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KPI's AND THEIR EFFECT ON THE SUPPLY OF SERVICES AND REHABILITATION And the negative effects there of.

#1 User is offline   flowers 

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Posted 06 January 2008 - 08:06 AM

KPI's AND THEIR EFFECT ON THE SUPPLY OF SERVICES AND REHABILITATION

Please read the hazel Armstrong report and see how KPI's can and do corrupt the rehabilitation process.
If you are presented with an IRP and are not happy that it is realistic and in line with your doctors and advisors imput you should aquire the following report from ACC.

This report is about the policy's and goals of ACC. Get it from ACC as its too big to post on here.

Contact for Information:
Kathryn McPherson PhD
Professor of Rehabilitation (Laura Fergusson Chair)
Division of Rehabilitation and Occupation Studies
Auckland University of Technology
AA Building, Room 263
Private Bag 92006
Auckland
Phone: +64 9 921-9999 ext 7110
[email protected]


9. The nature and effect of Key Performance Indicators (KPIs) drive behaviour that is not always focused on rehabilitation and/or compromises claimant centred rehabilitation for RTW and independence

Processes, Key Performance Indicators (KPIs) and Leadership

Whilst standardising processes was identified as an important aspect of trying to improve the quality of ACC services, there were many instances when stakeholders reported these processes had become somewhat divorced from the intent and purpose of the Act and instead, become an end in themselves. This was particularly evident when discussing Individual Rehabilitation Plans (IRP) and assessments such as IOA/IMA.

Individual rehabilitation plans (IRP):

One case manager commented upon timeframes for return of the signed IRP:
Every rehab plan we send has that in place, and the thing is most people dont read and dont discuss and quite often they sign and return or else we do just deem them, so not discussion, and a rehab plan, I think even in the act it goes on about you know in consultation with your general practitioner and its not supposed to just be a mailing out of a plan, but because the KPI is based on it, then that is what youre going to you can set a KPI can you get i. Yes you can you know, there are KPIs about exits, I can get exits, they might not be right, but I could get them you know they might not be the best for the person so its not creating an environment then to say you know like your KPI isnt indicating you have provided the best rehabilitation

Another reported:

I personally dont believe IRPs should be signed up without discussion with the person themselves, but interventions need to be well - you need to sit down and go through them and discuss them, then they need to have the opportunity to go and discuss them with their GP, and then - send out the IRP but . I wouldnt type one out and send it out and say please sign. They only time Ive done anything like that is if the intervention has stayed the same but the outcome to be achieved date, again thats a KPI thing, were not allowed to have expired, so if things havent been achieved on the IRP you need to extend that date out, and so thats why lots of those IRPs go out, and payments say it all the time, its got the same things on it, and it has, but for bureaucracy weve now just sent a new one out for longer extension date and you know that sort of thing I say about how busy case managers and things are, that lots of our time is wasted on things like that

And

Yeah but 80% of claims, look at the stats, 80% of claims get better in three weeks. So who needs a rehab plan for three weeks. ACC have thirteen weeks to make their mind up before one is legally required. If youre in the partnership program what is it, fourteen days, one week two days, so I think rehab plan needs to be defined and probably explained better, because the ones the TPAs doing, are doing it to pass an audit.

Yeah I mean I guess it depends on um, yeah, KPIs are a difficult thing, I mean we had KPIs round individual rehab plans, theyre not actually about the quality of the individual rehab plan, theyre about have you got one and is it signed on file, so just the connotation that it has to be signed on file and youve got to have them there all the time takes away from the fact that individual rehab plans are supposed to be negotiated, discussed and agreed to, and you cant tell me that you can have 100 percent of your people happy with their individual rehab plans as youve written them, and have that on file, and people do but thats not because theyre, its not because theyre providing good rehab or doing anything great for the claimant, they can have you know, we can suspend, decline entitlements, we have lots of power to get those things that we need for our KPI

Regarding vocational rehabilitation generally: A number of people reiterated the value of work and a stay at work approach where ever possible being key, but not prioritise for example:
And I said, for all sorts of medical reasons, people need to be in work, and our whole society would benefit and we would have much more money to go round if they rehabbed properly and we all owned the problem, rather than shifting it. But they just wanted it off their books, and we dont care that theyll go onto the invalid benefit and then stay there and have all the health things that go with unemployment.

Regarding assessments:

its like IOA, IMA within 6 weeks thats a KPI for the branches, so its not how good it your IOA because you dont want to look at that because if you have to have it repeated youre not going to get it in within your 6 week timeframe.

