Productivity

Seven tips to measure productivity

Use data to better manage your practice and staff.

BY JANNA S. MULLANEY

After 30+ years working in the eye-care industry, I recently learned something very valuable. Previously, I made most decisions based on my intuition — after all, I’ve been at this for many years and trusted my instincts.

In May 2014, the leadership of my practice changed, and for the first time, I found myself reporting to a numbers-driven CEO. Not that my former CEO wasn’t, but we had worked together for so many years that he understood the anecdotal basis behind my decisions. Now, not so much. After the new CEO turned down my request for six new technicians on the basis of my simple decree, I remember thinking that this wasn’t going to work for me. I mean, really, would I say I needed the techs if I didn’t really need them?

He challenged me to come up with facts to support my request: how much would this cost the practice, how many patients would each technician see, what was the effect on the provider’s schedules without them? My first thought was that something that should take me five minutes was now going to take me an hour. But, I actually learned a valuable lesson — you can’t really make business decisions without the numbers.

Here are seven tips that I’ve come up with to measure staff productivity.

1. Understand your business.

In this new world of regulatory changes and reductions in payment, you need to clearly understand your business and what it costs to turn the lights on. You can review all of the benchmarking studies out there, but if you don’t know where you are in the mix, how much do those studies actually mean to you? Understand your volume, your revenue and your costs so that you can clearly report on those items in a way that makes sense and can be tracked for consistency.

2. Find your baseline.

You have to start somewhere, so first consider the departments that you need to measure and get a good normal run rate for each one. Look at your technicians, your surgical counselors, and your front desk staff. How many staff members would you have each day if all departments were fully staffed? Then consider provider capacity, not their average — work on the premise that you’re fully booked. Look at data such as patients per tech and per front desk representative, surgeries per counselor, etc.

3. Make appropriate comparisons.

Studies and surveys look at practices of all shapes and sizes. When using them to compare your practice to others, remember that it’s not always about the number of doctors in the practice or part of the country. Make sure that you compare your practice to those that run similar to yours.

For example, if you have a high-volume practice, count the number of patients per tech, not the number of techs per doctor. Five high-volume providers may collectively see the same number of patients as eight average providers. This goes back to understanding your business. Once you’ve made your comparisons, see where you stand — are you understaffed, overstaffed, or right in the middle?

4. Measure what makes sense.

When you measure and manage your staff’s productivity, have a reasonable goal, and make the best use of your efforts. Measure things that you can affect and where you can show improvement. If you have a provider who always has more techs than every other doctor, don’t get hung up on trying to prove a point that will never be considered. Even if you can’t get that provider to accept less help, facts such as revenue and costs per appointment can help them understand the financial impact by providing the data, which most times can be a greater argument.

5. Make it sustainable, and affect a change.

Whether it’s front desk, technicians, billing staff, etc., managing staff productivity is an ongoing project. Don’t make things so complicated that it’s not sustainable. Use your baselines, and set goals to stay within them (at a minimum) or to project improvements.

Over the past two years, in addition to the ongoing review of clinical staff, I chose to improve the number of patients each patient service representative (PSR) works with per hour. I continually heard that we don’t have enough front desk staff, but when I looked at the number of PSRs in some of our smaller locations vs. the largest office, the numbers didn’t jive. A small office could work with a team of two, but the larger location needed twice as many for the same number of patients?

Once we started measuring, we pinpointed several genuine reasons why we needed more staff in one location and not others and realigned certain responsibilities to balance duties between the locations. For instance, in some locations, patients needed more assistance understanding their insurance policies, while the younger patients at our urban location successfully utilized kiosks and were more apt to handle registration related tasks independently.

6. Build on your accomplishments.

Once you get started and can establish a rhythm, build on that momentum. Our next step was to examine the number of surgical counselors. With this exercise, it wasn’t simply the number of patients, but also the rate of performed surgeries — it’s not enough to schedule the cases if you have a 20% cancel/reschedule rate. If adding one more person means you can prevent cancellations or collect a greater rate per surgery when capturing all of the out-of-pocket dollars or increase your premium conversion capture rate, then you may find that you can increase your staff and relieve personnel stress while improving the revenue per case.

7. Share your “why” with your team.

When staff understand the purpose behind your project, you get better results. For example, if you start tracking how many patients your technicians see per day or per hour without explanation, they may react negatively.

If you instead tell them that you are working on a project to “measure improvements,” you should get better staff buy-in. You could stay to the staff, “I would like to start tracking the number of patients per tech, per hour, so that I can work on my 2017 schedule and budget.” Or you could explain that you want specific facts when performing annual staff reviews. This helps when a staff member says, “I work harder,” or, “I work up so many more patients than everyone else.” If that is the case, the numbers should show it.

Conclusion

We are no longer in a world where you can go with your gut. We face payment reductions, increased clinical requirements, very public patient satisfaction reviews, and market consolidations. Measuring your staff’s productivity, managing to those results, creating opportunities for greater efficiencies continues to grow in importance.

Whether it’s to predict for annual budgets, to create goals to increase staff productivity or to manage your practice using clearly definable, trackable and measurable results, just get started.

Take the time and make the effort to prove your intuition. OP

Janna S. Mullaney serves as chief operating officer at Katzen Eye Group and the executive director of Operations for Eyecare Services Partners in Maryland. Ms. Mullaney has earned certifications in Healthcare Marketing, Ophthalmic Assistant and Ophthalmic Technician, Ophthalmic Scribe Certification, as well as completing a program for Certified Professional Coding and Ophthalmic Coding Specialist. She is an active member of the American Society of Ophthalmic Administrators and serves as a board member of The American Academy of Ophthalmic Executives. She also serves as an EHR and practice consultant.