1. Educator Productivity: Using Time Study Data and Monthly Reports Affiliate Conference Call, April, 2008

2. 2 Confidential Objectives  Analyze Affiliate time study results  Compare time study results to monthly reports  Clarify definitions for monthly reports  Report on CQI projects  Identify potential CQI projects

3. 3 Confidential Affiliate sharing  What did you learn?  Any surprises?  Did your selection of “other hours” help your analysis?  Differences between dietitians and nurses?  Variance between educators?

4. 4 Confidential How do we explain the differences?  % Direct time 28 – 50%  No show3 - 17%  Charting 6 – 15%  Meetings1 – 12%  Phones4 – 31%  Other 19 – 50%

5. 5 Confidential Comparing then and now 2000 (14 sites) 2005 & 2006 (2 sites/ 3 studies) 2007 & 2008 (7 sites/ 8 studies) Direct patient care hours 40%32%42% Charting14%18%11% Meetings5%10%7% Phones7% 16% Other27%31%27%

6. 6 Confidential Joslin educator goals  60% face time with patients (24 hours in a 40 hr work week)  100% billed time as % of paid time (bill 40 hrs/wk if paid 40 hrs/wk)  Need to schedule more than 24 hr/wk to cover no show patients and paid time off

7. 7 Confidential Productivity comments from outside Joslin  RD, CDEs responding to list serve request for comment (DCE Practice Group)  Most do 60 min new and 30 min follow up  Most expected to see 6 hours of patients in 8 hour day  Details available at www.dce.org; search on March 28, 2008, Linda Sartor emailwww.dce.org

8. 8 Confidential What if these were your annual program expenses?  Salaries / benefits for 2 CDEs $ 150,000  Secretary (.5 FTE) $ 10,000  Educational material for pts $ 5,000  Office supplies $ 5,000  Travel, meetings, CME $ 5,000  Office space and overhead $ 10,000  Marketing $ 5,000  Total: $ 190,000

9. 9 Confidential Joslin’s sample scheduling template  With the Joslin sample schedule your net revenue would be $165,610  How close is this schedule to your available direct time with patients?  Let’s look at monthly reports to see how you have been doing  How much of your expenses would you cover based on your time study?

10. 10 Confidential Affiliate sharing  How did you use the time study results?  What did you try for CQI?  Results of CQI?

11. 11 Confidential Variance in education coordinator time  12 sites reported  5% - 76% of time spent in coordination  How is each site reporting coordinator time on monthly reports?  How are education coordinators spending their time?  How does that affect educator productivity?  Can any of those tasks be delegated to support staff?

12. 12 Confidential Importance of monthly report accuracy  The analysis is only as good as the data  A patient is considered “new” if they have not been seen in 3 or more years  The # of new patients receiving Education & Medical services should generally not be > sum of new MD and NP visits  Identifying new Ed patients who also had medical services may require manual steps  Education Coordinator FTE is NOT reduced for admin duties (unless there is no CA)  Please refer to Monthly Report Instructions and Definitions posted on the website– or ask questions!

13. 13 Confidential Let’s summarize What strategies have been successful in increasing educator productivity at your site?