Initial medical assessment, its not who is the best doctor to send this person to, its who can I get within this timeframe, so its taking away the good of what could be a good assessment by attracting KPIs that require you not to provide the best things, so its the same with the rehab its the same with the assessments, its you know its not always about getting the best person for the job, you know having the best programme, its just having the programme getting it done

and the in appropriateness of ill timed assessments just to be in keeping with a KPI:

Rehabilitation was something that you inflicted or imposed on somebody, and the IOA is a classic example of that. I can remember talking to a gentleman who had a particular injury, had surgery for it, was going to be able to return
65
to what he was doing prior within a certain timeframe, but, on no uncertain terms was I to delay his occupational assessment, I had to do that at point x. The reason for that is that if you go through a process and then you get an exit before week 52 in effect.
Although some branch staff talked about the KPIs not influencing the day to day relationships and communications with claimants, the data would suggest that in fact otherwise.

Current KPIs appear to impact on both the vocational rehabilitation process and outcome negatively and this is also evidenced by the case note review and questionnaire data eg.

The second thing would be to put more focus on looking at upskilling people if there arent suitable job options for them, and also putting a greater emphasis on people returning to the workforce in any capacity it doesnt, like just because somebodys not working full time doesnt mean its not a good outcome. So I think there needs to be some emphasis on there as well on that, but they probably need to be KPI because thats how people respond because people say well thats what the corporations sees as important then thats where Ill focus my effort.

you can set a KPI can you get i. Yes you can you know, there are KPIs about exits, I can get exits, they might not be right, but I could get them you know they might not be the best for the person so its not creating an environment then to say you know like your KPI isnt indicating you have provided the best rehabilitation
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#2 User is offline   Alan Thomas 

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Posted 06 January 2008 - 07:02 PM

ACC case managers should be motivated in the same way and have the same effects as medical professionals and therefore not need any form of bonus scheme for simply doing their job. it would be nice to think that case managers were motivated to rehabilitate people and to provide them with their legislated entitlements in a timely fashion instead of being left to languish in Never Never Land.
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#3 User is offline   doppelganger 

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Posted 07 January 2008 - 10:58 AM

Can we see from the tag team and others what can be done to put ACC in th eposition to remove the KPI's and bonuses.

I have put up all the information that I can be used to help the ones wanting the bonuses removed. Others have also but put information up but it is left to just a few to really carry out the correcting of the ACC management.

You want change then target the ones that ACC and the goverment don't want you to target. If you stand out side a MP office only a very few freinds of the MP will take notice.

Just remember that it costs the Coverment and ACC nothing to pay the bonuses but the comunity suffers.

Employers don't know and don't want to know that ACC are paying bonuses unless the bonuses are hurting the bottom line, that is their profit.

If there is no real purpose behind the bonus removal then why should I spend time helping others when no others want to help others.

Alan you and your fight would acheive more in your case by forcing ACC to remove the bonuses and showing the public that the bonuses are there for senior management to trap juniour staff members.

Mimi you will find it easier to obtain your entitlements including interest.

Sparrow this would remove the non rehabilitation social and vocational as it would remove the 52 week completion date

Flowers your entitlements will be given and Barbs will not be getting any more overseas trips.

yes it will help me in the Conviction of staff members fraud, the removal of other staff for dishonesty in there written claims.

It will help fred to obtain his proper rehabilitation for all of his injuries.

you think its in the too hard basket I think it be easier than getting entitlements as it can not be reviewed and reveiwers can not change the facts.

We do not go to the ACC or the ACC minister but let them know what we are telling every one else.

Bad news for Not Waddie he will have to find a new job as he will not have any fights with ACC.
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#4 User is offline   Battleaxe 

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Posted 07 January 2008 - 12:45 PM

Minutes before reading this thread, I thought to myself that attacking Case Managers isn't the way to go because they are merely puppets in the hands of ACC. They want - like everyone else - to be able to pay their rent, feed themselves and their families, etc. - and it seems to me that ACC don't pay their Case Managers a "living wage" so they're forced to participate in this KPI system.

