8 GREAT productivity tips for occupational therapists that work in SNFs. | SeniorsFlourish.com #geriatricOT #OT #occupationaltherapy

8 Productivity Tips for Occupational Therapists Working in SNFs

Mandy Chamberlain MOTR/L Education & Tips for Independent Living 18 Comments

Productivity. Ugh. I almost don't even want to say the word out loud...

In all actuality, I feel it shouldn't be called "productive," it should be called what it really is: "billable." We are ALL as efficient as we can be in skilled nursing facilities, as there are so many extra things that we do to provide excellent patient care that facilities can't get paid for - talking to co-workers and support staff, calling physicians, hunting down patients around the building, waiting for medications to be administered, reviewing charts, completing screens, attending department meetings, making copies of handouts, etc, etc and the list goes on. Some great productivity tips for occupational therapists that work in SNFs. | SeniorsFlourish.com #geriatricOT #OT #occupationaltherapy

This article is not about how I feel about the demands of productivity standards, but about how we can be the most productive (billable) in our work environments.

It is many OT practitioner's reality - right now...today... and I want to help give some tips to deal with the cards we have been dealt so we can both provide amazing skilled occupational therapy services to our patients and meet the demands of our employers.

I also know that all of these tips won't work for every OT in every SNF setting and it is absolutely not always realistic to do some of these things while providing hands-on, client-centered care, but hopefully you can take away some ideas that you can integrate into your day and make things a little easier.

1. Stay on Track

When we get behind on our first patient of the day, it causes a domino effect, making us behind for the rest of the day.

Tip: One way to help with this is to figure out tentatively how long you are spending with the patient and set an alarm on your watch 10 minutes before the end of your treatment session so you know when it is time to wrap things up.

2. Point of Service Documentation

I say as an occupational therapist, documenting during our treatment session is more challenging than other professions as we are so hands-on, but if possible, document a little bit at a time throughout your treatment session if possible.

Tip: If you feel rude, tell your patient exactly what you are doing and why. Example: "I don't want to forget this, so I am going to write this down right now." Most patients understand this.

3. Using Dictation When Possible

If you are using an iPad for documentation, use the dictation feature when completing your daily soap note. It is  definitely faster than finger typing everything out on an iPad.

One way to increase productivity in a SNF is to use the dictation feature on your ipad if this is how you document | SeniorsFlourish.com #geriatricOT #OT #occupationaltherapy

4. Invest in an Attachable Keyboard

If you use an iPad for documentation, an attachable keyboard definitely speeds things up and is much more efficient than finger typing your entire weekly note.

5. Plan Ahead

Some great productivity tips for occupational therapists that work in SNFs. | SeniorsFlourish.com #geriatricOT #OT #occupationaltherapy

If you are fortunate enough to know who is on your caseload and know who you are going to be seeing each day, on your way to work, think about what you will be working on with your patients for the day.

Tip: If you know what you are going to be doing, you can make copies, dig out games and figure out any other supplies that you will need. This way you can get them ready or at least know where things are when you are going to need them!

6. Set Up Appointments

Set up appointment times with patients for the week or even just for the next day. They may be able to come down to the therapy department at the designated time or even be up and ready to work in their room for ADL training.

Tip: Doctor appointments, outings, family visits, bingo and MORE fill up a patient's week. Post a Weekly Schedule Form in a patient's room or closet so you can see what their week looks like. Click here for an example of one I created with Sarah from OT Potential.

7. Don't Document More Than Necessary

If you have a weekly note due today, you don't have to write a daily note as well. Accurate documentation is necessary, but over documenting is time consuming.

8. Don't Reinvent the Wheel

Use tactics, experience, forms, handouts, etc that co-workers have used and found to be tried and true to work in your facility. Ask around, see what they use and do.

Leave a Comment - I'd love to hear what tips you have used to be more productive.

For more information, check out: Dealing with Productivity Standards: Resources for Ethical Practice from AOTA

Looking for more OT treatment ideas, education videos, clinical resources, patient handouts, assessments and support? Check out the Learning Lab membership and join today!

Comments 18

  1. I am not an OT or COTA (PTA!), but I appreciate the article. I work PRN in SNF’s. I was given some of the same tips by one of my DOR’s to make my time with the patient as billable/productive as possible. Propelling themselves to the gym (if they have long legs, talking/gathering data about pain level, if they have short legs and they are in a wheelchair I can have them do LAQ to get their legs ready. But, I still find POS documentation and the idea of productivity difficult. Sometimes, you need to talk to the nurse or CNA because the pt had a difficult night or something changed that could affect the therapy session. That’s not billable time, but it is necessary. Some patient’s are chatty. I would rather just get through all the pt treatments and document at the end of the day. I can take a breath and possibly write a better note. I try to reread my notes before I sign them to make sure I didn’t forget any exercises we did (which eats time). Hope I’m not crossing any lines since this article was directed towards OT, but I think as a whole, we face the same struggle.

