Go Lean:
Acute Occupational & Physical Therapy Services Lean Initiative
What began as an assessment of Acute Occupational and Physical Therapy services offered on the weekends evolved into overall service improvements every day for the Department of Physical Medicine and Rehabilitation.
A lean team found that PT and OT therapists were spending nearly 58 percent of their time every day – about 4.6 hours – on medically necessary tasks other than direct patient care. They knew they were onto something big. The team applied several lean quality measurements and researched the records of more than 800 University Hospital and Cardiovascular Center patients to gauge the frequency of service delays and impact on care delivery.
“Realizing that we were not matching the right skills with the task was a major 'a-ha' moment for us,” says Jose Kottoor, M.S., P.T., director of Occupational and Physical Therapy.
Kottoor says a true “culture shift” occurred by moving many routine non-patient care tasks from the physical and occupational therapists to technicians – and by the entire group taking ownership for identifying further improvements to the process. Sustained success has been made possible by the strong leadership of supervisors Debbie Pettitt, O.T., Kim Dosch, P.T., and Don Packard, P.T.
“The project has given the therapists time to focus on the value added work they were hired to do: provide therapy to our patients,” says lean coach Brendon Weil, who helped steer team members through the lean process.
“The therapists are making a difference in more patients’ lives by being able to see more patients each day and provide more focused skilled care,” says Lindsey Boutell, P.T., a physical therapy clinical specialist. “It has been a lot of fun to be able to integrate a new accessory to our department by adding techs to our daily activities. The techs provide an incredibly positive outlook to our patients, making physical therapy a little less intimidating.”
Rehabilitation technician Cassandra Redmon says, “The patients now have an opportunity to have any needs addressed beforehand, such as their medications, and gives them time for mental relaxation and preparation for physical therapy.”
The lean process resulted in many significant improvements:
- the number of patients seen per therapist per day improved by 12 percent
- the number of billable units improved by 33 percent
- the median response time to new referrals improved by 42 percent
- the percent of time therapists spent providing value-added care to patients at the bedside improved by 27 percent
Written by Cathy Mellett
For more information about this project, please contact Jose Kottoor at 734-936-7070.
The lean team:
- Jose Kottoor - M.S., P.T., director
- Kimberly Dosch - M.S., P.T., supervisor
- Don Packard - M.S., P.T., supervisor
- Debbie Pettitt - M.S., O.T., supervisor
- Christina Fields- P.T., clinical specialist
- Rob Ferguson - O.T., clinical specialist
- Lindsay Boutell - P.T., clinical specialist
- Kim Watt - P.T.
- Cassandra Redmon - tech
- Brendon Weil - lean coach
- Michael McVicker - lean fellow