It is my personal experience that every government agency in NZ ignores statutes and instead implements "policy" which is then allowed - if not encouraged - to supercede the statute. The latest example of this is where my son's legal aid grant was withdrawn without notice to him shortly after the new Legal Services Act became law (in the last quarter of 2007). This was done without any notice to him and his lawyer swears that the two letters the agency claim were sent to him did not reach him. The disadvantage to my son is significant since his original legal aid grant did not require him to repay any part of the grant but under the new statute he is required to pay a weekly sum to the Agency. (His finger was amputated in a workplace accident, the Legal Services Agency refused his application for legal aid to pursue a private prosecution as per the new Health & Safety in Employment Act (where OSH refuses to prosecute), and he is an apprentice earning less than the minimum wage so battles financially). The attitude of the management of the Legal Services Agency (Wellington) is that it is their policy to only advise lawyers of changes in legal aid grants. (Like us ignoramuses do not have the mental capacity to understand the laws of the land!!!). This blatantly ignores the statute which clearly and specifically states that the legal aid recipient MUST be advised of any change/s to their legal aid grant.

I believe that the person/s who wrote and put in place the ACC policies needs to come under the spotlight. Again, it is my experience that Case Managers and lesser persons have no idea what is written in the statute (mostly) and, they don't care either way. So ACC educate them on the subject of ACC's policy - not the statute - and this is all they know and work to.

The fact that we (mostly) know the statute and what our rights are makes us excellent observers and criticizers of ACC's decisions. Strikes me that so much positive energy is being wasted and that perhaps what we need to do is advertise our knowledge to those who are ignorant of the ACC statute (and regulations). In other words, should we not spread the word that we can educate and perhaps even help the injured in terms of what their REAL entitlements are. (Kind of like an ACC advocacy service). In this way we will get more and more people complaining about their rights being ignored/abused and if we encourage them to 'go public' with their complaints, then eventually ACC will be under so much pressure that they'll be forced to change their policy.
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#5 User is offline   flowers 

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Posted 07 January 2008 - 12:56 PM

From what I can see it appears that these KPI"s and the way that they are used cause major problems both for claimants and ACC.
Kpi's create an envioronment that creates incentive for fraud and have bugger all to do with delivering the act as intended.
What they do instead is encourage policy decisions in line with branch and taem goals outside the act and as we Know and have proven and demonstatively show wrong decisions being made or not made to enhance income for the perp of what is malfaesence. and criminal fraud by casemanagers. management amd staff at ACC.
Never mind Client fraud ..... what about acc staff fraud?????????
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#6 User is offline   Battleaxe 

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Posted 07 January 2008 - 01:22 PM

So what's the point in writing and passing all these statutes if they're to be ignored as the end result? And at what cost are policies written, are we paying for this nonsense? Kind of like duplicating the law but bending it (through policy) to suit the governments real agenda ...
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#7 User is offline   Battleaxe 

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Posted 07 January 2008 - 01:25 PM

View Postflowers, on Jan 7 2008, 01:56 PM, said:

Never mind Client fraud ..... what about acc staff fraud?????????


The volume of internal fraud will never be known I'm afraid but I believe that this could amount to vast sums of money that should be spent on claimants.
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#8 User is offline   Alan Thomas 

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Posted 07 January 2008 - 01:39 PM

Battleaxe instead of taking the whole system perhaps we should attack individual employees of the ACC. If the individual employee produces a false statement bring about a criminal prosecution against that individual. I think the individual must be in fear of committing a crime because there will be personal repercussions.
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#9 User is offline   freshrain 

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Posted 07 January 2008 - 01:52 PM

Hiya Battleaxe,
I agree with you that policy is one of the most important things for us to address. In many other govt agencies too.
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#10 User is offline   redsquare74ucys 

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  Posted 07 January 2008 - 02:39 PM

Hiya Battleaxe,

That has been my experience too. I was shocked to learn that WINZ (for example) has policies that in some cases are IN DIRECT CONFLICT with the statutes.
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#11 User is offline   flowers 

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Posted 07 January 2008 - 05:32 PM

Quote

So what's the point in writing and passing all these statutes if they're to be ignored as the end result? And at what cost are policies written, are we paying for this nonsense? Kind of like duplicating the law but bending it (through policy) to suit the governments real agenda ...

First is the statutes, thgen there is the "CONTRACT" between the minister on behalf of the people of new Zealand as interpretaed by the labour social and fiscal engineers and the board of ACC.
Then there is ACC policy which is the way in which ACC interprets the act in line with the contract with the minister.... this is "POLICY" which avoids, circumvents or just as in cases that are proven here on site and the courts, that bear little resemblence to the "intent" of the act.
And then there are KPI"S which have the again proven effect of delivering results in line with the stock and liability minimisation as in the "CONTRACT" and has and still is, seriously having the effect of not getting the services and much Vaunted *COVER to the claimants, again as these pages and documents show.
ACC management effectively through the minister have the legislation altered minutely to facillitate this exit and nonsupply process and is aggravated by less than ethical staff engineering the clients paperwork so as to earn the bonusus and kpi points available which encourage and has led to a general culture of denial and abuse.

