Managing Human Resources

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Managing Human Resources:

Managing Human Resources


Objectives Discuss factors related to staff recruitment, development and retention. Evaluate why people leave a job and actions that can minimize turnover. Explain productivity from the perspectives of a manager and a staff therapist. Identify methods of coordinating work in a rehab context to maximize efficiency and productivity. Analyze the significance and methods of appraising performance

Recruiting the Right People :

Recruiting the Right People A typical therapy department has several categories of employees: Management Professional staff Skilled support personnel Unskilled support staff


Management Planning What needs to be done and how these objectives need to be accomplished Organizing and staffing Designing and delegating work loads Establishing lines of authority and communication Training, development, and promoting Directing Motivating and guiding L eading Controlling Establishing standards Measuring, evaluating, and correcting performance Braveman, 2006

Professional Staff:

Professional Staff Therapist Licensed OT, PT, SLP, etc . Therapy assistants Licensed OTAs, PTAs, SLPAs, etc . Other licensed professionals Social workers, behavior specialists, etc.

Unskilled Support Staff:

Unskilled Support Staff Therapy technicians and aids Office personnel/receptionist Intake coordinators Billing coders Cleaning and maintenance personnel

Generational Issues in the Rehab Workplace :

Generational Issues in the Rehab Workplace Four distinct generations each with its own traits, strengths and weaknesses: Traditionalists (born before 1946) Baby Boomers (1946-1964) Generation Xers (1965-1981) Millennials (1982-2000) Can lead to friction among staff, “ clash points ”

Generational Issues :

Generational Issues Therapists may have entered profession with a certificate or bachelor’s degree Aides/techs may have decades of practical experience Values, work habits, and customs are a product of the work environment they entered and are firmly established Supervisor may be a fairly recent gruaduate

Generational Issues in the Rehab Workplace :

Generational Issues in the Rehab Workplace Some of the differences: Comfort with new technology Preferred communication methods Attitudes toward work-life balance Attitudes toward authority Interaction styles Motivational strategies

Generational Issues :

Generational Issues Traditionalists Civic-minded with firm beliefs in public harmony Big business Cooperative social discipline Straight, orderly lines Top-down authority Hard work, deferred gratification, and self-restraint expected Loyalty strong in workforce

Generational Issues :

Generational Issues Baby Boomers Idealistic High level of self-satisfaction Their work defines them Appearance matters Value consensus building and relationship building Highly competitive

Generational Issues :

Generational Issues Generation X Grew up in world characterized by change More comfortable being alone and less at ease in large groups of strangers Expectations of the world fairly low Reliance on self is strong Focus more on getting the job done than on establishing rapport Look for balance – work is not the driving force Don’t believe in “paying your dues”

Generational Issues :

Generational Issues Millennials Expected to achieve and excel by parents Self-esteem is paramount Team-oriented Conformists Respectful of authority figures “To a (Millennial) every second is a stretch, a year is long term and three years is just a mirage .” Martin and Tulgan

Generational Issues in the Rehab Workplace :

Generational Issues in the Rehab Workplace “All generalizations are dangerous, even this one.” Alexandre Dumas Workplace motivational messages: Traditionalists: Your experience is valued. Baby Boomers: You are needed. Gen Xers : Do it your way. Forget the rules. Millenials : You work with bright, creative people.

Generational Issues in the Rehab Workplace :

Generational Issues in the Rehab Workplace Interactive styles: Traditionalists: individuals Baby Boomers: team players, like meetings Gen Xers : entrepreneurial style Millenials : participative style

Generational Issues in the Rehab Workplace :

Generational Issues in the Rehab Workplace Appreciating the differences: Younger therapists can learn from the clinical experiences of the older Older therapists can learn from the latest knowledge and skills of the younger Keys to making it work and work well: Approach everyone on an individual basis Mutual respect Keep open lines of communication Mentoring opportunities

When Generations Collide :

When Generations Collide http ://

Work design – Three parameters       :

Work design – Three parameters       Work design – Three parameters Job specialization Horizontal specialization: breadth (scope) of the job Vertical specialization: depth of the job   Where do PTAs and COTAs fit?

