Sigh.... I just knew I'd get your attention with this cute heading!! Ha!
 Wanted to pass on to you some information I learned today from our
management engineering consultant.

1. Hospitals are getting away from only counting chargable items in
productivity measures. When hospitals are pricing their services for outside
organizations (like PPOs) they need to know the cost of the care that is
being delivered.  That means that our services need to be visible.

2. Management engineering (or whatever you call your productivity experts)
can tie a labor standard to such things as "case management", phone
follow-up, class time (both teaching and prep), chart review (case finding),
etc.

3. This puts previously non-chargeable staff functions into the hospital
finance computer so that the hospital can better track costs of patient care.
 This means that your heretofore invisibility can be uncovered, if you are
not charging for your services (especially applicable for inpatient care).
 You do NOT want to remain invisible.  If you do not show up in some computer
somewhere, you are expendable!

4. On the printouts from the productivity functions, there would be numbers
and labor standards calculated out to show that your department was very
active.  There may be a "zero" charge with the activity.  (Of course, I
believe that we also should be charging for our servicesand am currently
trying to get this done where I work.....  It is also important to be in the
insurance company's computers, too.)  Most of us will never be able to charge
for phone calls, but it still is a necessary activity and we should be
credited with the amount of time that we spend.

I can give you better examples from the field of dietetics.  Hospital food is
usually lumped in with the room charge (along with the wall paper, the trash
collection, etc.)  In our hospital the ONLY measure of productivity currently
used is the number of patient meals served.  This does not reflect the
dietitian involvement, since most of the sickest patients do not even eat!!
(Certainly it does not have anything to do with outpatient services.....)
 JCAHO requires dietitians to do assessments of patients, classify them into
levels of care, etc. etc.  Since none of this is chargeable at the present
time, if there is a large patient turn over with shorter patient stays, there
are more people to assess, the dietitians are running wild and it looks to
management like they are doing nothing!  In the outpatient area, if a patient
does not keep an appointment, I still have to send the physician a note, do
record keeping activities, perhaps reschedule a second appointment, etc.
 Under "case management", I will be able to get credit for this
non-chargeable but necessary activity.  Phone calls, both follow up and wierd
questions also count as "case management" or can be put into a separate
category.

LCs could have follow up phone calls counted, charge "case management"
transactions when doing a 10 minute pump demo, charge an extended increment
for more intensive care, etc. For those of you who wear 2 hats, this would be
a way of showing the hospital just how much of your time is spent in LC
activities.  Another activitiy that could be counted is phone contact with
insurance companies, physicians, looking for rental pumps for patients, etc.

Bottom Line:  Adding in all this stuff for productivity may affect the way
FTEs are assigned, will alert management to actual staff use, and will make
you feel like you are contributing to the hospital in a new way.  (It is a
sick feeling to know that under the "bottom line" is the only measurable way
of contributing system, having a day when no one shows up and spending one's
time doing invisible, but important activities looks like loafing.  Tracking
these other activities that may not be direct patient care but do affect
patient outcomes.

Go for it!!

Martha (really excited) Brower RD LD IBCLC (hoping to charge for outpt. LC
services as soon as I can do all the work. I've been assigned to find out how
much everyone else in the entire universe is charging.  So, if anyone wants
to privately e-mail me...  Thanks in advance [log in to unmask])