PERSONNEL MANAGEMENT

Managers, supervisors, & personnel are

people.
Hospitals and other health care agencies
are organizations.
Personnel management in physical
therapy is management of people, by
people, in organizations
ORGANIZATION
Participation
by no. of people
Common goal, purpose, mission
Cannot be accomplished by a single
individual
Requires coordinated effort
 Pyramid of organization

Middle
Management

Work/ service
units
Need for pyramid of org
Clarity

Stability
Organization Goals
Result oriented
Increase productivity
For measuring performance
Team work to achieve goals
Management & Supervision
Managers – power to make decisions.
◦ Director
◦ Head of Dept.
Supervisors – oversee the work of others
◦ No power to make decisions
Functions of Managers & Supervisors
 Planning-
 establishing objectives & priorities
 Developing policies
 Determining methods & procedures
 Scheduling implementation
 Organizing-
 Subdividing the total work to be done into jobs, duties, groups & relationships
 Delegating authority and responsibility
 Directing-
 Guiding, instructing,& persuading subordinates
 Establishing work standards
 Making work assignments
 Cost analysis & budgeting-
 Retrospective review
 Prospective projection of objectives, activities, resources, expenditures & income
 Evaluation-
 Performance appraisal

 New trends & technologies should be adopted

Contd…
Allow for innovations & creativity in
development of new ideas
Extreme fluctuations in methods,
procedures, activities, & budgets must be
prevented
Management style
Defensive supervision
High fear & low trust
 frequent reports,orders without
explanations, strict rules,frequent
inspections,withhold of information from
subordinates,insistence that people stay in
channels.
Contd…
Participative supervision
High trust & low fear
Gives opportunities for staff to share &
cooperate to achieve objective
To innovate
To participate fully in dept activities
7 Sins commited by manager
Snap judgment to select employees
To overlook standard performers
Failure to make clear instructions
Boss instead of leader
Indifferent towards discipline
Too busy to train subordinates,instead apply
pressure to increase productivity
Playing everything close to the chest
6 virtues of effective manager

CONFIDENCE
Contd…
Creates a climate of involvement
Maintains open channels of communication for
all levels of staff members
Delegates responsibility with commensurate
authority
Assignes responsibility according to staff
members capacity
Offers staff members opportunities for
professional growth
Manager as an effective leader
 Resolve conflicts early
 Allow participation in decision making for the common
good
 Encourage creativity and innovation
 Manage by results, with emphasis on upward
communication
 Provide control & feedback,information on progress
 Maintain morale,with emphasis on good performance &
opportunities, not problems
 Negotiate and maintain a mutual commitment to goals
 Use performance appraisal for setting future objectives
Communication
Communication means the interchange of
information,ideas & feelings
It includes
sending,receiving,understanding, &
responding to messages that may be
conveyed in oral or written form,by
actions & by body language, gestures,
postures, & facial expressions
Principal characteristics of healthly
communication
Enable people to form positive
relationships
Allow people to participate in commu..
Process
Free flow of information
Department Planning,Design &
construction
A properly designed & appointed
department reflects the clinical services
rendered & facilitates the delivery of
quality care in an efficient & economical
manner
Planning & Innovation
Health planners, hospital administrators,
and hospital architects need assistance of
physiotherapist to plan PT dept
Architects having previous experience in
designing physical therapy department
will still require direction to cope with the
variations in approaches to the delivery of
physical therapy services
 Contd…
To Innovation means to introduce something
new
Requires confidence, which comes with
understanding & research of what is to be
introduced
Requires courage to implement ideas and
translate them into progress
Early considerations
Planning- most imp aspect of construction
It conceptualizes a program before it
exists & it also envisions the type of
facility required to meet the program
needs
Depends on wheather it is a new project
or expansion of existing project
1 -Type & size of hospital
Type has more significance than size , egs
orthopaedic setup would be diff from
neurology or any other setup
In-patient or out patient facility in
hospital
Space of dept should increase with
demand of PT services
2 - Population characteristics
Population in the vicinity of the hospital
Industralised or residential area- no. of out & in
patient would differ
Age of population – geriatric – chronic cases.
Young popu – accident or sports injury
Shifts in population
Overview of location,no. & type of people
3 - Existing Services
What & how many services are already
avaliable
Their level of activity
Avalibility, accessibility & quality
4 - Referral sources
No. & type of sources
Review of physicians referral habits &
their knowledge about value of physical
therapy
5- changes in delivery & practice
PTist must be informed about the
potential changes being made in the
health care delivery system
Change is the result of adoption of new
knowledge,research,technologies,methods
,equipment,special expertise
6- Services & activities
Acute or chronic setup
More pts for long term care - bigger the
gym area
Only for patient services or center for
students also
Clinical research- special
equipment,isolation
First Requirements
1- Accessibility
 Location – convenient for both in & out patient
 Elevators are required to transport both in & out patient
 For out patient services , PT dept on 1st floor is recommended with
reserved parking
 Clustering of departments in the same area, so that waiting areas,
receptionist offices,& rest room facilities can be shared
 Facilities for physically handicapped
 PT dept must be in a prominent area of hospital & not in a remote area
 Small ancillary physical therapy units need to be established on nursing
floors
 Storage of certain essential equipment on various nursing floors is
essential- these storage areas wil increase the efficiency and effectiveness
of bedside treatment programs
2- Functional Areas
 The four essential areas are-

