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Efficiency and Organization

This guide outlines practical strategies for improving inpatient care efficiency at Contra Costa Regional Medical Center using the Time Square method. Key practices include estimating visit lengths early in encounters, prioritizing pre-rounding activities, effectively managing rounding agendas, and optimizing note-taking and task management. Emphasizing delegation, organization, and self-care, this approach aims to minimize distractions and maximize patient care efficiency, ultimately creating a productive environment for both healthcare professionals and patients.

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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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