It can be an overwhelming task to stay on top of these caseloads. Even when you have your day or week planned out, there are usually a couple of "fires" that need to be put out. Managing difficult or incompetent staff doesn't make it any easier.
The one thing that I have noticed in this field is that there never seems to be enough funding and none of the processes seem to be streamlined. This is where I have made changes. Being an independent contractor allows me to essentially get the job done like it supposed to (meeting regulations), but I do it my way. I embrace technology and utilize it in my business everyday. I am always reachable whether by phone or email. Essential tools for me are a Blackberry, Netbook (small laptop), an online fax service (I get my fax in my email and can read these on the road), portable scanner and printer, and I take advantage of mobile offices in the area. I have access to co-op offices that have everything I need and don't cost a lot of money. No lease agreement either. Of course I could also use a restaurant/coffee shop with Wi-Fi. I also have a dedicated home office as well.
There are some areas that will initially take more time. If I have to write a brand new medical protocol for a condition/diagnosis, then this can take some additional work and research. But, one thing I do is save all of these digitally and I have built up a database of care plans
and protocols that can be "tweaked" a bit for another client if needed. Establishing relationships with the primary medical team can take some effort as well. Once these relationships are established, the nurses, NPs and docs call me directly with lab and diagnostic results. They see me around enough and know what a vital role I play. Generally this population is non-compliant, but if a nurse is overseeing their medical care, then chances are things are going to get done.
It's not easy and I do work quite a bit, but I make an effort to work more efficiently. You might be surprised as to what a little technology can do for you, but I admit that I am a little bit of tech geek at heart.
The organizational chart here consists of:
An executive Director (oversees entire operation)
Program director (supervises the program coordinators and the day to day)
Program Coordinator (day to day management of the client's residential life)
The nursing department is basically on its own organizationally speaking. Many agencies sets this department up as an independent entity, but still under the same umbrella. Difficult staff can be, well they can be difficult. I try not to use a punitive approach, but encourage staff members to let me know if mistakes are made. They view me as someone who is willing to provide support and education and they see me in the "trenches." Once you get their respect then they will come to you. My phone and inbox are busy with questions. Again, my availability to them has helped fill a lot of gaps.
Some days are just nuts as we all know. It's like moving mountains to fix a broken system. I just choose not to fall into that cycle. I only have control over my department and business. No matter what business you are in, if you can't streamline a few if not all of the processes, then you are going to sink. Stay strong and work smarter.