With the next wave of OT new grads about to start their OT careers, a popular talking point at the moment is “What is a good KPI for a new grad OT?”

When you hear the word KPI, you’re probably immediately thinking of billable targets. OT salaries are rising in response to a super-competitive employment market and it’s a delicate balance between expecting the new grads to complete a reasonable amount of billable work to help pay for their salaries, without overloading them as they try to find their feet in often complex caseloads (I’m talking about you mixed NDIS community roles!)

I’ve heard of billable KPIs ranging from no targets, to 6 hours each day. There’s not really a right or wrong answer (although I’ll call it – 6 hours is wrong), so how do you know if you’ve set the bar at the right level?

Well here’s my suggestion.

The magic number you should aim for is…..it depends!

I can’t give you a magic number, because it varies depending on a range of factors. If you’d like to try to find the right balance for your workplace, read the considerations below.

1.  Graded expectations

For the best result, grade your expectations. Your new grad shouldn’t be expected to reach the same target as an OT with 5 years experience, within the first two months of their career. Even if you allow an induction or shadowing period for a few weeks with no KPIs, don’t jump to your highest KPI expectation straight after that.

New grads need plenty of time put aside for not only workplace orientation, but also self-directed learning, supervision, formal professional development opportunities, and team building. As they get more comfortable and confident in their skills and knowledge, the amount of time they need for these things will decrease, but if you set the bar too high too soon, you’re just going to kill the new grads enthusiasm and self-belief. It’s not uncommon for new grads to leave their first job, or even the profession, within the first 6 months of being an OT, with high billable expectations being a big factor in this – please don’t be that employer that contributes to this issue!

Here's how you can grade your expectations (but remember the actual numbers you’re aiming for should take into account all the other considerations I’m about to outline below):

• Week 1-2: No KPI – lots of time for onboarding, shadowing, and meeting the team

• Week 3-6: 2 hours per day

• Week 7-10: 3 hours per day

• Week 11-14: 3.5 hours per day

• Week 15+: Keep building until you get to close to the same target as your experienced OTs (just make sure this isn’t 6 hours or more per day!); this could take anywhere from 3 months to 6 months to reach!

2.  Caseload complexity and diversity

How complex and diverse the caseload is also needs to be considered when setting a fair KPI. Traditionally a lot of new grads would try to go for rotational hospital positions – these worked well because often they could focus on one caseload at a time, before eventually moving to a new clinical area where they could apply and advance their skills in a new clinical area.

While a mixed community caseload may have the selling point of “there’s so much variety, you’ll learn so much!”, the flip side is that many new grads will instead find the opposite: “There’s so much variety, I feel like I don’t know anything!” If you’re trying to manage a caseload that includes paeds, mental health and physical conditions, there’s not going to be much repetition of the skills you are learning and applying (contrast this to a new grad hospital role in an orthopaedics ward where you’re routinely seeing patients after elective hip replacements, or even a paediatric clinic role that focuses primarily on teaching school readiness).

Throw on top of this the fact that many clients we see within NDIS caseloads in particular, can be highly complex. The functional difficulties they experience are complex, the way we work with each client needs a very individualised approach, and the inconsistencies within the NDIS system itself create another layer of confusion and complexity. If you’re not an OT but you employ OTs, please don’t underestimate the complexity of the work you are expecting a new grad to do, and know that while universities do their best, there is no way they can produce graduates that will be 100% ready to tackle a complex caseload on their own.

If you can’t minimise the diversity or complexity of their caseload, then at least accept that your KPI expectations are likely going to need to be lower, so there is enough time built into their schedule for all the extra self-directed learning or supervision they will need to do. If you can offer a new grad caseload that minimises complexity or diversity initially, you’re actually going to provide more opportunities for repetition and skill consolidation, and with this comes confidence and a feeling that “I actually know something!”

Here's how you might be able to do it within a community NDIS caseload…

• Restrict the type of client diagnoses they are working with – e.g. just paeds, or just adults with mental health conditions, or just neurodivergent adolescents, or just adults with physical conditions – not a mix of all these populations!

• Restrict the type of service they provide – e.g. just do functional capacity assessments to start with, or just do assistive technology trials and applications

• Don’t go near anything requiring specialised skills – e.g. Specialist Disability Accommodation (SDA) reports

I understand it may not be simple or achievable – you’ll need to have a steady stream of referrals where you can pick and choose and even say no to referrals that will be beyond the new grad’s ability. You may need a big enough team where you can split up the type of referrals each person takes on, to allow for more repetition. If you can make it happen though, do it!