Fact!

I see 2008 as a year when many employees will be dragged into the civil courts, prosecuted and jailed. The evidence is being collated, more each day, and presently we will see these Kpi Box tickers and their bosses prosecuted and sacked.
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#12 User is offline   happy1 

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Posted 07 January 2008 - 06:34 PM

Good .I hope head witch Falloon Walkers name is on that list.

Pity the prison population when this fraudster gets her lag !
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#13 User is offline   doppelganger 

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Posted 08 January 2008 - 02:02 PM

I can see that there is a few but its all mouth and no facts.

Happy if you want to target a CM or ACC employee then its up to you to do it.

Flowers Employers end up in court is s................ as the tax payer is going to pay the taxpayer for what they are doing wrong.

Most tax payers don't know that they pay for all of ACC mistakes. Look at ACC accounting process Allan thomas books was in as good shape as ACC books.

the tax payer will have to pay for all of the corrections and this is a message that every one needs to get out.

You all are going to have to show that people are better off been rehabilitated to the max. this means that with rehabilitation the cost is less than now.

the business world is not worried about people on ACC unless it affects there pocket. Look at Alan Thomas all that he wants is money. he is not interested in rehabilitation or earning money.

This is were you have got to change. Business hate people stealling money from them. they don't care if you are stealling for there competer because it gives them the advantage.

so ever you do you need to show that ACC is charging them levies to boost the ACC employees pockets and not applying legislation.

to get the point accross you use documentation and from ACC were possible. you quote the documentation especially if that documentation is from ACC.I haven't got the documentation that shows how the bonuses are devided up with in ACC and are unlikely to get. I don't need this and any investigation into case management will disclose this.

remember you are working out side of your own case which will be new for a lot of you.

this reminds me to enquire why the ACC has not told me why the ACC policy is not public. This is something that will go well for the ones that need to discredit the staff that can not apply legislation.
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#14 User is offline   flowers 

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Posted 05 October 2008 - 08:38 PM

bump
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#15 User is offline   hukildaspida 

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Posted 30 April 2012 - 11:37 PM

Refresh
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#16 User is offline   unit1of2 

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Posted 01 May 2012 - 09:51 PM

WOW HUGELY interesting thread!!!! BIG BUMP .... REFRESH
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#17 User is offline   Boxer 

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Posted 15 June 2012 - 07:02 PM

Flowers, do you you have a link to this paper? I can't seem to find it anywhere. :huh:
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#18 User is offline   Rosey 

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Posted 09 May 2013 - 11:22 AM

Old but KPis appear more relevant.


View Postflowers, on 06 January 2008 - 08:06 AM, said:

KPI's AND THEIR EFFECT ON THE SUPPLY OF SERVICES AND REHABILITATION

Please read the hazel Armstrong report and see how KPI's can and do corrupt the rehabilitation process.
If you are presented with an IRP and are not happy that it is realistic and in line with your doctors and advisors imput you should aquire the following report from ACC.

This report is about the policy's and goals of ACC. Get it from ACC as its too big to post on here.

Contact for Information:
Kathryn McPherson PhD
Professor of Rehabilitation (Laura Fergusson Chair)
Division of Rehabilitation and Occupation Studies
Auckland University of Technology
AA Building, Room 263
Private Bag 92006
Auckland
Phone: +64 9 921-9999 ext 7110
[email protected]


9. The nature and effect of Key Performance Indicators (KPIs) drive behaviour that is not always focused on rehabilitation and/or compromises claimant centred rehabilitation for RTW and independence

Processes, Key Performance Indicators (KPIs) and Leadership

Whilst �standardising processes� was identified as an important aspect of trying to improve the quality of ACC services, there were many instances when stakeholders reported these processes had become somewhat divorced from the �intent and purpose� of the Act and instead, become an �end in themselves�. This was particularly evident when discussing Individual Rehabilitation Plans (IRP) and assessments such as IOA/IMA.

