The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts


Nicholas J. Macmillan1, Gregory K. Spratt1

Background: Home care continues to face changes in reimbursement. Indications are that competitive bidding will lead to additional reductions. Employee costs represent over one-half of the total operating expenses of home medical equipment companies. (1) Clinical resources remain a key component of those costs. These combined dynamics puts greater emphasis on the efficient use of clinical resources.

Purpose: The purpose of this study was to assess the impact of focused training and tracking of RC productivity with the objective of increasing the number of patient contacts in any given week.

Methods: Clinical Managers (CM) were trained on the identification and alleviation of obstacles impacting RC productivity. Topics included: planning, start times (leaving the office on a timely basis), performance of non-clinical tasks, scheduling, routing and consistent measurement of performance. Measurement tools were created and weekly reporting of performance was implemented. RCs were given their specific productivity measures and anonymous productivity measures were shared weekly with management and RCs so they could compare themselves with peers.

Results: Productivity was measured by capturing the average number of patient visits per RC per week. Time for vacation, holidays, sick time and training was excluded from the productivity calculations. Measures were taken over a period of 24 months. Baseline productivity for the twelve months prior to the completed training was 18.5 visits per RC per week. The second twelve month period resulted in 19.5 visits per RC per week or an 8% increase. Splitting this first 12 month period resulted in a more immediate increase in productivity of 14% as training was progressive during the first twelve months.

The second and more desirable outcome was the identification and resolution of patient needs. RCs on averaged realized a 15% increase in need identification which ultimately leads to improved patient care. RCs training now includes producivity and as such these results were maintained into the third twelve month period.

Conclusion: Identification and resolution of hindrances to productivity are the first step to improving productivity. Sharing data regularly maintains and supports productivity gains.

Clinical Implications: Improved productivity increases the opportunities to improve patient care.

Disclosures: Nothing to disclose.

(1) 2002 AAHomecare Financial Performance Survey