Work design – Three parameters :

Work design – Three parameters Behavior formalization Ways a business can standardize work Health care relies heavily on standardization Increases efficiency and consistency Decreases potential for errors Means include: job descriptions, standard care plans, treatment referrals, policies & procedures, operating manuals, licensure requirements

Work design – Three parameters:

Work design – Three parameters Job training Process by which job skills are taught Can occur inside or outside the organization E.g.. therapists Formal education / degree / licensure Orientation Mentoring Competencies Continuing education

Work design – Three parameters  :

Work design – Three parameters   Job Description “Road map to employee success.” Nosse , p 202 Job title Organizational relationships List of duties Description of decision-making authority of the position Applicable work standards Minimum job requirements

Employee Development   :

Employee Development   Plan should be designed to help employees: Adapt to changes in job duties and performance expectations Do their job well today Do their job better tomorrow Keep pace with new technology Fulfill their professional goals Meet continuing education requirements for licensure

Job Competencies :

Job Competencies Clearly defined and measurable tasks Meet performance expectations and accreditation requirements Internal programs In-services, mentoring External programs Self-study materials, internet courses, CPE Consultants

Employee Retention :

Employee Retention U.S. businesses spend over $200 billion annually recruiting and replacing their staff. Turnover costs can easily exceed $25,000 per nurse. Thomas Group, Inc., 2009 Loss of an experienced employee can impair an organization in several ways: Decreased productivity Lost business opportunities Lost revenue Decreased customer satisfaction Decreased (remaining) employee satisfaction

Employee Retention :

Employee Retention Five common reasons employees leave: Corporate culture Perceived lack of appreciation Insufficient resources in the workplace Lack of advancement opportunities Inadequate compensation R Herman, 1999

Herzberg Two-Factor Theory of Job Satisfaction :

Herzberg Two-Factor Theory of Job Satisfaction Dissatisfiers Administration Benefits Interpersonal relations Job security Organizational policy Salary Supervision Satisfiers Achievement Advancement Growth potential Interpersonal relations Power Recognition Responsibility Status

Organizing and Engaging Workers   :

Organizing and Engaging Workers   Healthcare is under constant cost-containment pressure. Healthcare is a human resource-intensive industry. With decreasing reimbursement and increasing costs, healthcare companies must control HR costs to stay in business.

Productivity :

Productivity Employee’s contribution to organizational goals Cost of resources used (Input X Expense) to value of outcome produced (Output X Price) If the organization spends more to produce the service (Input X Expense) than the customer will pay (Output X Price), it will lose money. The options are: Increase output without increasing cost Decrease cost without decreasing output

Productivity :

Productivity Productivity depends on: Having the right people (recruitment and retention) Dividing the work between them (organizational structure) Coordinating their work into a productive whole

Productivity :

Productivity How do we balance between “dividing” and “coordinating?” Standardization: improve performance consistency and decreases need for supervision (e.g. Policies, procedures, protocols) Supervision: direction of one person by another (Manager to senior staff, senior staff to junior staff, professional staff to support staff, etc.) Mutual accommodation: ongoing interaction between workers

Management Styles :

Management Styles Push, Pull, Lead Supporting, Coaching, Delegating, Directing Motivating toward high productivity: Know the work Set clear expectations Recognize and reward good performance Listen and respond Encourage personal pride and sense of purpose

Productivity Standards in Rehab   :

Productivity Standards in Rehab   Common methods of calculating productivity: Billable units per hour or per day Patients per hour or per day Expectations vary by setting, patient type, organizational mission, etc. Percentage of work time expected to be billable: Staff PT/OT 75-80% IP, 85-90% OP Staff PTA/OTA 85-90% IP, 90-95% OP Contract employees 95-100%

Productivity :

Productivity Non-billable activities include such things as: Documentation (progress notes, insurance forms, charge tickets) Consulting with family members, physicians, rehab team members, nursing staff, medical equipment suppliers, orthotists , prosthetists , past or future caregivers Staff meetings Set-up and clean-up, etc.

