reports sent to the insurance company or referring

physician. When do you recommend these reports to be done?

GROUP 2

In a 40 hour work week, how do you schedule lunch times. When is the last

patient before the scheduled lunch (1hr, 30 minutes etc?)

Is it paid or unpaid time.?

Do you increase their work week by 2.5 hours for a 30 minutes lunch every day to

42.5hrs for paid or unpaid time.

Do you give them a choice to skip lunch (eat around canceled patients) if they

want to eat and not extend the hours they work each week?

Thanks for your opinions.

Ivashenko PT DPT OCS CProT

Edison NJ

[Guest guest]

Hi Group,

My understanding is that Washington State Law notes that employers must

provide a half hour of unpaid lunch, as well as one 15-minute paid break

every 4 (or 5?) hours of work. I roll this into one hour lunch: half paid,

half unpaid.

I do not have any PT’s on salary. Salaried employees have different rules.

So the answer of lunch/break parameters depends upon your particular

responsibilities as an employer in your particular state.

If the employee works from 7:30-6, that is 10 hours of paid time and .1/2

hour of unpaid time. They may choose to take their unpaid ½ hour time at

the end of the day and have a ½ hour lunch.

Their last client finishes at the start of their lunch hour. Good

inspiration to stay on time.

All of my clinicians have a one hour lunch. If they choose to spend their

lunch working through it charting, I cannot control that. However I do

emphasize that they need to take a lunch, go outside and step away from the

clinic. Burnout from working 40 hours per week, working through lunches

and/or staying late to chart is a huge risk, and one that I feel is not

worth taking. Good PT’s who are also positive team members are tough to

find. I want to hold on to the good folks I have. All full time staff are

to work their hours and no overtime.

My PT’s get 45 min documentation time blocked out every day. If there is a

client who needs to get in from the waiting list, the front office checks

with that PT to get their permission. Our cancellation rate is generally

10% or less, so even with a smattering of cancels, they can still meet the

productivity benchmark most of the time.

30 minutes of documentation time in my opinion is ridiculous. As long as

you never run overtime with their last client, go to the bathroom, have a

conversation with another staff member, call a doc or check on a piece of

equipment ordered, call a client back to answer a question, etc……it may be

adequate along with the cancellation rate. But if your cancellation rate is

low, 30 minutes is just not enough time in my opinion.

If you are a good PT with a strong following, cancellation rates are low and

you just cannot rely on a significant enough number of cancellations to do

all prog notes, reports, phone calls, emails, etc. I have been an employee

under those circumstances and it is brutal, as you all know. Recipe for

heart disease and stress!

My PT’s do the initial data intake and/or prog notes on the computer during

the visit, then finish up the rest later if need be. Daily notes are

written with the client during verbal intake and supervised movement, though

if you spend the entire session with hands-on manual therapy, neuro re-ed or

whatever, the note needs to be completed later. (We only have PTs treating

folks, no assistants or ancillary staff, no double-bookings, etc so we are

always with clients.)

Although it likely compromises my bottom line, I have chosen to operate this

way. After having worked for over 20 years, and working way too much time

that I was never paid for, I am committed to protecting my staff so that

they do not fall out of love with their profession due to burnout.

Great topic, thanks for putting it out there. I am eager to hear what other

folks do.

Best regards,

Hampton PT, WCS, BCIA-PMDB

Core Therapeutics Physical Therapy

www.corept.org

_____

From: PTManager [mailto:PTManager ] On Behalf

Of hitendave@...

Sent: Friday, August 21, 2009 11:01 AM

To: PTManager

Cc: PTManager

Subject: Re: Documentation Time

To: The Group;

I am a private practise owner and I have the same question as .

In the past I have give a paid 1/2 hour after lunch to get caught up with

chart notes.

I have my front office person typing MD reports.

Any comments or ideas others have?

Hiten Dave' PT

Documentation Time

Hi Group,

I work in a multi PT outpatient group. I have 2 groups of questions. I am

not disclosing what we do beucase I don't want to skew your answers.? We are

considering revamping this entire procedure.

GROUP 1

How do you guys allocate doumentation time for the daily teatment??

Do you advice your therapists to do it during the time they are with the

patient, immediately after the patient or at the end of the shift??

I don't mean the typed reports sent to the insurance company or referring

physician. When do you recommend these reports to be done?

GROUP 2

In a 40 hour work week, how do you schedule lunch times. When is the last

patient before the scheduled lunch (1hr, 30 minutes etc?)

Is it paid or unpaid time.?

Do you increase their work week by 2.5 hours for a 30 minutes lunch every

day to 42.5hrs for paid or unpaid time.

Do you give them a choice to skip lunch (eat around canceled patients) if

they want to eat and not extend the hours they work each week?

Thanks for your opinions.

Ivashenko PT DPT OCS CProT

Edison NJ