The 10 principles of practice efficiency
Time-saving routines to manage the “psychology of waiting” and set a game plan for each day
A quick and easy tip for equipment preparation is to draw an outline of the equipment in the base of the drawer, or hang a hook on the wall for each piece. That makes it easy to see at a glance whether something is missing—and you’ll always know where to look for the equipment.
If physicians change rooms (eg, at lunch), make sure that the staff knows to restock personalized items such as notepads and prescription pads.
4. Create a start-of-the-day checklist
Provide a written description of what you expect your staff to have accomplished by the start of the clinic. The list may instruct them to:
- Ensure cleanliness of the clinic
- Turn on computers, including those in exam rooms
- Contact the hospital for overnight admissions and cross-match with your schedule
- Review all schedules to anticipate problems
- Evaluate inventory of supplies and equipment in the clinic and each exam room
- Gather and organize incoming results from email and fax machines
- Ready equipment
Commit 5 minutes every morning to huddle with your staff, using your schedule as the agenda. At a minimum, ask your clinical assistant and scheduler to be present.
This huddle is not a meeting. It’s about setting the game plan for the day. Consider the analogy of a football team: The quarterback huddles with his teammates before every play. The team members have practiced the play and are prepared to execute it, but the opposing team creates some dynamics they need to plan for. Your day is similar: You and your team are prepared, but every patient poses a challenge to the routine plan. Predict and prepare for that challenge and you’re more apt to be efficient at managing it. Start huddles a few minutes before the clinic begins.
The huddle is your opportunity to anticipate problems—and solve them before they happen. Don’t let the day control you; predict problems and manage them proactively.
Let’s consider a couple of examples that are a daily occurrence in ObGyn offices, yet wreak havoc in practice efficiency:
The situation: Too few slots for acute needs
Several patients call at 8:15 AM with acute needs that must be handled today in the office. The scheduler has to guess where to direct them. You delivered Mrs. Smith’s baby at 2 AM this morning, yet she is still on your partner’s schedule for 9:30 AM today.
The game plan: The huddle reveals that Mrs. Smith won’t be presenting for her 40-week antepartum visit; 2 patients with acute needs can be scheduled during her now-open slot.
The situation: 3 patients with depression are scheduled for the same slot
Three patients, all in their 50s and all with a history of depression, were scheduled for annual well-woman visits at 10 AM. At 10:05, you’re looking for someone to blame for the scheduling mistake that will cost you—and the rest of your patients—dearly that day.
The game plan: Holding the huddle in advance of the clinic reveals that 3 patients were mistakenly scheduled at the same hour. Decisions are made about where and how to accommodate the patients elsewhere in the schedule. A decision is made to contact 1 or 2 of the patients immediately and ask them to reschedule.
6. Establish intake protocols
An efficient ObGyn knows that, when he or she walks into an exam room, the patient is ready to be seen. Intake protocols tend to vary with the style of practice, but it is wise to set minimum expectations for the following intake activities based on the patient’s chief complaint:
- Documentation of chief complaint and symptoms
- Position of patient; for example, seated or on the exam table
- Dress of patient
- Vital signs
- Date of last menstrual period
- Urine sample
- Standing orders for laboratory or other tests
- Current medications and refills needed
- History
Train staff to anticipate needs
Teach your clinical assistant to anticipate needs for each patient. For example, if a 50-year-old is presenting for her well-woman exam, your assistant should anticipate completing the administrative portions of the mammogram requisition form in advance of the exam.
The power of a simple introduction
Although it might seem the intuitive thing to do, make sure your clinical assistant introduces herself to the patient, provides an overview of her role, and briefly describes the course of the encounter. Thus informed, the patient will be less anxious about the few minutes she may spend waiting for you after your clinical assistant leaves the room.
7. Ask the patient about other concerns—first
Your first step with a patient should be introducing yourself (if she is new) or greeting her warmly (if she is an established patient). A handshake often is appropriate, or a gentle touch of the shoulder.
