Increase Your Clinician Productivity: 5 Key Strategies

“Productivity has been low at the clinic, and this is an issue we need to tackle. Please tell us your recommendations.” This was Deline’s statement to Rodis, the consultant, who responded, “Most agencies I have worked with share the same concerns and often have different approaches to increasing clinician productivity. Let us delve into what has been proven to work.”

Rodis then proceeded to advise Deline and the rest of the leadership team on strategies to increase clinician productivity, as described below:

1. Help them engage better

In a previous article series, Tips To Help Engage Your Patients And Clients part 1 and part II, I explained that patient and client engagement is a challenge across all aspects of clinical care and more so in mental health.  I then added that there is no single best definition for patient and client engagement, but I usually describe it as the active patient and client involvement in his or her care, for best outcomes.  By helping our clinicians better engage our patients and clients, they will be able to:

1. Meet them where they are at;

2. Instill trust;

3. Identify barriers and problem-solve; and

4. Establish concrete goals with clear metrics.

5. Involve family members, the community, and use them as allies;

6. Use motivators for their patients and clients;

7. Engage early; and

8. Have an overall strategy around engagement.

2. Help them on New Strategies for Initial Mental Health Assessment

In a series of articles entitled, New Strategies for Initial Mental Health Assessment, I explained that mental health assessment is one of the most miss-conceptualized activities performed in the field of mental health, but we could learn to harness and leverage its significance, in order to make a difference in the lives of our patients and clients and in clinician productivity.  I also described that through new strategies for initial mental health assessment, our clinicians would master new ways to:

1. Establish a strong therapeutic alliance;

2. Obtain an accurate understanding of the problem;

3. Craft a comprehensive and effective treatment plan; and

4. Have a road map.

With new strategies for an initial mental health assessment, our clinicians will also increase their likelihood of desired clinical outcomes, and all this is the foundation for an increase in productivity.  (See our article series, New Strategies for Mental Health Assessment, for further reading).

3. Help them with De-escalation Skills

In a previous series of articles, De-escalation skills, I explained that de-escalation skills help confer:

1. A sense of safety for clinicians, which is essential for clinician productivity:

2. Burnout prevention, without which clinician productivity would slowly but surely plummet; and

3. Iatrogenic occurrence prevention.

I also explained that de-escalation skills do not automatically come with years of education or experience, but these skills require conscious learning and time spent in mastery.  I added that these are soft skills, which require critical thinking and problem solving abilities.  The feelings of competence in these areas add to career gratification and clinician productivity.  In a previous article entitled, De-escalation Skills: 6 Reasons Why, I also narrated the story of Eileen, Matthew’s therapist, who uttered, “I don’t know what to do anymore. Two weeks ago, I called 911 for 4 clients, just in a space of 2 days.  There was not even enough guidance available, to know if I was doing the right thing.”  Clinician productivity will suffer under these circumstances.  But with regular clinical supervision, slowly but surely clinician productivity will increase.

4. Provide regular supervision:

“Those people are never going to get better. Nothing is going to change. I sometimes wonder what exactly we are doing with them,” Guerline, irritated, articulated these words to Rodis, the consultant to the HOPE Care Center. This case is illustrated in a series of articles on burnout.  Guerline was not receiving proper supervision at her agency and, as a result, started experiencing burnout, developed a cynical attitude and wanted to give up.  And her productivity was plummeting. “How did we even get here? How did we happen to lose that passion that we came into the field with?” Rick asked.  “I used to be that go-to person, and I used to take pride in that. However, for the past few months, the front desk staff and my co-workers have been telling me how impatient and different I have been, and they have been asking me if I am ok. I never thought the work could have such an impact on me. I could not pinpoint what had been going on, until now, through this group,” stated Albert, sadly, who went from being a source of inspiration for his co-workers and other staff, to a source of complaints for Sylvain, the clinic director.  This is another case in the same series of articles on burnout, which illustrates the value of regular supervision and the negative effect when it is lacking.  (For further reading, see article series, Preventing Burnout: Self-Care for Clinicians).

5. Give them a safe place to reflect on their daily work

“I took some time to reflect over the weekend, and the more I thought the sadder I got,” said Doris to the rest of the self-care group, a group started with only Rodis, the consultant at the HOPE Care Center, in response to the epidemic of burnout in the clinical staff.  “I could not wait to complete social work school and go and make a difference in the world. After graduation, I started to work with the justice-involved individuals with mental illness, a population with dire needs, but there are limited resources available for me to do my work well. There has been limited time to process or reflect; limited supervision, and before I knew it, this intrinsic motivation of mine started to fade away,” said Sabrina, a social worker, during the self-care group.  In several previous articles, I mentioned that increasing productivity is related to increasing show rate.  It also goes beyond that.  Some studies show that when we are working at our optimal level, we tend to be more innovative, more efficient, more dedicated to our work and therefore more focused.  These factors are necessary for increasing productivity and providing a safe place for clinicians to reflect on their daily work can help with all that.  Taken altogether, these can be powerful strategies for overall increasing productivity.

“Productivity has been low at the clinic, and this is an issue we need to tackle. Please tell us your recommendations.” This was Deline’s statement to Rodis, the consultant, who responded, “Most agencies I have worked with share the same concerns and often have different approaches to increasing clinician productivity. Let us delve into what has been proven to work.”

Rodis then proceeded to advise Deline and the rest of the leadership team on strategies to increase clinician productivity.  At the end of their first meeting, Deline and her team agreed to start working on clinician productivity, by helping their clinicians:

1. Engage better;

2. Master New Strategies for Initial Mental Health Assessment; and

3. Master De-escalation Skills.  They also agreed to start working on clinician productivity by providing their clinicians with:

4. Regular supervision; and (5) A safe place for them to reflect on their work.

The leadership team at the HOPE Clinic has decided to take steps to increase clinician productivity.  When would you like to start addressing clinician productivity at your agency, applying at least one of these five strategies?  Contact us and let us know how we can help.  Thank you for reading, and we look forward to next time.

Your colleague,

Mardoche

References:

1. Yankauer A, Tripp S, Andrews P, Connelly JP. The costs of training and the income generation potential of pediatric nurse practitioners. Pediatrics. 1972 Jun;49(6):878–887.

2. Abouleish, A.E. (2008), “Productivity-based compensations versus incentive plans,” Anesthesia & Analgesia, Vol.107, No.6, pp.1765-1767.

3. Purbey, S., Mukherjee, K. and Bhar, C. (2007), “Performance measurement system for healthcare processes,” International Journal of Productivity and Performance Management, Vol.56, No.3, pp.241-251.

4. “Time Spent in Face-to-Face Patient Care and Work Outside the Examination Room,” Andrew Gottschalk, BS, Susan A. Flocke, PhD, Annals of Family Medicine.Cebulski, P., & Sojkowski, M. (1988). Clinical education and staff productivity. Clinical Management in Physical Therapy, 8, 26–29

5. Leiken, A.M. (1983). Method to determine the effect of clinical education on production in a health care facility. Physical Therapy, 63, 56–59.