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Efficiency and Organization

Efficiency and Organization. Inpatient Care Contra Costa Regional Medical Center. Time Square Method. Using the Time Square. Estimate the visit length within the first 30-60 seconds of the encounter Use the time estimate to either prepare a longer agenda and/or engage in “ limit setting ”

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Efficiency and Organization

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  1. Efficiency and Organization Inpatient Care Contra Costa Regional Medical Center

  2. Time Square Method

  3. Using the Time Square • Estimate the visit length within the first 30-60 seconds of the encounter • Use the time estimate to either prepare a longer agenda and/or engage in “limit setting” • Give the patients the time they NEED • Remember the majority of patientsare not “difficult”

  4. Pre-Rounding • Use time wisely: sickest/new/dc patients first • Copy previous days note and *** things you need to change • Let your note write itself: template collects vitals/labs for you vs. only collect sig vit/lab/etc. • Start to-do list (AM labs/ daily note/ sign-outs/ important PE follow up) • Refresh note before rounds to include AM labs • Collect thoughts (big picture vsdetails), or read a little, for assessment and plan

  5. Rounding • Set an agenda (sickest/new/dc patients first) • Open note and finish while discussing • Double screen • ‘Sign’ as you finish each patient • Write orders while rounding • Or have your attending write the orders • Call consults during rounds • Pager/phone list on badge or open Scoop nearby • Update to-do list (red pen or * important) • Discharge med rec’s while with an attending

  6. Afternoons • Free for procedures, discharges, admissions, family conferences, more detailed history, update sign-out notes • Sign-out at to HO/ICU resident at 5:00!! • Find a quiet space to finish up without distractions • Go home! • The longer you are in the hospital… the longer you are in the hospital

  7. General • Make a Schedule: and stick to it! • Batch your activities • Delayed gratification system • Systematic approach • Organize your workspace (protopage.com) • Complete dc summaries the day of discharge (dictate!) • Delegate/ask for help/let someone know if you are struggling! • Minimize interruptions (screen pages/quiet space for notes/rounds) • Self care: exercise, sleep, eat, etc. • Finish every activity you start • Call translator service on your cell while walking to pt room • Keep asking “is this the most efficient thing?”

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