Is your agency's clinician productivity target actually achievable—or is it simply a number that's been passed down for years?
In Episode 02 of The Home Health and Hospice Profitability Podcast, host Doug Walters breaks down the math behind clinician productivity and explains how home health and hospice agencies can build productivity expectations based on the actual workload of their clinical teams.
Many agencies use targets such as 30 points per week, five visits per day, or a hospice caseload of 15 patients. But the more important question is: Where did that number come from?
Doug walks through a practical framework for calculating productivity from the ground up.
In this episode, you'll learn:
• Why simply counting visits can give you an incomplete picture of clinician workload
• Why a start of care and a routine visit shouldn't necessarily carry the same productivity value
• How a point system can help measure workload rather than simply counting visits
• How PTO, holidays, meetings, training, administrative work, orders, calls, and other responsibilities reduce available clinical capacity
• Why a 40-hour employee may have significantly fewer than 40 hours available for visits
• How to calculate realistic visits per day based on actual available hours
• Why a 30-point weekly target could potentially represent more work than a clinician can reasonably complete
• How unrealistic productivity expectations can push documentation and other work outside normal hours
• How clinician productivity affects labor cost per visit
• Why increasing visits per day can reduce direct labor cost per visit—but only to a point
• The difference between productivity and sustainable productivity
• How turnover, overtime, documentation quality, recruiting, training, and patient experience can affect the true cost of productivity decisions
• How to translate hospice caseloads into estimated visits per day
• Why two hospice nurses with different caseloads may have very different workloads
• How admissions, call responsibilities, drive time, patient complexity, and support teams can affect capacity
• The three major productivity mistakes Doug sees agencies make
• How to begin calculating a productivity standard based on your own agency's operations
Doug walks through an example beginning with 2,080 paid hours per year and subtracting time that realistically isn't available for patient visits.
After accounting for PTO and holidays, meetings and training, administrative responsibilities, and patient-related work outside the visit itself, the example leaves approximately 1,555 hours per year—or 33.8 hours per week—available for visits.
If a routine visit requires approximately 1.5 hours from start to finish, including travel, time in the home, documentation, and related responsibilities, agencies can begin calculating what a sustainable productivity target might actually look like.
Doug also examines the financial side of productivity.
Using an example of a fully loaded RN costing an agency $120,000 annually, he demonstrates how changes in visits per day can affect direct labor cost per visit. But simply demanding more visits isn't necessarily the answer.
Once productivity expectations move beyond a sustainable level, potential savings may appear elsewhere as additional costs through turnover, overtime, rushed documentation, recruiting, training, or patient experience.
For hospice agencies, Doug also explains why caseload should be translated into what the clinician's actual day looks like. A caseload number by itself doesn't account for admissions, call responsibilities, geography, drive time, patient complexity, or the support available to the nurse.
The goal isn't to find a universal industry productivity number.
The goal is to find your agency's number.
Start with the hours you're actually paying for. Subtract the time that realistically cannot be used for visits. Determine how long your visits take from beginning to end. Then use those numbers to determine what your clinical team can reasonably accomplish.
And one practical exercise Doug recommends: take your agency's total visits and divide them by your clinical FTEs. Compare what productivity actually looks like today with the target you're currently using.
Knowing what you want productivity to be is one thing. Knowing what it actually is—and what your clinicians can sustainably achieve—is something completely different.
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