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Put Time On Your Side
Five Ways to Get the Most From Your Day
by Judy Capko
Judy Capko is a writer for Physicians Practice
Poets and songwriters have
penned verses about it. Politicians have spoken of its fleeting
nature and its inevitable march forward. You can’t save it,
buy it or borrow it; you can’t replace it, and it seems there’s
never enough of it. Physicians and their staff often race through
each day trying to make the most of this precious commodity.
Time may seem uncontrollable, but in truth there are
ways to manage our time better. Here are some time management tips
that I’ve seen work in medical practices, and that, with a
little effort, you can put to work for yourself.
Start on time, stay on time
To keep time from getting away from you, it’s crucial that
you have a realistic schedule that is customized to your needs and
work habits. I’ve seen too many physicians whose schedules
have them seeing patients at 8:30 a.m. — when in reality,
they rarely get into the office before 8:40. They play catch-up
all day and never get out of the office when they planned. When
they finally do leave, there’s a mound of paperwork on the
desk to deal with tomorrow, making it even more difficult to get
a handle on the next day’s schedule.
To really see how your schedule affects your time,
examine your work patterns using a patient activity time study to
document how much time is spent on each step of the patient’s
visit. This can help you find where delays in patient flow are happening
— In the waiting room? In the exam room? — and uncover
why activities are postponed that might otherwise be completed in
real time.
Working in real time means doing today’s work
today. For example, allow sufficient time in the schedule to document
or dictate chart notes and complete charge tickets as you go, rather
than stacking charts to deal with dictation at the end of the day.
Some physicians use the so-called “fourth exam room”
approach. They simply see three patients in a row, then use the
fourth time slot to catch up on paperwork related to those patients.
Your staff must be committed to consistently completing
the documentation for the time study, recording all the activities
that have an effect on the schedule. When they realize the effort
is geared toward improving the flow of activity, they should have
no problem incorporating it into their day. The key is to keep it
simple, review the process at the end of the first day to be sure
everyone is filling out the information completely, and remind everyone
at the beginning of each day. Be sure to thank staff for helping
with the project.
Once you’ve tracked your time utilization patterns
for one week, it will be easy for you to develop a realistic schedule
that is compatible with your style and patient needs. This holds
true whether your schedule is traditional, modified or open-access.
Use space and tools wisely
Take a critical look at the resources you have and how you use them.
Ask yourself some basic questions about the design and function
of your facility and you are likely to discover many time-robbers.
Is the general clinical space efficiently laid out
and used? The exam rooms and the nurse’s station should be
in close proximity to allow for easy flow and minimal steps. If
your private office is not within a stone’s throw of this
hub of activity, you will want to set up a workstation in this part
of the office. This will allow you to do essential activities between
patients, such as charting and making phone calls. If it takes three
minutes to walk to and from your private office and you do this
10 times a day, you’ve lost a half hour every day.
Are the exam rooms physician-ready? This means when
you go to see the patient, all equipment is working properly, supplies
are well-stocked and the chart has been prepared before the visit.
Your nurse has anticipated your needs so you will not need to leave
the exam room until the patient visit is complete. If you do find
you need something during the visit, use a signaling system to call
for help rather than going out in the hallway to look for your nurse
or medical assistant.
At a time when profits are shrinking, physicians are
often reluctant to purchase new equipment for the office. But there
are scores of worthwhile timesaving devices that reduce errors,
improve performance and allow you to spend your time more wisely.
One example is using automated telephone systems for appointment
reminders, obtaining lab results and providing “on-hold”
patient information and patient education messages. You’ll
notice significant savings in time, improved performance and profitability
over time when you ramp up your office’s phone capabilities.
Certainly the addition of Electronic Medical Records
(EMR) is a boon to any medical practice, particularly since it can
mine clinical data. For example, should you need to recall patients
with a specific condition or who are taking a particular medication,
the EMR can sort and retrieve the data quickly and accurately. To
do this manually would be time-consuming and extremely costly. An
essential element to maximizing the success of your EMR is adding
terminals at each workstation so staff can have simultaneous access
to files, and providing physicians with a personal digital assistant
(PDA) so they can retrieve information on the run.
Delegate, delegate
I frequently discover during practice site visits that the
physicians are taking on many tasks that should ideally be delegated
to the office manager or other staff. Why do physicians do this?
Here are a few reasons that come to mind:
- You don’t think staff can do things as well as you can.
- You think assigning someone else the task takes too much effort.
- You want things done your way.
- You are accustomed to doing things for yourself.
