Increasing Therapist Productivity: Using Lean Principles in the Rehabilitation Department of an Academic Medical Center

Abstract

The Department of Rehabilitation Services, within the University of Maryland Medical Center's 650-bed academic medical center, was experiencing difficulty in meeting productivity standards. Therapists in the outpatient division believed they were not spending enough time performing billable patient care activities. Therapists in the inpatient division had difficulty keeping pace with the volume of incoming referrals. Collectively, these issues caused dissatisfaction among referral sources and frustration among the staff within the rehabilitation department. The department undertook a phased approach to address these issues that included examining the evidence, using Lean process improvement principles, and employing transformational leadership strategies to drive improvements in productivity and efficiency. The lessons learned support the importance of having meaningful metrics appropriate for the patient population served, the use of Lean as an effective tool for improving productivity in rehabilitation departments, the impact of engaging staff at the grassroots level, and the importance of having commitment from leaders. The study findings have implications for not only rehabilitation and hospital leadership, but CEOs and managers of any business who need to eliminate waste or increase staff productivity.

Entry level caseload expectations and perception of full caseload capability during student physical therapist terminal clinical experiences: A pilot study

“…Half of the respondents reported productivity was assessed using both number of patients and billable units per day, whilst the remaining respondents stated that only utilised number of patients or billable units per day were assessed. This inconsistent approach to calculating productivity is reflected in the literature with productivity being reported as billable units, 19,20 number of treatments per hour, 20 day, 3 or week, 21 patient evaluations per hour, 20 percentage of billable time per day, 3 and patient visits per week. 21 With the CPI's dependence on clinical sites' new graduate caseload expectations and employers utilising a variety of metrics to assess productivity, it may be challenging to assess student caseload consistently.…”

“…These factors relate to student physical therapists' ability to manage time efficiently. Johnson et al 3 found it can be challenging for novice physical therapist clinicians to manage their workday to meet productivity standards and difficulty communicating has caused CIs to question students' ability to demonstrate ELP. 10 These findings support respondents consideration of efficiency factors as moderately important.…”

“…Within the Consensus Statement on Clinical Judgement in Health Care Settings, the American Physical Therapy Association (APTA) identifies patient-centred outcomes as the true measure of quality care for patients 2 and discourages unethical productivity quotas. 2,3 But the reality of clinical practice is that productivity measures permeate A poster presentation of this work was presented at APTA Educational Leadership Conference 2019.…”