Census and Productivity… The Numbers Game

Many of you have asked - is this blog real? Yes it’s real. I’m personally writing each entry and always welcome suggestions for topics.

People also ask, “Are you just going to talk about soft issues or will you use the blog to talk about the hard stuff?” Okay - so I heard you and I took on the challenge and this post is one of the issues I know there is chatter about, not necessarily to me but chatter none the less. This post is about productivity and pressure on keeping the census in all our programs.

So, what’s with all the numbers? Why do we have a daily census report? Or monthly cash goals?
And why do we put so much emphasis on patient productivity in our outpatient sites?

First and foremost know that Senior Leadership knows how hard you all work. Whether it is treating kids or scheduling appointments, we are all giving our best. We also know that if you don’t measure what is meaningful, you have no way to know whether you are being successful or not.

The easiest answer for why we measure things like efficiency and collections is in some cases these numbers generate bills, which generates cash, which is how we pay our employees and all of our bills. Just like in your budget at home, your salary covers most of your bills and provide you with the recourses to do your job. There may be some flux with a check from a family member for a holiday, but 99% of the dollars come from your salary. When we treat a child in any of our settings, billing for that service is what pays our bills. When kids aren’t admitted, or don’t get treated, or cancellations occur - we don’t get paid and then we can’t pay our bills.

Every year we set a budget for each department based upon our mission and strategic plan, as well as your requests for new programs, equipment, and how we expect to be paid for each of our services. We also examine how many children are on the waiting lists to be served. We take that budget number and then determine how many children we would have to treat in all of our areas: inpatient, outpatient, EIP, the school, medical day care and long term care. For the last few years, we have had to hire more staff to be able to meet those numbers,

There have been lots of questions about productivity - how is it calculated?

On the inpatient side, we are budgeted for an average daily census of 50 and children should receive on average, three hours of therapy a day. In long term care we need to have a total of 64 children being treated in both sites and in medical day care 25 children need to be treated every day. In EIP we have made a change recently to our hours based upon the changes in the market places. On the outpatient side, we ask staff to treat children 24 hours a week if they work a 40 hour week. That leaves 16 hours for meetings, cancellations, paper work etc.

We anticipate for TOP time, conference time when we calculate these expectations. When we fall below those budgeted numbers, simply put, we can't pay our bills.

Now we all know that kids get sick, there are holidays' there are cancellations and it makes it hard some weeks to make the numbers. But overall, those are the numbers we have to make. When we don’t make those numbers, we fall behind and can’t pay our bills.

I know this isn't the fun stuff. This isn't the warm and fuzzy stuff that makes you feel good about getting up and coming to work. I know these questions are out there and wanted to address them head on to help clear up the gray areas.

Let’s hear it: Do you have any questions/comments about patient census or productivity?