1. Optimizing the Therapy Scheduling System on the Acute Rehab Unit

2. Team Rehab Leadership: Nicolette Mitchell, BS, OTR/L Michele Simler, MS, CCC- SLP Kate Steinhable, PT, MPT Vivian Tyler, BS, PT Clinical Staff: Moira Aronson-Brown, CCC-SLP Sara Dopirak, PT, DPT Lisa Fabian, PTA Shanna Glastetter, OTR/L Margaret Marinovich, PTA Chris Nees, OTR/L Tony Pawlisz, PTA Danita Wilson, PTA Julie Wolk, OTR/L

3. Opportunity Statement As an Acute Rehabilitation Unit, we are required to provide each patient with an average of 15 hours of therapy per week. Patients are scheduled for three hours of therapy per day Monday through Friday. If time is missed during the week, therapy is scheduled on weekends to reach the 15 hours/week target which challenges weekend staff coverage.

4. Goal Scheduling was identified as the most significant cause of missed units of therapy during the week. Analysis of the data from June ’06 through September ’06 indicated an average of 24 missed units of therapy per week due to scheduling conflicts Goal: Reduce missed units of therapy related to scheduling conflicts by 50%

5. Solutions Implemented Old Scheduling Process Staff create their own daily schedules Staff keep track of missed units of therapy At the end of the week, staff schedule patients for additional weekend treatments to make up missed time New Scheduling Process Staff create their own daily schedules Leadership staff reviews the schedules Schedules are adjusted to accommodate missed time on a daily basis

6. Missed Therapy Units Missed Therapy Units due to Scheduling Issues Week/Month 5/8/06 5/15/065/22/065/29/06 6/5/06 6/12/066/19/066/26/06 7/3/06 7/10/067/17/067/24/067/31/06 8/7/06 8/14/068/21/068/28/06 9/4/06 9/11/069/18/069/25/0610/2/0610/9/06 10/16/0610/23/0610/30/06 11/6/06 11/13/0611/20/0611/27/06 12/4/06 12/11/0612/18/0612/25/06 0 10 20 30 40 50 60 UCL Mean=16.35

7. Results & Analysis The new process resulted in a statistically significant decrease in the number of missed units related to scheduling. Our average went from 24 missed units to 2 missed units. Leadership involvement in daily scheduling has been successful in decreasing the number of missed units during the week.

8. Next Steps We will collaborate with the multi-disciplinary team to address reasons for missing therapy other than scheduling issues Other reasons for missing therapy include: Patient unavailable due to tests/procedures Patient too ill to participate Patient refusal