Four Things You Can Do Now To Increase Your Efficiency - As Physicians In The Inpatient Practice

As I was learning to be more efficient in the outpatient setting, I was becoming more efficient in the inpatient practice too. Sure, some strategies to enhance your efficiency are useful in many aspects of life. There are, however, certain things to focus on to improve your inpatient experience even more.

In the hospital setting, whether you are working in the emergency department, in the intensive care unit, on the medical floor, as the admitting physician or consultant, one thing we can be sure is that unexpected things happen all the time. Anything can happen to any patient.

The first strategy to enhance efficiency is to prioritize. Assess the situation. Look at your census. Take care of the patient who is the sickest first. Sometimes, a few minutes make a difference. This applies to all specialties. Remember the goal is to take good care of our patients. Teamwork is always important. Work together for the common goal.

As a hematology and medical oncology consultant in the hospital, our schedule is that we take turns to work five to seven days in the hospital about every two months. The first day is usually the hardest, because I am not familiar with most of the patients. I usually discuss with the colleague who just finished the hospital duty. That way, I get a brief overview of the patients and know who I should see first.

The second strategy is to be flexible. As the clinical status of each patient can change at any time, it is important to go a different direction if all of a sudden a stable patient becomes critically ill. Be ready to change around your planned schedule. Be okay with having detours. Ultimately, it goes back to optimal patient care.

If you are a hospitalist, for example, you may have twelve patients on your census. If you are also doing admissions that day, you may be called at any time to admit a patient. You will have to determine how soon you need to evaluate that new admission. That is the same for doing inpatient consults. Even when I plan to see certain patients around a certain time frame for ongoing management, if there is a request for consult about a possible hematologic emergency, my planned schedule is put on a halt. I drop everything I am doing to get right to that consult.

The third strategy is to be patient. Although the inpatient rhythm is usually fast-paced, it is essential to keep the calm. Take the time to review the patient’s information. It may only be an extra few minutes.  That will likely save you time and energy on the long run. Have the patience to listen. What is the patient or the family telling you? Reflect on the encounter and see if you have addressed the patient’s needs. Does the patient feel seen and heard?

There are times when I am in a rushed mode of operation, when a patient reminds me to slow down by telling me their story. When a patient keeps asking questions, I do my best to put myself in their shoes and remind myself that the patient may be anxious and scared. By doing this, it allows me to offer a little more time to talk to the patient, without feeling angry or flustered.

The fourth strategy to be efficient in the hospital is to do one thing at a time. As chaotic as it can be in the hospital, our human brain is capable of doing only one thing at a time well. If you try to juggle three different things, you will end up using more time to complete all of them compared to the total time spent to do them one at a time. When you attempt to do more than one thing simultaneously, your brain is switching between the tasks back and forth, in the attempt to make believe that you are handling everything at the same time. When you switch your focus from one task to another, it takes time (seconds to minutes) for your brain to adjust. In other words, the more times you switch back and forth between tasks, the more time you waste.

Imagine you are taking care of a patient’s orders and the phone rings. In a split second, you get to decide what to do next – to continue to finish the orders or stop what you are doing to pick up the phone. If you try to do the orders while talking on the phone, it is easy to make mistakes. It is easy for you to be distracted. This means that you are not working efficiently.

The first three strategies help you achieve the last one – to do things one at a time. When you can prioritize, be flexible and be patient, do things one at a time, you will be more efficient, no matter how hectic or unpredictable your day is.