One thing they don’t teach in therapy school is how to be productive on the job.
Yes, I learned how to memorize 5 textbooks worth of material during finals and juggle projects and essays and internships. But how to manage my time and responsibilities in the real world of therapy? I was completely on my own.
And I struggled with it. A LOT.
Thankfully, my sister Chung Hwa, the coauthor of this blog, is naturally productive. Amazing!
She’s put together 19 Steps that Adult Home Health therapists can take to be more productive. If you implement these steps, you can save HOURS every week, no joke.
What We’ll Cover
Agencies differ in their productivity standards and how standards are measured. Some agencies simply recommend treating a certain number of people per day. Others encourage therapists to earn a certain number of points per day.
An example of the points model is a daily productivity goal of 7 points, with each evaluation worth 2 points and each routine visit (treatment) work 1.5 points.
Documenting During Your Visit
Your agency will likely encourage you to document as much as you can during the visit.
There are sections of your documentation forms that are easy to fill out, so do those first. Complete these sections right after taking vitals and before starting therapy:
- Mileage driven
- Pain level
- Part of the therapy subjective
- (More in-depth details below)
Unrealistic Productivity Standards
At some point, you may feel that your company’s productivity standards are unrealistic- maybe you’re feeling overwhelmed or are spending hours of unpaid time at home finishing documentation or prepping for your patients. Follow our tips, problem solve with your supervisor, and talk with colleagues who have a ‘knack’ for being productive.
But if it continues to significantly impact your quality of life, be forthcoming with your needs.
I spent years as a therapist not following this advice and feeling as if I were drowning in everything I had to do. I spent hours of unpaid time working from home or working late, off the clock. It took me years to realize that 1) I have the right to a good quality of life too! Just like I advocate for every one of my patients! And 2) It’s okay to stand up for myself, respectfully but firmly.
In “Let’s Talk About Therapist Burnout” (link here), we wrote a script that you can copy and paste in an email to your supervisor. The article also includes a few tips for timing and the overall tone of your request for a more manageable schedule.
Unfortunately, there are some companies who may not be willing to adjust your schedule, despite your diligent efforts to meet their productivity standards and to communicate respectfully. At this point, you may want to consider whether the strain is worth it.
But luckily, most managers will do their best to work with you to find a good compromise.
20 Tips for How to Be More Productive in Home Health
1. Prior to setting up initial evaluations: Briefly review the patients’ medical records. For now, don’t read the entire hospital or SNF reports: quickly review age, diagnoses, presenting illness, overview of stay, and speech therapy treatment notes.
2. After scheduling evaluations and re-certifications: Now is the time to thoroughly review medical notes. Every once in a while, a patient declines an ST evaluation, so you don’t want to spend 20 minutes reviewing a chart and end up not even meeting the patient. So schedule the visit first!
3. As you thoroughly review the medical notes, start to write the therapy subjective in a word document (on a password protected device), including previous medical history and reason for referral.
4. Schedule patients who you suspect may have less flexibility in their schedules first. These are the patients who are on dialysis or receive chemotherapy and/or radiation treatment. These may also be the patients whose caregivers prefer to observe treatment sessions. Of note, patients living in ALFs, SNFs, and memory care units are often easier to schedule as they often allow their nurses to make their schedule for them.
5. Schedule patients who live close together (use the Road Warrior Route Planner app).
6. Have worksheets and handouts ready the night before you see your patients. These include lists of compensatory strategies, exercises, and homework. I keep a small filing box in my trunk stocked with multiple copies of these handouts.
7. Start the visit on your device as soon as your patient welcomes you into his or her home. Most agencies will use documentation software that automatically keeps track of how long your visit is, but you will have to manually “start” and “end” the visit on your device (your agency should go through this all with you).
8. Next, take the patient’s vitals and fill them out in the appropriate sections on your device.
9. Fill out the subjective portion of your SOAP note, vitals, pain information, recent falls, or changes in medications while you discuss the plan for the day. There may be a few minutes of awkward silence but that’s okay: it’s important to document these things before you forget the details.
10. Do the therapy. Sometimes it’s possible to chart as the patient is completing a task. However, if charting feels like a distraction from providing good cues and properly observing your patient, then jot notes on a piece of paper or in the objective section of the SOAP note.
11. Between treatment tasks, chart basic information about accuracy and amount of cueing provided in the objective section. Discuss what you’re typing with the patient so she can receive feedback about her performance.
12. At the end of the session, chart as much as you can in the assessment section and fill out the plan section of your SOAP note. Again, there may be a few minutes of silence and that’s okay. Review strategies and how to complete homework with your patient.
13. Have your patient sign your device. Save your visit. Start driving to your next patient.
14. If you have extra time between patients, complete the documentation if possible. This can easily be accomplished for routine visits.
15. At the end of the day, complete the documentation. Park somewhere close to your last patient’s house instead of going straight home. It may be very tempting to do it at home, but I’d highly recommend completing all documentation before returning home for the sake of accuracy and work/life separation. I can guarantee that completing documentation at home can sometimes take 2 to 3 times longer thanks to kids or Netflix. So just do it!
16. Send emails with questions concerning patients as soon as possible. This includes questions for another discipline or staff member within your company.
17. If your patient reports a fall or acute, serious sounding medical concerns, then call the PCP’s office during the visit.
18. If you would like to refer the patient to another discipline, fill out a referral form immediately after the visit. Use time between patients to complete and send out the fax as soon as possible.
19. Document any upcoming appointments your patient mentions in a coordination note that all of your coworkers can see. This may be a with a PCP, medical specialist, or lawyer.
Go home, drink a margarita, and enjoy the rest of your afternoon!
* It may take a period of adjustment to add these productivity strategies into your routine. Be patient with yourself and remember that it’ll be worth it! Think of all the things you’ll do with the time you free up!!
(As always, check your company and payer requirement before implementing any of our suggestions)
7 Printable Evaluation Templates
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