Guest guest Posted October 11, 2011 Report Share Posted October 11, 2011 Your Daily Posterous Spaces Update October 11th, 2011 #Physical Therapist Value Stream. We are Force Multipliers | MyPhysicalTherapySpace.com<http://ptmanagerblog.com/physical-therapist-value-str\ eam-we-are-force> Posted about 21 hours ago by [image: _portrait_thumb] Kovacek, PT, DPT, MSA <http://posterous.com/people/1l1oCkDWEWjv> to PTManager<http://ptmanagerblog.com> [image: Like this post]<http://posterous.com/likes/create?post_id=74896984> October 10, 2011 #Physical Therapist Value Stream. We are Force Multipliers We interrupt my series on Physical Therapist Pet Peeves<http://blog.myphysicaltherapyspace.com/2011/09/physicaltherapist-pet-peev\ e-1.html>to bring you some excellent data from Health Affairs Sept edition on Virginia Mason, Collaboration Among Providers, Employers, And Health Plans to Transform Care Cut Costs And Improve Quality<http://content.healthaffairs.org/content/30/9/1680.abstract>(abstract only, full text for subscribers only). EIM blog reported to the physical therapist community on the day of publication<http://blog.myphysicaltherapyspace.com/2007/01/a_pr_campaign_w.html>\ the now widely distributed WSJ article on Virginia Mason's novel efforts to wean itself off pricey tests through the use of Physical Therapists<http://online.wsj.com/article/SB116857143155174786-email.html>(not physical therapy!) as front line patient access points. It has been our belief for some time that physical therapists are truly force multipliers that achieve cost<http://blog.myphysicaltherapyspace.com/2010/09/expansion-of-practice-nurses\ -can-teach-us-a-few-things.html> <http://blog.myphysicaltherapyspace.com/2010/09/expansion-of-practice-nurses-can\ -teach-us-a-few-things.html>effectiveness and outcome through the consistent adherence of EBP for low back pain. (another example is here<http://blog.myphysicaltherapyspace.com/2010/10/that-which-seeks-to-kill-wil\ l-only-make-me-stronger-acosobamacare-and-private-practice-pt.html>). There is also no question that downstream costs in imaging, pharmacy, and surgery can be realized <http://blog.myphysicaltherapyspace.com/2010/11/physical-therapy-is-not-a-zero-s\ um-game.html>by greater utilization of physical therapists. Fortunately, as the Health Affairs Article points out, we now have empirical evidence. The article details the importance of the collaborative process in getting groups of providers to agree on defined clinical pathways for high cost drivers resulting in a " value stream " . Virginia Mason's group defines quality in terms of access, high patient satisfaction, rapid return of functioning and the use of evidence based care at an affordable price. While we often think of EBP in terms of our own profession, the most critical point of agreement amongst collaborators is that EBP be based on a particular clinical question as opposed to the expertise of a single practitioner. The majority of providers participating in the clinical value stream complete full course in EBP and their belief is that the first office visit where the appropriate treatment is determined and initiated is the most important step. For low back pain, this is the job of physical therapists. While much of the article points out the significant savings in value stream headache by avoiding over utilized MRI's in the diagnosis, LBP is given ample coverage. Rapid access to care is deemed critical in achieving correct care AND savings. From the article: For our back pain value stream, the use of physical therapists to perform some functions previously assigned to physicians improved Virginia Mason’s financial performance by increasing the number of patients seen and making more efficient use of physician time. Under the back pain value stream, we were able to accommodate 2,300 new patients per year, compared to 1,404 under the old system, in the same physical space. The physicians also became more efficient under the new system, with an average billing of 58.3 relative value units per day compared to 28.1 relative value units per day under the old system. Relative value units are the basis for physician payment under fee-for- service, so they represent an estimate of revenue generated. Costs to the employers were decreased through the elimination of unnecessary imaging tests and fewer patient visits to providers. In addition, rapid access to care and increased efficiency of care delivery contributed to more rapid return to work. Postvisit surveys of patients seen in our back pain collaborative value stream revealed that patients in this collaborative required fewer physical therapy visits and fewer lost work days than local averages (4.4 compared to 8.8 and 4.3 compared to 9.0 for physical therapy visits and lost work days, respectively) Perhaps even more indicting on cost elements is the dollar assessments of providers: Providing the services of an orthopedic surgeon or other procedural specialist costs approximately $4 per minute. A generalist physician whose practice consists predominantly of patient evaluation and management, rather than performing procedures, costs Virginia Mason $2 per minute. A nurse practitioner or physical therapist costs $1 per minute or less. Acuity is likely a factor in the decreased number of visits vs. local averages which supports early and direct referral to physical therapists. While there are advantages to organization of a vertically oriented system like Virginia Mason, it is not a difficult task for a payor to direct care on low back pain to physical therapists. This should be the standard. We will likely continue to pile up evidence that PT's are the force multipliers in healthcare. We now have to actively advocate for appropriate changes to make it happen. Thoughts? larry@...