Dealing with Productivity Expectations vs. Quality Therapy

December 10th, 2014 by

high quality speech therapyIn a perfect world, quality and productivity would complement each other no matter what treatment setting we are in.  As speech therapists, we want to provide the best therapy we can.  Naturally thinking, “that’s productive, right?”

The real world is not perfect, we aren’t, and neither are our patients.  Let’s look what our employers mean by productivity. That way we can create common ground and conduct effective treatments productively.

The Wikipedia definition of productivity is,”Productivity is an average measure of the efficiency of production. It can be expressed as the ratio of output to inputs used in the production process, i.e. output per unit of input.”

Sounds pretty cold doesn’t it?  Lets compare that to the definition of quality as in in “quality of life”. After all, we all want our therapy to enhance our patients’ quality of life.

Wikipedia says quality of life is,”the perceived quality of an individual’s daily life, that is, an assessment of their well-being or lack thereof. This includes all emotional, social, and physical aspects of the individual’s life. In health care, health-related quality of life (HRQoL) is an assessment of how the individual’s well-being may be affected over time by a disease, disability, or disorder.”

Because these concepts are opposites, we as therapists are left balancing them.  For instance in the school setting, case loads are large and seeing as many kids as you can and doing group therapy is the only way to be productive. This does have a negative impact on quality because you can’t offer children the individual attention they need.

In other settings, (such as Skilled Nursing) therapists only get paid for “direct patient contact.”  Often the quality of the contact suffers because patients are not in good enough physical and/or cognitive shape to receive therapy. Management often wants them seen anyway, so that the facility and therapy company gets paid.  Therapists often don’t get paid for charting and communicating with nurses and doctors so this needs to get done (and does get done). That is part of quality treatment, but it is not considered “productive.”

Below, I’ve included a list of tips to help you balance these issues.

  1. Determine the greatest need and treat that first.  If you can make a big impact, you immediately improve quality and may be able to get more treatment time from insurance.
  2. Write achievable goals and communicate them to families.
  3. Enlist the help of the families to help you meet these goals.  Give them simple treatment tasks (if they are willing). If they help with treatment, the can advocate for the patient.
  4. Keep open positive commucication with your supervisor and doctors.  They may be willing to get you more time with a patient.
  5. Train nurses, family, caregivers.  Therapy time is precious.  Caregivers can extend what we do and inform us of changes in a patient’s condition.  Good family support really helps balance productivity and quality.

I am sure you’ve got tips of your own so leave them in the comments below.  And remember to do the best you can given today’s constraints and take good care of yourself. The quality of you bring to the job can really tip the balance!

About the Author:

Sandra Alexander has over 20 years of experience in the speech therapy field. In 1994, she received her Master’s Degree in Communicative Disorders from San Diego State University and in 1985 she received a B.A. in Communicative Disorders from the University of Redlands. She is also a returned Peace Corps Volunteer who taught speech therapy in Ecuador from 1987-1989.

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