1- Hydrotherapy area
2- Gymnasium
3- Treatment cubicle area
4- Support areas – administrative,student activity,patient
waiting,storage,& restrooms

 The amount of space allocated to each area will depend on a

no. of factors such as type & no of patients to be
treated,constraints imposed by costs & architectural barriers
3- Staffing
Number & type of professional & support staff
needed to operate the proposed department is
the most imp requirement that needs to be
determined
The no. of personnel in a developing PT dept
will increase
The clerical demands on the service will
increase
Personnel cost will represent the major annual
cost
Narrative & schematic presentation
Narrative proposal-
A complete narrative proposal will enable the
architect to prepare schematic drawings which
are a first step of a construction project
Decisions must be made about types of patients,
accessibility, functional areas, services &
accessibility, activities,staffing & possible
future expansion
Schematic Drawing-

 Itis a diagram or scheme, showing relationship and traffic

flow among the various functional areas and other major
elements of the department

 Arrange various areas within the dept so that traffic flow is

orderly and cross-traffic patterns are kept at a minimum

 A patientshould be able to enter the dept, register, go to the

appropriate areas for treatment, checkout, exit, in orderly
fashion.
Space requirements
Defining Functional Areas:
 Cubical area-
◦ Treatment cubicle
◦ Examination/special procedure room
◦ Cubicle area work station
 Hydrotherapy area-
◦ Small whirlpool
◦ extremity whirlpool
◦ Hubbard tank
◦ Hydrotherapy work station
 Gymnasium-
 Admin/support services-
◦ Patient waiting
◦ Reception/business office
◦ Director’s office, staff office, staff restroom, charting area,
◦ Conference room/library, staff lockers
 Storage-
◦ Clean lenin, dirty lenin, supplies ,equipment, chart/forms, wheelchair/ strecher
1- No. of Functional Area Elements
 To estimate the no. of cubicles needed-

1- determine the average occupancy time-includes time required

for preparation, undressing & dressing,& cleanup

2- total no. of patient treatment. A treatment is defined here as –

a patient enters a cubicle, receives treatment in the cubicle, &
then leaves.

 Identify the total available time per day for a cubicle

 2 - Occupancy time & space required

Attempts should be made to alleviate

congestion in treatment rooms. It is possible &
advantageous to move patients out of selective
treatment areas when a part of their treatment
program has been completed
 3 - Available Time & Space
To utilize the space effectively, periods of
services should be extended.
PT services should be made available for
patients hospitalized only for physiotherapy
Many working outpatients would welcome
extended hours or weekend services
Staffing pattern – to meet the demands of
extended working hours
 Gymnasium
½ or 1/3rd of total space occupied by dept.
should be allocated to gymnasium
Ceiling height must be at least 10 feet to
accommodate the various kinds of apparatus
 Patient Waiting Area
Type of patients- in or out patient
Space for wheelchair or stretcher
16 feet for ambulatory patient and 25 feet for
wheelchair bound
Make provision for periods of peak utilization
Storage Facilities
Equipment ,linen, supplies, patient
records
Location for these storage – should be
accessible
Separate space for soiled linen
Charting Areas
Adequate space for record keeping
Charting areas –close to treatment area
Timer should be kept in charting areas
Construction Cost
Costs are always of paramount importance in
any type of construction & hospitals are no
exception
We are dealing with health care delivery system,
so safety is important
Sophisticated signal systems
Refined air filtering devices
Stand by electrical plants
Equipment
Fixed
Movable
Electrical systems
110-220 volts output
Electrical equipment must be grounded
No & location of electrical points must be
determined
Communication systems
Telephones
Intercoms
Closed circuit television
Alarms
Medical Records
The existence of accurate, meaningful
methods of recording factual material is
one the most significant attributes of a
scientific profession
Uses & Requirements
1 – Communication

