Overwhelming paperwork has often been cited as a source of stress and burnout in the physical therapy field. The amount of documentation required can be overwhelming on its own, but when paired with a high volume of clients, it can feel nearly impossible to keep up with. Implementing a few automation and streamlining strategies to reduce the amount of time spent on documentation can improve your work-life balance, documentation accuracy, and patient care.
3 Ways To Make Patient Documentation Easier
1. Utilize Custom Templates
Templates are a great way to streamline the documentation process. They allow physical therapists to be able to quickly fill in standard information without having to fully start from scratch with each patient. Additionally, customizing these templates to fit the information that you most commonly gather from your patients is a great way to cut down on time while still providing detailed documentation.
Many clinics and practices have a focus on a specific group of patients. For example, if your practice primarily sees overhead injury patients and general injury patients, customize your documentation templates to include either separate templates for your high-volume specific injury patients or include a separate section on your general forms that you can include specialized information for this group of patients.
2. Incorporate Point Of Service (POS) Documentation
It’s a common belief among physical therapists that taking notes while engaging with patients affects their ability to give connected one-on-one care. While this is an admirable way to view patient care, this can also lead physical therapists to spend multiple hours of unpaid time after work completing paperwork. This can lead to exhaustion, burnout, as well as documentation errors. Completing documentation after a long day, when the patient is no longer sitting in front of you, can lead to errors in your documents.
There are ways to incorporate POS, point of service, documentation, while also maintaining focused patient care. A great way to do this is to explain to your patients the components of your paperwork that you are completing in front of them. Let them know that receiving their comments and concerns while you are completing your documentation is beneficial to making sure you accurately and completely document their opinions on the state of their health and care. This allows you to reduce some of the weight of the documentation you will do after their session, while maintaining the empathetic one-on-one care you are providing.
3. Try Out Pull Forward Documentation Software
Switching from your documentation software or templates can be daunting. However, if you’re considering making a switch, pull-forward software is a good option to consider. Pull forward or copy forward software copies information from previous forms, including fields such as the patient’s name, diagnoses, current treatment plan, etc., and repopulates those fields in your current documentation. This allows physical therapists to quickly pull forward unchanged information while maintaining accuracy, as there is no repetitive entry needed. This type of software allows physical therapists to focus on the patient-driven information gained during appointments rather than the mundane entry of repeated information.
