How To Become Faster And More Efficient
It’s a Monday morning in the urgent care, your rooms are full and the waiting room is packed. You also aren’t necessarily working with the most efficient staff today and you are feeling overwhelmed. Take a deep breath, there is a trick to all this that can make you one of the most efficient docs out there and also decrease your stress/anxiety level by 75%!
You don’t need to compromise your care and efficiency in order to be faster. We are going to go off of a few principles. Think back to the patient with chronic fatigue and chronic pain and underlying depression that you spent way too much time with in the room. Think back to the sweet 80-year-old war vet who wanted to tell you about his 30’s living in Germany. The drug seeker who has waited until the very last appointment to catch you off guard. The room filled with family members who are livid having to wait for you to see their 16 yo daughter with pelvic pain and irregular periods.
The principles are as follows:
- If possible walk into the room as soon as the patient is roomed. Patients give the most efficient history within 1-2 minutes of being roomed. In more complicated cases patients tend to over think their history and symptoms.
- Have your nurse order any Strep test, UA, urine hCG before you even see the patient.
- Have your nurse administer immunizations that are due before you see the patient. Especially helpful if you are falling behind.
- While anesthesia is kicking in for a procedure go see another patient. They might need just a xray ordered, a med refilled. If it’s more complex you can tell them you will be back shortly after gathering some information – see #16.
- Pre-discharge your patients so that they can leave once the lab results are back, depending on the diagnosis. Mono, diverticulitis, strep, UTI…
- Provide the newest reading material in the rooms. Time flies when someone is entertained in a tiny room.
- Patients under 18 and above 65 tolerate waiting much better than ages in-between.
- You must educate your nurses/staff to triage patients effectively for you. Proper patient dressing and the right tests ordered can save you a lot of time.
- Always do a huddle with your nurse before you guys start the shift. Let her know about your checking in preferences.
- Develop your own algorithm for every chief complaint. A sore throat almost never will need more than 6-8 minutes of your time. Never skip a pelvic exam on a female patient with pelvic complaints.
- Repeat everything back to the patient or you’ll be caught with your hand on the door handle.
- Wear your scrubs, identify yourself, have your badge be visible, wash your hands. If the patients can’t question your bedside attributes in their mind then they are much more likely to trust you.
- When offering a patient treatment options don’t confuse them with multiple options. Offer them 2 options. And use the phrase “Let’s decide together on the best option for you.”
- For unclear diagnosis always ask: “What do you think it might be?” Feel out where the patient’s mind is going.
- As often as possible ask: “What made you come into the urgent care after so many days and what are you worried might be going on?”.
- If a case seems complicated thank the patient for the information, let them know you will need to go and look some things up or think over the information to decide the next best step. There is a lot of clarity when you step away for a minute or two.
- Know where you stand with drug seekers. If you change your practice style every time you are more prone to making mistakes and you will be less efficient.
- Set yourself time limits. Have your nurse politely ask for you if you are in the room for over 15 minutes. Doesn’t mean you can’t go back in but it will give you a chance to get into the conversation with a very verbose patient.
- Allow the patient to tell you their story for the first 3-5 minutes, the less you interrupt them the more they will feel heard. Which means they are far less likely to repeat themselves.
- If a patient keeps harping on a point then use the affirmation technique: “So what I hear is that this jaw pain has completely taken over your life”.
Do you have any time-saving tricks?
What helps you be a more effective and efficient provider?