What is your expected productivity and how is it measured

cookie102 · Aug 26, 2008

What is the expected nurse productivity at your agency ? How do they measure productivity ? I've been reading this forum and am interested in your answers. I work for an agency that is constantly complaining about the nurses not making productivity. We are computerized but still do a lot of paperwork. If I'm lucky I can get through an admission visit in an hour and then take another two hours to complete documentation. The acuity of the patient continues to rise. Hospitals discharge patients without making sure they understand discharge medications. Scripts aren't given or pharmacy isn't open. Referals have very little information and clients are often not homebound. The list goes on but suffice to say I waste a lot of time everyday doing things that don't contribute to productivity. Its very frustrating. I've been doing this for 7 years. I love the patient contact but am sick of the endless documentation and phone calls. They want to tie our raises to productivity but make it impossible to consistantly make productivity. It can't be that my coworkers and I are all too slow and dumb to be efficient.

6 visits in an 8 hr day,,,admits count as 2, recert as 1.5 EVERYTHING else is counted as 1 (even roc's)!!!

now if we only saw 6/day that would be ok in an 8 hr day, but as we all know that would be in a perfect world.

and to add insult to injury we just got notice that the are decreasing our mileage reimbursement by .02/ mile!!!!!!!! not a happy bunch!!!!

GmaC13 · Aug 28, 2008

We are currently recieving multple complaints about the same subject. Realisticly our nurses are currently seeing 3-4 pt in 8hrs. Administration coninuously reports that we are well below the standard and that other agency see far more pts. Unfortunately we are expected to be secrataries, intake nurses, insurance billers, phone answerers, supply runners etc,etc. Dispite our repeated complaints that we do not have any support staff we are just told its always been that way, deal with it and see more pts. We have a census of about 50 pts, combination of HH and Hospice. We have 2 full time nurses, 2 part time and 2 per diem. We do not have a pt care coordinator, only a partime secratry, no intake nurse, no social worker etc,etc. My frustration has gotten so high at this rediculous use of nursing hours I could scream. Anyone else have similar experiences? :banghead:

cookie102 · Aug 28, 2008

We are currently recieving multple complaints about the same subject. Realisticly our nurses are currently seeing 3-4 pt in 8hrs. Administration coninuously reports that we are well below the standard and that other agency see far more pts. Unfortunately we are expected to be secrataries, intake nurses, insurance billers, phone answerers, supply runners etc,etc. Dispite our repeated complaints that we do not have any support staff we are just told its always been that way, deal with it and see more pts. We have a census of about 50 pts, combination of HH and Hospice. We have 2 full time nurses, 2 part time and 2 per diem. We do not have a pt care coordinator, only a partime secratry, no intake nurse, no social worker etc,etc. My frustration has gotten so high at this rediculous use of nursing hours I could scream. Anyone else have similar experiences?

how are they (administration) justifying that there is no social worker and you see hospice patients let alone HH ones?

i know the nurses are doing there best but you can't wear all those hats and do the job correctly...!!! how is this agency functioning?? i would advise you to GET OUT!!!

GmaC13 · Aug 28, 2008

We did have a social worker for hospice but she was very part time. She had her own pratice and was not redily availble. She saw our hospic pts (the ones that would let her come) about every 2 weeks. She recently quit to get married. They ahve hired someone new that will actually be 20 hrs per week but only for hospice pts not home health. She won't be starting for a few weeks. I have thought many times of getting out but this is a very rural area and there is not much available without a major move or a long drive. Thanks for your input.

horsepoor · Aug 29, 2008

This subject really hits a sore spot. I see into the future that this is whats coming for all of us HH Nurses. And it's not pretty. Our company has started talking about it and calling corporate and asking how to measure our time. They dont think we are very productive but we as nurses all have to wear many hats and do multiple tasks. But they dont measure that.

purpledaisies · Aug 30, 2008

For 24 hrs/wk we see 6-7pts in an 8 hr day (SOC=2, ROC=2, recerts=1), and we case manage 18-22 pts. HTH:nurse:

annep · Sep 5, 2008

I am very interested in the string on productivity. I am doing an article for a home health newsletter on this very issue and wonder if anyone would be willing to help me by allowing me to use their postings? I do not have to use names, would just use titles and states, if you prefer. I think there is some really good information that other nurses (and office managers!) should see--we're not exactly the NYT, but we are national. I'd love to get more of the word out about what it is like in the trenches. Please email me privately if you would like to help me out. THANKS!

SandBetweenMyToes, BSN, RN · Sep 8, 2008

I work in Ontario, so I realize the home health setup is different, but we are expected to see 10 clients per 7.5 hour day. Most clients are listed as a half hour visit, and admissions are listed as either 0.75 or one hour (depending on whether they are short or long stay). However, if we are traveling in more than one district, and/or have admissions, that becomes extremely challenging. And...our planning center does not seem to take those above listed factors into consideration very often. Nonetheless, that is the expectation. Most days it is do-able, but as a new HH nurse, I am happier when the list is shorter than ten.

:yeah:

Wishinonastar, BSN · Oct 3, 2008

I don't understand how they justify paying nurses to do all the clerical work. You could see a lot more patients every week if you did not have to waste time putting charts together, doing intakes and insurance auths, etc. One full-time clerical at $10/hour would free up 40 hours a week of wasted nursing time at $25/hour -a savings of $31,000 a year. Plus, the additional patients you could see at $100 a visit for 50 weeks a year at 1 patient a day adds another $25,000 in profit. Even if you take off the additional costs of adding staff, you still win because of improved nursing satisfaction, increased efficiency, reduced turnover.

Hail to the clerical staff! We need them!

YogaloverRN · Oct 9, 2008

Hello everyone, well I have been on my own since the end of April, I work the week-ends, which is Sat,Sun, Mon. I have to cover all of the north side of the county which can mean traveling at least 100 miles a day. I usually have 10 patients a day, and sometimes 12-14. I have had the supervisor call me and try to give me more when I had 12, and the last time, I told her I couldn't do anymore. Gosh, they push me as hard as they can. And a lot of these visits are wound care, lab draws,admits, and post-hospital, etc, not many reg visits. It is a real challenge and I usually work 12 hours on those days. I was told when I was hired, that I would work 3 days and see 8 patients a day, my how that changed. But, it still beats the hospital!

Wishinonastar, BSN · Oct 9, 2008

I did weekends for a few years until my son went to school. I know where you are coming from. Weekends are a whole different ball game. You are right though, it still beats the hospital!