Time Study: Acute
Pediatric Therapy
Amy Swenson, PT
Heather Winters, OT
CQI Question:
Investigation of time use is
required to more fully understand
workflow and efficiency, time use
of documentation systems, and
effect on average productivity in
acute pediatric therapy
Anecdotal evidence suggests
therapists spend more than the
expected working hours per day
to achieve current average
productivity requirements
Annual employee satisfaction
survey results suggest current
productivity requirements and
documentation issues may
negatively impact quality of
care, quality of documentation,
efficiency, and employee
satisfaction
Methods:
Time study of daily activities of two
pediatric therapists (PT & OT)
Therapists completed daily data
collection sheets for 3 months
(11/08-1/09)
Sample Data
Collection Sheet
Date
7:15am
7:20am
7:25am
7:30am
7:35am
7:40am
7:45am
7:50am
7:55am
8am
8:05am
8:10am
8:15am
8:20am
8:25am
8:30am
8:35am
8:40am
8:45am
8:50am
8:55am
9am
9:05am
9:10am
9:15am
9:20am
9:25am
9:30am
9:35am
9:40am
9:45am
9:50am
9:55am
10am
10:05am
10:10am
10:15am
10:20am
10:25am
10:30am
10:35am
10:40am
10:45am
10:50am
10:55am
11am
11:05am
11:10am
11:15am
11:20am
11:25am
11:30am
11:35am
11:40am
11:45am
11:50am
11:55am
12:p m
12:05p m
12:10p m
12:15p m
12:20p m
12:25p m
12:30p m
12:35p m
12:40p m
12:45p m
12:50p m
12:55p m
1pm
1:05p m
1:10p m
1:15p m
1:20p m
1:25p m
1:30p m
1:35p m
1:40p m
1:45p m
1:50p m
1:55p m
2pm
2:05p m
Doubleclick on
sample
form to
open
document
for full
review
Data Collection
Time use was tracked by the minute
by category throughout each
workday
Major categories: productive/billable
vs nonproductive/nonbillable time
Productive Time
Evaluation
Treatment
Nonproductive Time
Scheduling
Chart review
Communication with rehab team
Travel time to patient room/building
Nurse approval
Discussion with nurse after session
Nonproductive Time
Waiting for patient
Failed attempts
Ordering equipment
Retrieving equipment/supplies
Set-up for session
Clean-up from session
Nonproductive Time
Documentation
Family education
Nonbillable patient care
Computer problems
Meetings
Work-related email
Nonproductive Time
CQI project
Organizational time (I.e. making
copies, filing)
Student time
Personal time (I.e. lunch, restroom,
making personal calls, socialization)
Time
Total time - personal time = work
time
Work time = productive(billable) +
nonproductive(nonbillable)
Productivity
Tracked:
Total units of productivity
# of evaluations & total evaluation
units
# of treatment sessions & total
treatment units
# of failed attempts
Documentation
Tracked amount of nonproductive
time spent on documentation
Documentation time per unit of
productivity
Documentation time per working
hour
Location/Day
Tracked work location
Inpatient
Outpatient (DOT clinics, preschools,
OHO)
Some days we do it all…!
Tracked day of the week
Results:
Time Study Data Tables
Section 1: Time Use by Major Category and Subcategory per Therapist/Type of Day
Table 1: Average tot al tim e, work tim e, and tim e by major category (in hours)
Category
Total ti me
Work time
Productive work time
Non-productiv e work time
OT: Weekdays
9.5
9.0
4.0
5.0
PT: All Days
PT: Weekdays
PT: Weekend Days
9.4
8.9
3.7
5.2
7.8
7.4
3.3
4.1
PT: Weekdays
PT: Weekend Days
8
36
17
32
12
6
5
4
0.5
3
1
3
39
183
139
2
6
2
12
4
29
6
5
10
0
13
36
13
18
15
5
2
5
2
7
1
4
17
183
107
3
1
0
0
1
20
1
4
8
0
9.2
8.7
3.7
5.0
Table 2: Average tim e/day per subcategory by type of day (in mi nutes)
Subcategory
Scheduling
Chart review
Communication with team
Travel between patients
Nurse approval
Nurse discussion
Wait for patient
Failed att empt
Order equipment
Get equipment
Setup
Cleanup
Evaluation
Treatment
Documentation
Family education
Non-billable patient care
Compute r problems
Meet ings
Personal ti me
Lunch
Work email
CQI project
Organization
Student
OT: Weekdays
15
25
7
11
5
6
1
7
0
4
6
4
32
206
126
11
13
3
37
3
25
12
8
0
0
PT: All Days
9
36
17
30
12
6
5
4
1
3
1
4
36
183
135
2
5
2
11
4
28
5
5
10
0
Double-click on
sample data
tables to open
document for full
review
Assessment:
 Productivity requirements at the time of
this study were higher than these
therapists were achieving in an 8-hour
workday
 Therapists start early, work through
lunch, stay late, complete work from
home, and/or complete work on off-days
to improve productivity and attempt to
meet scheduled patients’ needs
Inpatient
 Productivity is lower than in outpatient
setting
 More time spent on documentation
 Other major nonproductive time is spent
in scheduling, chart review,
communication with team, and travel
between patients
 # and time spent on failed attempts not
the major factor, although more than
outpatient
Outpatient
Able to achieve current productivity
requirements more often in
outpatient setting
Less time spent on documentation
Fewer failed attempts
Both settings
Documentation takes up majority of
nonproductive worktime
Increasing time on documentation
as week progresses from Monday
to Friday, possibly due to deferred
documentation…?
Recommendations:
Information collected in this study
was submitted to pediatric therapy
managers for use in developing
new productivity requirements and
to direct further investigation into
time use
Productivity requirements should be
lowered for days therapists cover
the inpatient setting
Known estimates of nonproductive
time that is essential to support
productive time should be
accounted for when assessing
productivity
 Team should investigate methods of
improving efficiency to increase
productivity in major areas of
nonproductive time in the inpatient
setting:
 Documentation
 Scheduling
 Chart review
 Communication with team members
 Travel between patients
Additional time use studies by
other therapists in
inpatient/outpatient, by floor or
unit, by therapist experience level,
full-time vs part-time, or by time of
year
May assist with departmental
planning, budgeting, and training
Pediatric Therapy Time Study
For questions or comments, please
contact Amy Swenson, PT
(615)835-0656