Tuesday, February 25, 2014

Caseload vs. Workload

Oh man, where have I been?  Well, I've been a busy busy BUSY SLP!  In fact, this particular blog post has been sitting in my draft box since the ASHA convention in November!

My split this year has been between two elementary buildings.  While I love working with the K-5 kids, both caseloads have grown as the year went on.  Last year, I added only 5 kids to my caseload during the whole year at a middle school.  This year, it seems like at least 2 kids a month- in each building!

There are a few things that I attribute the growth to.  The first is a change in the district RtI process.  I've gotten more referrals for screens for kids that teachers wouldn't bring to me, since more education has been given to teachers on my role.  Good and bad, right?  The second is that we have had a lot of move-ins this year from other districts, and it seems like they all come with an IEP!

For my own sake, I started to document my time using this ASHA workload analysis sheet.  It's broken down into categories so you can determine just where your week goes.  It's really quite eye opening.  I started to track my minutes before I went to the ASHA convention in November, and have been trying to ever since.  To help my case, I went to an ASHA seminar on adopting a workload method from Laura Epstein.  It was pretty interesting. She suggested that the approach doctors use in their practice to determine practice caseload is a possibility for us.   Patient panels are the way PCP's decide how much time each patient should receive.  Basically, if you are a typical person, they assume so many doctor visits a year at a certain time value, based on your age and health.  Additionally, they use EBP to determine treatment times based on diagnoses.  Strep throat may be one visit for 15 minutes, while something else could be 15 minutes x 6 weeks of follow ups.  

This website has a pretty good explanation if you are curious. 

So what do they recommend you do if you feel absolutely overwhelmed?  Aside from retail therapy (guilty!), there are some more productive ways to work on alleviating the stress and advocating for yourself.

1. Chart your workload for a month. Ms. Epstein recommended calculating the percent of your week spent in each activity.  For those who don't remember how to do that, convert the time that you are contracted to be in the building to minutes, multiply by 5 for the 5 days a week. Then add the minutes you are spending in each activity for the week and divide that by the total minutes.  (e.g. if I am contracted to be in the building for 2250 minutes a week, and I spend 980 minutes in a week doing direct therapy, then I know that 43% of my week was spent directly giving therapy).  Don't forget to include things like lunch and plan time if they are in your contract.  You can calculate the percentage of your week that *should* be spent in those activities, and then you know if you are hitting that goal each week (I would love to meet a related service person who is!).  The ASHA Workload Analysis Survey that I linked to above is really helpful in this endeavor.

2. Look at your student population.  Kids who stutter may be a heavy time investment initially, but theoretically, as they move to the maintenance phase there is less of a time investment with them. Same with articulation.  However, if you have a caseload that is heavily language based, your "invested time" might start high and stay high.  Ms. Epstein recommended that as a practice, we start to derive a more formulaic approach to this, but thinking about my caseload, I'm not entirely sure how that would even work.

3. Ms. Epstein also recommended comparing your district to others in regards to prevalence of disabilities. In other words, what does your caseload look like compared to districts around you? Are you over identifying students?  This one can be tricky, I think, because I know some districts are "magnet" districts for certain disabilities, and people move to the district because they want the services provided by the district.

4. If you want to really go the extra mile and make your case, ASHA also offers other workload analysis sheets to really break down the time you are spending on activities, as well as the time you NEED to spend on those activities.  They also have some great examples and templates for you to use to really paint a picture for your administrators.  

5. Look at what your state has to say.  Some states have set certain guidelines, and there are a few districts that have adopted a workload model.  In my case, the guidelines are pretty general.  I can't have a caseload of more than 60 students, but that does not pertain to my workload. 

It can be frustrating when you feel like your workload is not manageable, and typically, you are not the only one a district to feel that way.  While it can be tedious to track your minutes on a daily basis, I truly do recommend it.  If for no other reason than to see just how your days look.  I know some days the final bell rings and I wonder what happened to the day!

How about you? Does anyone work in a district where caseload is not the driving factor in your assignments?  How did your district transition to a workload model, and what does that look like for you?  I'd love to hear about it!  Or if you are like me, and trying to collect the data you need to advocate for yourself, do you have any additional recommendations?

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