If you are caught up in these reasons and are performing
office tasks that don’t require a physician’s level
of expertise, it’s time to start delegating.
Identify the tasks you don’t need to do and
find the right person to assign the task to. A good rule of thumb?
If a staff member can do a task 80 percent as well as you can, delegate
it. In addition to saving your own time, delegating is an expression
of confidence in your staff. It strengthens their skills and is
a source of job enrichment and fulfillment that helps improve teamwork.
See below for some delegation do’s and don’ts.
Communicate well
Physicians need to be a part of the office team and not rely on
their manager to do all the communicating. But then again, how much
time do you have to get your message out, and what are the most
effective ways to do it?
Certainly one-on-one meetings work when you’re
dealing with a high-priority or sensitive item that needs attention.
But sometimes it’s better to communicate to a group because
everyone hears the same, consistent message, and can give instant
feedback.
Regular meetings will help you gain an understanding
of each staff member’s contribution to the practice. Meetings
are also an opportunity for you to share your vision for the practice
and discuss what you would like to accomplish. When the staff understands
where you want to go, they will find a way to help you get there.
Be sure to establish clear meeting objectives and set time parameters
to keep meetings from turning into time-wasters.
Morning huddles are a great way to communicate informally
to a group and will help you and your staff plan each day. Take
five minutes before you begin seeing patients; review the schedule
with the staff and discuss factors that may affect your ability
to stay on schedule. Together, design a game plan to resolve potential
problems.
Intra- and interoffice e-mail and instant messaging
are excellent tools that help you communicate in real time and with
documentation of your “discussion.” Just as important,
it allows you to communicate when it is convenient for you, eliminating
interruptions. It’s a good idea to provide your staff with
guidelines for effective, appropriate use of electronic forms of
communication, such as:
- Keep the message short and specific.
- Maintain a professional tone.
- Do not use electronic communication to discuss sensitive or
complicated topics.
- Do not use electronic communication to avoid open dialogue
or confrontation.
- Don’t write something you aren’t willing to see
in print.
- Keep the messages work-related.
Success is up to you
Managing time requires self-discipline, planning and personal structure.
The daily “to do” list is a good starting point for
setting goals, prioritizing the many things that need your attention
and determining what you can realistically accomplish in a day.
When you take the time to plan your activities, you actually have
more time for them, and you will learn to be flexible to changing
priorities.
Making lists to manage your time has never been
easier. It can be a simple matter of marking a paper calendar or
planner, or using electronic help aids, such as Microsoft Outlook,
that will send a pop-up reminder to your computer screen or PDA.
But there isn’t any system that will work unless you are committed
to managing and controlling your time.
It’s up to you to determine when unscheduled
visitors, phone calls or meetings should be postponed or eliminated.
No one knows the demands on your time better than you do, and no
one else is in a better place to manage those demands.
In reality, time management is self-management.
Your success depends on commitment to building time management techniques
into your daily routine. Once you do, you will be amazed at what
you can achieve in a day and the time you gain for the personal
pursuits you just haven’t been able to get to.
| Dos and Don’ts
of Delegation |
DO |
|
| Select someone you have
confidence in to take over a task or responsibility. |
Assign the task to someone
who lacks the training or skills to accomplish the assignment. |
| Be practical and smart about what and to whom you delegate. |
Select an individual who does not have the
time to get the job done, and delegate only undesirable tasks. |
| Assign the task to a specific
individual and set a specific time frame in which to accomplish
it. |
Be vague and suggest that
one of the nurses do the task “when they have time.” |
| Tell the person the end result that’s expected. For
example, you want to explore and compare costs for replacing
your EKG machine and you want these specific features on the
new equipment. |
Overmanage the project by telling
the individual how to accomplish it. Give the expected result
and leave the means to the person doing the job. |
| Get feedback from the individual about the
project objective and time frame for completion. |
Fail to obtain
a commitment. |
| Mark the calendar with the deadline and hold the person accountable
for completing the assignment on time. |
Let the deadline slide. This will send a
message that it’s not important and the individual can
ignore future assignments. |
| Hold the individual accountable
for the outcome. |
Believe that just meeting
the deadline is good enough. If the task is not completed and
the objective is not met, get the person to whom you delegated
to finish it, rather than having yourself or someone else take
over. |
| Reinforce and give credit for a job well done. If it could
have been done better, thank the individual and give constructive
feedback. |
Be overly critical of the outcome. This will reduce your staff’s
motivation to accept additional assignments the next time around |
 |
| This article is provided
by Physicians Practice and represents the views and opinions
of Physicians Practice and not Humana. |
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