3.  Clinic v community based

Another consideration is whether the role is based in a clinic, or within a community setting.  Often community-based clinicians will find that they end up completing lots of travel that they can’t actually bill for, because it is beyond the limits set by the NDIS. If you expect your OTs to cover a large geographical area each day, also expect to lower your KPIs, because unless you work in a rural or regional area, chances are there will be time spent on the road that doesn’t count towards their KPI target (even though travel time is billable within NDIS caseloads).

Clinic settings may not have the headache of unpredictable travel times, but the risk to consider here is the length of client appointments, and how this translates to caseload size. If your new grad is seeing clients for 30 minute appointments only, don’t expect that they will be able to achieve the same amount of billable hours each day as a clinician offering 60 minute sessions. Shorter sessions means more clients, and with this comes more non-billable admin tasks and headspace to keep track of where everyone is up to.

So time for the ‘how to’ section – what could this look like in practice?

• For community roles, consider the location of client appointments and be strategic with bookings to minimise travel time.

• For clinic roles, don’t just focus on the hours completed each day, consider the number of clients seen each day, and what non-billable work might be needed for each client.

4.  Admin support

Don’t underestimate the power of having a great admin support team in place! If your new grads have to manage all their own appointment bookings, or even issue invoices to clients, your KPI expectation should be much lower! Depending on what’s involved, much of this work is non-billable. Playing phone tag with clients, support coordinators or equipment suppliers can also be more time-consuming than you think, not to mention it can interrupt whatever roll they might be on with getting through their report writing!

If you can setup good systems where admin staff or allied health assistants are completing tasks that don’t necessarily need an OT clinician to complete, you’re going to free-up more time and brain space for the new grad to focus on their billable work.

Here’s some things you could consider delegating to support staff:

• Give admin staff access to clinician calendars and allow them to make bookings not only for client appointments, but for joint meetings with builders, AT reps or other health professionals. Think about using a simple handover form where the OT can easily state what the appointment is for, who the admin staff member should try calling, and some options for dates or timeframes, so that they have enough information to make an appropriate booking.

• Delegate tasks to allied health assistants, such as creating resources for therapy sessions, or even completing data entry by transferring the results of standardised assessments to report templates (NB not the interpretation – this needs to be the OTs job – just typing in the scores or comments written by the OT).

5. Individualised approach

Even if you’ve worked your way through the list and come up with a KPI target that is fair, keep in mind that you may find your new grad still can’t meet the expectation. There’s lots of things you should do to find out why this is (something I might cover in a future article one day!), but it may be that you need to lower your expectations for individual clinicians.

Some new grads may need a slower increase in their targets because they’re having difficulties in their personal lives, or because their caseload involves clients or services that they’ve never come across even in their student placements, so they were starting way behind another new grad that just finished a 10-week placement in a very similar caseload.

If you can take into consideration these extra factors, and offer some flexibility in your approach, it will likely lead to a better long-term outcome. You could keep the KPI expectation the same, the new grad keeps missing the target, loses self-confidence, gets burnt out and quits OR you could lower the target for a short time, put in some extra support, your new grad gets through and is hitting their expected target in 8 months instead of 6 months, but they are still with you and you don’t have to recruit someone else and start at the bottom with KPI expectations. I haven’t crunched the numbers, but I’m pretty sure I know which will work out better long term.

My tip for what this may look like in practice could be a whole article in itself, so instead I’ll leave you with this:

• If a new grad is struggling to meet their target, take a supportive not punitive approach, lower the KPI expectation to what they are comfortably able to achieve, and build them up at their own pace. When you are in the recruitment phase, find out as much as you can about their previous experiences so you can set the bar at an appropriate level, and don’t take on a new grad unless you have a bit of a buffer to offer extra support initially if they need it.

Now just to finish off, don’t forget about KPIs that aren’t billable targets. If you truly want to support your new grads, consider having KPIs around completing supervision hours, or engaging in self-directed or formal learning opportunities; if you can capture this information, you’ll be highlighting that you see it as being just as important as the clinical work they are completing.

I understand that some of the suggestions in this article will be harder to implement than others, and in some caseloads they may be impossible, BUT if this is the case, consider whether you should be recruiting a new grad for your team in the first place…

If you found this article helpful, keep following Your OT Tutor – there are more tips, resources, and courses to come! If you need some one-on-one support then reach out and lets talk.

#OccupationalTherapy #NewGraduate #NDIS #YourOTTutor