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Abstract
Home health managers are under increasing pressure to look at the operations of their agencies with critical eyes to determine whether they are providing the best quality services in the most efficient manner. A primary objective in this agency review is to increase the visit time available while satisfactorily performing the necessary maintenance and administrative services. Because nurses comprise a large portion of agency budgets, a useful starting point is nurses' productivity. An approach is presented which sequentially breaks down nursing time into a number of components. At each step. the resulting figures can be examined to evaluate the existence and nature of problems. Within an agency, this approach allows agencies to identify problems and suggest options for change. In inter-agency comparisons, differences in agency policy which affect proguctivity are made explicit, making the comparisons more useful. Three measures are also presented to evaluate aspects of overall agency productivity.