Individual rehabilitation plans (IRP):

One case manager commented upon timeframes for return of the signed IRP:
Every rehab plan we send has that in place, and the thing is most people don�t read and don�t discuss and quite often they sign and return or else we do just deem them, so not discussion, and a rehab plan, I think even in the act it goes on about you know in consultation with your general practitioner and it�s not supposed to just be a mailing out of a plan, but because the KPI is based on it, then that is what you�re going to�� you can set a KPI can you get i. Yes you can you know, there are KPIs about exits, I can get exits, they might not be right, but I could get them you know they might not be the best for the person so it�s not creating an environment then to say you know like your KPI isn�t indicating you have provided the best rehabilitation

Another reported:

I personally don�t believe IRPs should be signed up without discussion with the person themselves, but interventions need to be well - you need to sit down and go through them and discuss them, then they need to have the opportunity to go and discuss them with their GP, and then - send out the IRP but �. I wouldn�t type one out and send it out and say please sign. They only time I�ve done anything like that is if the intervention has stayed the same but the outcome to be achieved date, again that�s a KPI thing, we�re not allowed to have expired, so if things haven�t been achieved on the IRP you need to extend that date out, and so that�s why lots of those IRPs go out, and payments say it all the time, it�s got the same things on it, and it has, but for bureaucracy we�ve now just sent a new one out for longer extension date and you know that sort of thing I say about how busy case managers and things are, that lots of our time is wasted on things like that

And

Yeah but 80% of claims, look at the stats, 80% of claims get better in three weeks. So who needs a rehab plan for three weeks. ACC have thirteen weeks to make their mind up before one is legally required. If you�re in the partnership program what is it, fourteen days, one week two days, so I think rehab plan needs to be defined and probably explained better, because the ones the TPA�s doing, are doing it to pass an audit.

Yeah I mean I guess it depends on um, yeah, KPIs are a difficult thing, I mean we had KPIs round individual rehab plans, they�re not actually about the quality of the individual rehab plan, they�re about have you got one and is it signed on file, so just the connotation that it has to be signed on file and you�ve got to have them there all the time takes away from the fact that individual rehab plans are supposed to be negotiated, discussed and agreed to, and you can�t tell me that you can have 100 percent of your people happy with their individual rehab plans as you�ve written them, and have that on file, and people do but that�s not because they�re, it�s not because they�re providing good rehab or doing anything great for the claimant, they can have you know, we can suspend, decline entitlements, we have lots of power to get those things that we need for our KPI

Regarding vocational rehabilitation generally: A number of people reiterated the value of work and a �stay at work� approach where ever possible being key, but not prioritise for example:
And I said, for all sorts of medical reasons, people need to be in work, and our whole society would benefit and we would have much more money to go round if they rehabbed properly and we all owned the problem, rather than shifting it. But they just wanted it off their books, and we don�t care that they�ll go onto the invalid benefit and then stay there and have all the health things that go with unemployment.

Regarding assessments:

it�s like IOA, IMA within 6 weeks that�s a KPI for the branches, so it�s not how good it your IOA because you don�t want to look at that because if you have to have it repeated you�re not going to get it in within your 6 week timeframe.

Initial medical assessment, it�s not who is the best doctor to send this person to, it�s who can I get within this timeframe, so it�s taking away the good of what could be a good assessment by attracting KPIs that require you not to provide the best things, so it�s the same with the rehab it�s the same with the assessments, it�s you know it�s not always about getting the best person for the job, you know having the best programme, it�s just having the programme getting it done

and the in appropriateness of ill timed assessments just to be in keeping with a KPI:

Rehabilitation was something that you inflicted or imposed on somebody, and the IOA is a classic example of that. I can remember talking to a gentleman who had a particular injury, had surgery for it, was going to be able to return
65
to what he was doing prior within a certain timeframe, but, on no uncertain terms was I to delay his occupational assessment, I had to do that at point x. The reason for that is that if you go through a process and then you get an exit before week 52 in effect.
Although some branch staff talked about the KPIs not influencing the day to day relationships and communications with claimants, the data would suggest that in fact otherwise.

Current KPIs appear to impact on both the vocational rehabilitation process and outcome negatively and this is also evidenced by the case note review and questionnaire data eg.

The second thing would be to put more focus on looking at upskilling people if there aren�t suitable job options for them, and also putting a greater emphasis on people returning to the workforce in any capacity it doesn�t, like just because somebody�s not working full time doesn�t mean it�s not a good outcome. So I think there needs to be some emphasis on there as well on that, but they probably need to be KPI because that�s how people respond because people say well that�s what the corporations sees as important then that�s where I�ll focus my effort.

you can set a KPI can you get i. Yes you can you know, there are KPIs about exits, I can get exits, they might not be right, but I could get them you know they might not be the best for the person so it�s not creating an environment then to say you know like your KPI isn�t indicating you have provided the best rehabilitation




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#19 User is offline   Tussock 

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Posted 16 May 2013 - 11:51 PM

Post removed

This post has been edited by Tussock: 04 June 2013 - 06:16 PM

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