Weekly Productivity (PT 2005) :

Weekly Productivity (PT 2005) Productivity Profit = revenue – labor costs – overhead If it takes 8 units of therapeutic exercise ( ther ex) per 8 hour day to cover your salary, how many more billable units will it take to cover your benefits, the salary and benefits of the receptionist/aides, the rent, the utilities, the supplies, marketing, etc., and allow your employer to make a profit?

Performance Appraisal   :

Performance Appraisal   Comparison of employee’s performance with management expectations Typically involves manager and employee and sometimes peers and customers Should be based on specific, clearly communicated performance standards Formally done at 3 &/or 6 months, 12 months and annually thereafter Ongoing feedback – no surprises! Potential rewards and consequences should be agreed upon in advance

Link Between Performance and Recognition :

Link Between Performance and Recognition Recognition Money Merit pay / raise Bonuses Non-monetary Increased responsibility Promotion Flexible schedules Time off New equipment or facilities

Link Between Performance and Recognition :

Link Between Performance and Recognition Performance discrepancy Common causes of unacceptable performance: Employee ability Inadequate support Inadequate effort Manager must determine the cause and take corrective action: Remove obstacles Remediate employee Replace employee

How To Be A More Productive Therapist:

How To Be A More Productive Therapist Manage interruptions throughout the day Have systems to limit interruptions and distractions Schedule specific times for taking, receiving, and returning calls and emails Focus on clinical care and save social interactions for non-work hours Richmond and Powers, 2009

How To Be A More Productive Therapist :

How To Be A More Productive Therapist Organize your day Schedule patients in manageable time slots IP-Anticipate discharges and plan accordingly OP-Anticipate cancellations and plan accordingly Prioritize tasks Prepare before lunch for the afternoon Prepare for the next day before leaving Richmond and Powers, 2009

How To Be A More Productive Therapist :

How To Be A More Productive Therapist Structure initial patient interactions Explain the importance of attendance at therapy Do not give “permission” to cancel Work with patients to develop mutual goals Emphasize patient responsibility and need for team effort for optimal outcomes Richmond and Powers, 2009

How To Be A More Productive Therapist:

How To Be A More Productive Therapist Structure ongoing patient interactions Be committed to patient education Back up verbal instructions with written materials Stress patient’s commitment to HEP and following recommendations Use simple language and avoid jargon in explanations Remind self to listen more and talk less with patients Richmond and Powers, 2009

How To Be A More Productive Therapist :

How To Be A More Productive Therapist Treatment philosophy Emphasize what works (EBP) Emphasize the patient’s role in their recovery Define quality from the patient’s perspective Define “good therapy” as what produces the best and quickest results Use a tiered approach: least costly, least risky before other techniques Richmond and Powers, 2009

How To Be A More Productive Therapist :

How To Be A More Productive Therapist Meetings Be punctual Request and stick to agenda Participate in meeting effectiveness by being prepared Richmond and Powers, 2009

How To Be A More Productive Therapist     :

How To Be A More Productive Therapist     Documentation Complete notes while with patients Use technology to your benefit Keep up with paperwork, don’t fall behind Richmond and Powers, 2009

How To Be A More Productive Therapist:

How To Be A More Productive Therapist Direction and supervision Delegate routine or repetitive tasks Communicate with support staff Use a legal and ethical decision making process to decide what, when, and to whom to delegate Richmond and Powers, 2009


Productivity is never an accident. It is always the result of a commitment to excellence, intelligent planning, and focused effort. Paul J Meyer

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