    1. We 100% face the same struggle! Thank you for your insight. I think MANY of us can relate. It is wild out there in the therapy world…

  2. Pingback: What You NEED to Know About Occupational Therapy Level II Fieldwork | Seniors Flourish

  3. To not ‘reinvent the wheel’…
    Does anyone have any good tips or scheduling forms they like to use in inpatient/SNF settings. We are starting a new transitional/swing bed unit in our hospital and I am brainstorming for scheduling patterns/organizations to help our unit flow with PT/OT and nursing schedules.
    Would like any input.

    1. Hi Sierra. Not sure exactly what you are looking for, but I created these forms that we used in our Swing unit as well as in our SNF. We laminated them and put them inside the client’s closet door (you may be able to put it on the outside, depending on the facility’s HIPPA policy), so we could schedule therapys, see when they were going to be out of their room for procedures (if they knew in advance, which we know is not always the case), etc. This is the form we used: http://otpotential.com/share/weekly-therapy-schedule-room-sign

      We also used this for safety instructions,adaptive device/transfer assistance, client likes/dislikes, precautions, etc so we could update/change/get a quick overview: https://otpotential.com/share/client-overview-room-sign

      And because it was a swing status vs the typical inpatient, the documentation schedule is a little different as well (depending on what your average length of stay will be), so this documentation calendar is good too: http://otpotential.com/share/snf-ot-documentation-calendar

  4. Pingback: Productivity Standards (and Ethics) in Today's Occupational Therapy World

  5. Multitasking around the patient is not productive, doing notes when you’re supposed to be engaged with the patient is not therapeutic or in the patients best interest. Documentation is part of the cost of doing business. I believe that documentation and treatment should be separate. For profit companies squeeze productivity to maximize profits. 75% productivity and the rest for incidentals and documentation is reasonable. Let’s not fool ourselves and make MBA’s think we are a robotic production line giving the user(client) a suboptimal experience. Push back.

  6. I’m currently in a community outreach hospital, so we cover SNF, in-patient, out-patient, home health and several of the local schools.

    My supervisor is not happy with me because my productivity is only 64% and I’m running into over-time. So much of what schools need isn’t billable, and our documentation system is super old and difficult to manage. (you have to look for the correct tab for each and every little thing you want to document.) And get this- they have their own G code system! Unlike anything else in the country. Our biller then converts it to standard Medicare G codes.

    I’m a traveler, so I’ve only been here 3 months, and it’s very confusing. Having the mixes of all the different settings adds to the non-billable time.

    Anyone ever worked at a place like this and have ideas? I’m actually carrying weights and treating in the room to avoid transportation, and I document POS when I can, but like others have said – it’s rare in OT to be able to set up a patient with an activity and let them go. With our system, I can’t document periotically, because after a short time the computer locks, so I have to keep logging back in to the computer and to the documentations software. In some cases I’m finding POS to actually be slower because of this.

  7. I find your recommendations to be great for those who work in the same building every day and have some control over their schedules. I cover several buildings and don’t know my schedule until the morning of treatment. I do tell the person I have to write about them but when they need cues and assist with adls, rom etc, POS is not possible. In order to fill in all the required boxes in a manner the company requires, how can I have them “set up” on a task while I type for 15 minutes at least which is the minimum it takes to read through notes of daily treatments, let alone talk to the COTA. What are having them do that is skilled while you are writing a progress note or discharge summary?

    1. I’m typically not, Susan. Discharge summaries and progress notes take too much time and I cannot do both – skilled pt treatment and these notes at the same time = bad productivity ;(

  8. I’ve been working on this since my yearly review in June. I’ve been writing down everything I do just to see where I’ve been “eating” my productivity minutes. It has been a challenge but I’m learning a ton about where my minutes go. I’ve been “reviewing” the treatment session during the last 5 minutes with my patients and been using that time to finish up my note with my patient. I do try to get some of it started during the session but I fail with those folks who require more assist. Also, I have, have, have to take a laptop into the room when I do an initial evaluation or I’m in trouble. Sometimes I don’t get it all done before the social worker or dietary manager or someone else wants the patient. The eval has to get done so I can hand the treatment off to a COTA the next day. Any suggestions?? I also lose minutes when I have to work on paperwork for people who have discharged to the hospital, when I’m updating a plan of care for a patient I only see for supervisory visits – I usually get only 15 minutes with those folks and I’m just not fast enough.

  9. Post
    Author
  10. Making transport “active” and therapeutic , such as having the patient ambulate/propel self, way finding, providing a dependent patient with a sensory prop or positioning device during transport, review the previous session with the patient during transport or provide some other education if possible.

    1. Post
      Author
  11. Mandy…Good tips ! I have been a COTA for almost 24 years and really appreciate the fact that we are all in this together. Although.. hoping to part time or PRN soon…this was helpful…keep up the good work?

    1. Post
      Author

Leave a Reply

Your email address will not be published. Required fields are marked *