-ASHA evidence maps TBI -ASHA practice portal -ACRM manual and training -ANCDS -Be explicit. Tell them what you are working on and why they are working on it -NIH toolbox TBI -Academy of neurogenics -Favres test -Neurogenic communication disorders -Goal plan do review model -Metacognitive training -Semantic chunking -External compensations taught through errorless learning approach -Chaining -Spaced retrieval -Direct attention training
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Being a "productive" worker in a Skilled Nursing Facility (SNF) is not as easy to achieve as you would think. 90-100% busy all day everyday sounds pretty easy, right? Even if you consider yourself a Type A personality, "productivity" in a nursing home setting means you are only "productive" when you have direct patient care. Meaning, only the time spent actually "treating" patients matters. Everything else you do throughout the day, no matter how busy you think you are or how much you do matters. I repeat it does not matter and does not make you "productive."
So in order to be 100% productive, you need to have 480 minutes of direct patient care time. 480 minutes of direct patient care is equal to an 8 hour day and 8 direct patient care hours, which would make you 100% productive. Sounds achievable, right? But you also are expected to complete those daily notes on all of your patients before you leave for the day or at least before the end of the day. And you are expected to stay up-to-date on all documentation including daily notes, plan of cares, weekly progress notes, supplemental plan of cares, updated plan of cares, and discharges. Also, remember, nothing else besides direct patient care time matters. So if you think you are being efficient or "productive" by completing screens including chart reviews for screens, new admit screens, quarterly screens, nursing referrals, discussing patient information with mentors and other disciplines such as PT/OT, attending daily morning meetings, attending weekly rehab meetings to discuss all patients, looking for patients, painting the picture documentation where you need to vary your documentation so it looks vastly different for each patient, driving between facilities, walking to patient's rooms, past patient's visiting, people asking you to fix them coffee, people wanting to chit chat, lunch, bathroom breaks, consulting with dietician and dietary manager, writing orders to eval/treat/discharge, writing orders for diet consistency changes, faxing diet changes to dietary manager, updating nurses and CNA's on diet changes, requesting approval from MD for MBSS on patient, scheduling MBSS, discussing patient's change in medical status/cognition/behavior with nurses, inservice trainings with staff, slow internet, no internet, documentation software issues, learning new documentation software, looking up diagnoses codes, g-codes, signing papers, logging time into two systems, end of month requests, preparing therapy materials, printing education handouts, walking to the kitchen and requesting food trials, reading company emails, questions about forgotten daily notes, questions about missed visits, room treatments, code greens, writing restorative programs, patient's working with other therapists, texting/talking/emailing managers and mentors, meetings with managers and mentors, and audit reviews. (I'm sure there's more). Also, what else interferes with productivity: patient's not up and dressed, patient's refusing, patient's sick, patient's visiting with friends/family, doctor's appointments, shower day, weight day, patient's lunch time, smoke breaks, hair day, nail day, rosary, mass, and various nursing home activities. (I'm sure there are other things too). Many people are achieving 90% productivity and higher because many people finish their daily notes, weekly progress notes, plan of cares, updated plan of cares, and discharge summaries at home, after work hours and on the weekend. Many people are being manipulated by these productivity standards. Such as, if you are unable to achieve these productivity requirements then we will find someone who will. And of course that statement is scary when people have bills to pay. No one wants to lose their job or income. So the process and cycle continues. What else can you think of that isn't considered "productive"? Also, other productivity posts that may be of interest to you include: Productivity and the SLP by www.dysphagiaramblings.net and What does 90% productivity look like? by www.graymattertherapy.com |
Ashley Perkins,
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