Shifting Your KPI Focus

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Manage your practice to implement clinic-wide buy-in

By Michael Nula, MS, DPT

I grew up playing sports, perhaps like some physical therapists. We all have varied motivations for doing this work. By the time I got to high school, I was solely focused on basketball. However, during my senior year, I suffered a patella tendon tear resulting in me sitting on the bench, directly next to my coach. I spent the rest of that final season in physical therapy rehabbing my knee.

Coach Jimmy put me to work since I was unable to play. Coach had me track the team’s statistics. I would provide him with “the stats” at halftime and at the end of the game. During that time, I was able to gain an appreciation for how Coach Jimmy planned and prepared for every game. I observed how he was able to coordinate strategy, make effective coaching adjustments, and organize individual players and the entire team.

Among the many wonderful and successful things that Coach Jimmy did in leading our team to two state championships in four years, he managed efficiently and effectively with key performance indicator (KPI) metrics. There was more learning than I expected from this injury.


I learned that KPIs guide choices and decisions with objectivity. They provide means to support accountability, following through, and following up responsibly. Physical therapy practices around the country and other business sectors around the globe activate high, value-based performance using KPIs. Coach Jimmy knew what he was doing.

Given the complexity and uncertainty in the marketplace during a constantly evolving healthcare landscape, it is essential that physical therapy practices utilize KPIs in leading and managing their businesses. Bringing a little Coach Jimmy to your game plan is essential these days.

KPIs are an effective tool for our clinician toolbox. KPIs are multi-measurement collectors; they don’t just grab one slice of statistics or numbers. KPIs — when done right — measure performance and effectiveness in an individual, clinic, and business. Quite simply, numbers don’t lie.

Like treating patients, when our care plans reflect analytical orientations we can get better results. By assigning numerical values to ascertain baseline starting points, we can then organize measurable activity to productively work towards realizable goals. Heck, if a high school kid with a bum knee can see the value of KPIs, I know physical therapists surely can too.


When KPIs are used routinely by all team members in a clinic, they can provide stability to a group. People drive KPIs, and when they do, the KPIs, in turn, can also drive the people in your clinic. It’s a cross-fueling relationship. At the end of each day, they strengthen communication, expectations, and alignment. KPIs help people see their own potential.

Leading with KPIs can help reduce emotional reactions. When you live in a “measurement-is-meaningful-culture,” you do it because it’s part of the way you know you are having an impact. That’s what all modern workers want. They want to know their work matters. But how you deliver and “do KPIs” can vary. If you do like an over-directional leader, the result can water down that meaning-making impact, so do it like Coach Jimmy. Do it because KPIs help everyone win.


Like all tools, it is important to know how to use them safely and effectively. The following are fundamental principles to use when applying KPIs:

1. Be clear about your intention.

Lead with your why. For your patients and community, your business, your team, and yourself. Know your business’ purpose. It is a vehicle, and you need to know how to operate the gauges and dials.


KPIs are numbers that measure how well, or not so well, your purpose is being fulfilled. KPIs are tracking tools. Always keep that in the front of your mind. It’s all about patient care and their experience with us. By tracking what you measure, you can “check yourself” against your commitment to do good work consistently.

2. KIS it twice.

I had a great math teacher in high school – Mr. Fullerton – who regularly reminded us to keep it simple (KIS). For me, this makes sense, but when you are working with other key partners and employees, you have to make sure they think “your simple” is truly simple. KIS it twice means make it simple for you and your key people.


Check your KIS with yourself. Check your KIS with your people. It will certainly help to establish a scoreboard dashboard and a simple process for everyone to enter, track, and review KPIs. Name the standard and get the group’s buy-in. Be willing to support it, keep setting goals, and grow to strengthen it.

3. Be clear and consistent.

The main responsibility of each team member is to know the KPIs that they are assigned to in their role. As professionals, they are expected to hold themselves and others accountable to influence and produce something that adds value to patients, the group, the company, and the community.


KPIs help to measure how well we are doing that. Show them to your employees and stakeholders. KPIs can empower them to have more control over the day-to-day controllable variables.

4. Re-evaluate your scoreboard and KPI tracking.

Do this regularly and as the business continues to grow and evolve.


Routinely review with the group so that everyone understands their part and how it ties to the business and overall success in championing the shared purpose and mission.

5. Include the group.

Sometimes, business owners think they are helping the team by shielding them from the business side. However, today’s practitioner must operate confidently with a broad awareness and knowledge of the entire business entity.


Everything is related and connected. It requires a team to win at the highest level. So bring your team into the fold!

No one can effectively or efficiently function alone. Take the time to implement a teaching, coaching, and mentoring system for your team in the benefits and functionality of leading with KPIs. Share a common focus to serve and care for patients at the highest level — and be willing to measure that success.


The landscape is rapidly changing in healthcare. As we do clinically, we must embrace change through adaptability in order to thrive and help society. We need to manage our energy and pay attention to patient needs, so that we may organize ourselves and our business to serve them at the highest level. KPIs are a critical and valuable fundamental tool — not a task.

Just as I observed how Coach Jimmy was able to coordinate strategy, make effective coaching adjustments, and organize individual players and the entire team, may the insights I shared today fuel your thinking and doing of your “good work” with good KPI management and clear motivation. 

In loving memory of Rogers High School, Newport, RI Athletic Hall of Fame Basketball Coach, Jim Psaras (December 06, 1963 – July 02, 2022).

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Michael Nula, MS, DPT

Michael Nula, MS, DPT, is the founder and executive director of Nula Training Systems, a PT Business Coaching & Professional Development firm, and founder and former CEO of Elite Physical Therapy, where he grew the company to 13 locations before its integration into Ivy Rehab Network. Michael is also an adjunct professor at Johnson & Wales University and has been an active contributor in establishing a Physical Therapy doctorate program.

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