Among clinicians
Records, communicate best if they are
standardized
Records must be kept up to date so that the
patient care will be consistent with the patients
needs
2 – Quality of Care Assessment

Use of feedback in the assessment of quality of care

A critical review of admin records should display
strengths or weakness within the dept
The criteria of thoroughness, reliability, analytically
sound logic, & efficiency should be considered
Should include a measurement of the outcome of the
patient’s treatment
3 – Education

 Records serve as an educational resource for the departmental

staff, students, fellow health team members, including the
patients, physician, administrator & other workers

 Records can be used to “teach” the physician, administrator,&

other workers the value & productivity of physical therapy

 Patienteducation & compliance can be improved by preparing

home instruction program
4 – Research

Useful for retrospective clinical studies &

provide the information base for prospective
studies
Scientific methods must be carried into
clinical pratice
 5 – Motivation

Records serve as a reinforcement tool for staff

personnel

Feedback to the patient in the form of graphs

or recorded information will help him in
improving his performance
6 – Medical Legal Aspect

Legality of record

Record should be thorough, accurate, dated, &

signed

Document should be signed by physio-in-

charge
7 – Third Party Requirements

Documentation for receiving payment

Record must be completed for payment

Clinicianmust present a factual, positive

documentation of his or her activities
 PRINCIPLES
of
MAKING RECORDS
1 - Function & Purpose

To notify, order, claim, report, acknowledge,

certify, agree
2 – Communicability

The content of any record must be communicable

Records must be accurate, brief , clear, objective &
specific
It must also be legible, & identifiable
Speed of communication – imp aspect of effective
record keeping
Electronic data processing
3 – Standardization

 To achieve consistency
 To make reliable comparisons e.g. Pre & post discharge status
4 – Form Development and Design

Analyze need to develop new form

Unused space on record forms to be kept at a
minimum
Determine the need & purpose for every item of
information on the form
Use clear, understandable words
Use consistent terminologies
Patient Care Record
1 - Referrals
 Form should have a written reference from the physician

 Must be signed & dated by the referring physician

 Other information – name of patient, address, room no., bed no. birth-date, gender,
insurance no.

 Any precautions or instructions to physios

 Forms should be standardized

2 – Evaluation Forms

Patient information – identification, date of eval &

signature of the therapist

Evaluationforms should contain all the tests &

measurements used in physical therapy
3 – Specialized Forms

 Out patient appointment card

 Signature of person making appointment

 Informed consent of patients

4 – Progress Notes

 Should contain patient identification, date & signature

 It should be written when-

◦ patient is initially treated

◦ the patient’s condition changes during course of treatment
 Should tell the complete clinical story of the patient
 Should include diagrams, motion pictures, slides & graphs etc
5 – Discharge summaries

 Should be a capsule view of patient’s progress during therapy

 Should include the reason for referral, initial treatment plan,

evolved progress & patient’s status at the time of discharge

 Home programme, family education

 Follow-up appointments
Administrative
Records
 Departmental Data & statistics

Need for Data Collection

1. Department Planning – Caseload, staffing pattern, space, equipment
needs

2. Budgetary & cost analysis Factors – return for investment

3. Scheduling

4. Standards of work – to evaluate performance of workers

5. Organizational Control – optimum use of personnel, space, equipment

Information related to patient & treatment
1 - no. of modalities/patient
2 - no of daily visits/patient
3 - daily charges
4 - no. of home visits
5 - travel time for home visits

Information related to staff personnel

1- no. of patients treated
2- no of pt. visits
3- no. of in & out patients
4- no. of modalities used
5- no. of new pts
 ELECTRONIC DATA
PROCESSING