<http://blog.myphysicaltherapyspace.com/2011/10/physi\ cal-therapist-value-stream-we-are-force-multipliers.html?utm_source=feedburner & u\ tm_medium=feed & utm_campaign=Feed%3A+EvidenceInMotion+%28Evidence+In+Motion%29/ma\ ilto:larryphysicaltherapist> via blog.myphysicaltherapyspace.com<http://blog.myphysicaltherapyspace.com/2011/10/p\ hysical-therapist-value-stream-we-are-force-multipliers.html?utm_source=feedburn\ er & utm_medium=feed & utm_campaign=Feed%3A+EvidenceInMotion+%28Evidence+In+Motion%2\ 9> Companies Adopt Gaming Techniques to Motivate Employees - WSJ.com<http://ptmanagerblog.com/companies-adopt-gaming-techniques-to-motivate> Posted about 15 hours ago by [image: _portrait_thumb] Kovacek, PT, DPT, MSA <http://posterous.com/people/1l1oCkDWEWjv> to PTManager<http://ptmanagerblog.com> [image: Like this post]<http://posterous.com/likes/create?post_id=74932554> Latest Game Theory: Mixing Work and By RACHEL EMMA SILVERMAN<http://online.wsj.com/search/term.html?KEYWORDS=RACHEL+EMMA+SILVERMAN & \ bylinesearch=true> [image: [GAMIFY]] Sloan Companies are trying to bring more play to the workday. Striving to make everyday business tasks more engaging, a growing number of firms, including International Business Machines<http://online.wsj.com/public/quotes/main.html?type=djn & symbol=IBM>Corp. and consulting firm Deloitte Touche Tohmatsu Ltd., are incorporating elements of videogames into the workplace. They're deploying reward and competitive tactics commonly found in the gaming world to make tasks such as management training, data entry and brainstorming seem less like work. Employees receive points or badges for completing jobs or meeting time limits for assignments, for example. Companies also may use leaderboards, which let players view one another's scores, to encourage friendly competition and motivate performance, experts say. This " gamification " of the workplace, or " enterprise gamification " in tech-industry parlance, is a fast-growing business. Companies have used digital games for a number of years to help market products to consumers and build brand loyalty. What's emerging is using games to motivate their own employees. All Work and All Play Examples of videogames in workplace management. View Slideshow<http://online.wsj.com/article/SB10001424052970204294504576615371783795\ 248.html?mod=WSJ_hps_RIGHTTopCarousel_1#> [image: [sB10001424052970203388804576617310816687604]]<http://online.wsj.com/article/SB1\ 0001424052970204294504576615371783795248.html?mod=WSJ_hps_RIGHTTopCarousel_1#> Global consulting firm Deloitte employs digital games for its Deloitte Leadership Academy Tech-industry research firm Gartner estimates that by 2014, some 70% of large companies will use the techniques for at least one business process. Market researcher M2 Research estimates revenue from gamification software, consulting and marketing will reach $938 million by 2014 from less than $100 million this year. Some companies build their own games in-house. Others rely on outside firms such as San , Calif.-based Bunchball Inc. and Menlo Park, Calif.-based Badgeville Inc. to " gamify " various business processes including employee training. Business software company SAP<http://online.wsj.com/public/quotes/main.html?type=djn & symbol=SAP>AG employs a variety of games, including one modeled after a golf game that assigns sales leads and environmental challenges that award points for tasks like carpooling, says Herger, senior innovation strategist, at SAP in Palo Alto, Calif. SAP even turned its gamification efforts into a game, holding a series of " Gamification Cups " to generate ideas for turning various business processes into games. One recent winner turned the traditionally boring process of invoicing into a competition. IBM uses a variety of game-like strategies throughout much of the company including video games in which users can help make a virtual city more efficient or simulate various business scenarios, says Chuck Hamilton, IBM's virtual learning leader. With some 400,000 employees, roughly 40% of whom work from home or on the road, gaming is a way to help colleagues connect and stay engaged, explains Mr. Hamilton. And global consulting firm Deloitte employs digital games for its Deloitte Leadership Academy, an executive education program it uses to train clients and its own consultants. Users receive virtual badges after completing training courses and " unlock " more complex training courses when basic levels are completed, says Farrall, a partner with Deloitte in Melbourne, Australia, where its gamification initiative began last year. He says that the tools are still too new to gauge their effectiveness, but that they seem to be catching on among consultants. " The reason why gamification is so hot is that most people's jobs are really freaking boring, " says Gabe Zichermann, organizer of the " Gamification Summit " conference held last month in New York. So far, the tactic has proved effective. A study last year by Traci Sitzmann, an assistant professor of management at the University of Colorado Denver Business School found that employees trained on video games learned more factual information, attained a higher skill level and retained information longer than workers who learned in less interactive environments. LiveOps Inc., which runs virtual call centers, uses gaming to help improve the performance of its 20,000 call agents—independent contractors located all over the U.S. Starting last year, the company began awarding agents with virtual badges and points for tasks such as keeping calls brief and closing sales. Leaderboards allow the agents to compare their achievements to others. Since the gamification system was implemented, some agents have reduced call time by 15%, and sales have improved by between 8% and 12% among certain sales agents, says Sanjay Mathur, vice president of product management at LiveOps, Santa Clara, Calif. Still, gaming experts say there are some pitfalls for companies when implementing games internally. Companies need to make sure that the games are designed to actually reward desired behaviors and are not just doling out meaningless awards or badges. Firms also need to make sure that friendly competition doesn't get out of hand, fostering animosity among employees, says Byron Reeves, a professor of communication at Stanford University and a co-founder of Seriosity Inc., a firm that helps companies develop gaming strategies. " Adding gamification to the workplace drives performance but it doesn't make up for bad management. If you are a bad manager, gamification won't help you, " says Kris Duggan, chief executive of game-maker Badgeville. *Write to * Emma Silverman at rachel.silverman@...<http://online.wsj.com/article/SB10001424052970204294504\ 576615371783795248.html?mod=WSJ_hps_RIGHTTopCarousel_1/mailto:rachel.silverman@w\ sj.com> via online.wsj.com<http://online.wsj.com/article/SB100014240529702042945045766153717\ 83795248.html?mod=WSJ_hps_RIGHTTopCarousel_1> [image: Posterous] <http://posterous.com> Want your own?<http://posterous.com> Change your email settings<http://posterous.com/email_subscriptions/hash/gspsqucxgqviGogjvCufJwAxB\ xkgmH> Quote Link to comment Share on other sites More sharing options...
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