Weekend rotations give staff bonus for extra duty
Weekend rotations give staff bonus for extra duty
Hospital provides coverage seven days a week
Chester County Hospital, a 250-bed hospital in Westchester, PA, began its weekend rehabilitation therapy program four years ago at the request of orthopedic surgeons who felt their patients lost ground if they missed two days of therapy. Now the program has been expanded to provide treatment for most patients seven days a week because of payer demands, says Troy Norton, PT, OCS, ATC, director of the physical medicine and athletic rehabilitation department at Chester County Hospital.
"In the past, we tried to prioritize our weekend treatment somewhat, but with managed care guidelines, we can’t do that as much," he explains.
All wound, orthopedic, managed care, and newly admitted patients receive weekly treatment, as do those who are being discharged soon. Therapy staff treat patients in the acute care hospital as well as in the 20-bed skilled nursing facility. The staff average 25 patient visits on Saturdays and 12 to 15 patient visits on Sundays, Norton says. "It pretty much ends up being a full schedule, plus or minus a few people sometimes."
Patients receive one physical therapy treatment per day on weekends, compared with two per day during the week. Speech therapy is provided on weekends as needed.
At present, occupational therapists work only five days each week. Norton expects to expand occupational therapy services to seven days a week in the near future.
When the weekend rotation first got under way, two therapists volunteered to work a weekend rotation, allowing other staff to work Mondays through Fridays. When both week- end therapists left on maternity leave, nobody would agree to fill their slots. That’s when Norton decided to establish the weekend rotation system.
Staff who want to work weekends are allowed to sign up for as many as they want, logging their choices on a calendar. The vacant weekend days are divided equally among the rest of the staff. About a half dozen staff have opted to work on weekends on a regular basis. The rest of the staff end up working about three weekends a year, Norton says.
Employees have many options
Weekend staff are paid a flat fee based on the average number of hours they will be expected to cover on Saturday and Sunday. Staff may work their regular shifts and receive the weekend per diem as a bonus, or they may work out compensatory time with their supervisors during the two-week pay period.
To establish the weekend per diem fee, Norton compiled the weekend caseload for the past year and then divided it by the number of days. He also surveyed other rehabilitation directors in his area and came up with an average weekend rate for therapists, assistants, and aides.
Weekends are second nature
When the weekend staffing rotation first began in 1997, some staff complained, "but it’s second nature to them now. They know they are going to be responsible for a certain number of weekends," Norton says.
He makes sure that new staff understand they will be required to work weekends when they’re interviewed for the job, and he goes over the weekend program again during new employee orientation.
Once the weekend staff have finished their caseloads, they may leave, no matter how few hours they have worked. They’re expected to make sure that no new orders have been issued before they leave the hospital.
Norton schedules two physical therapists and a physical therapy assistant on Saturdays and a therapist and a physical therapy assistant on Sundays. He is working on a system that will ensure aides are available on call in case there is a high census or a large number of new evaluations on Saturdays and Sundays.
[Editor’s note: For more information on Chester Country Hospital’s weekend program, contact Troy Norton at (610) 344-7705.]
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