Efficiency

[hehe5347]

Hi, question for EPIC people, but I guess anyone can chime in;

What are you doing to increase efficiency?
Specifically:
1) do you review next days patients in advance?
2) are you charting while in room with the patient at all?
3) let’s say a chemo pt keeps going on and on, what’s your strategy to get out of the room on time?
4) hospital consults- do you see them at the end of the day?
5) epic inbasket- are you checking throughout the day?
6) notes- are you pre-charting at all the day before or writing all the day of?


Thanks and any general pointers?
I’m fine so far but always like tips to improve…

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[gutonc]

Hi, question for EPIC people, but I guess anyone can chime in;

What are you doing to increase efficiency?

Big question for you is where are you in your career? <2y out? 5y? 10+y? My advice will vary.

Specifically:
1) do you review next days patients in advance?

As a new grad I extensively did this. Now I spend however long it takes me to eat my breakfast reviewing the morning patients and however long it takes me to eat lunch reviewing afternoon patients. I will sometimes have a quick look at new patients the day before, just so I know what I'm getting into.

2) are you charting while in room with the patient at all?

Yes. Somewhere between 2 quick lines to completing a note in its entirety.

3) let’s say a chemo pt keeps going on and on, what’s your strategy to get out of the room on time?

See #2 above and start charting the next or last patient while they're babbling.

4) hospital consults- do you see them at the end of the day?

I don't see inpatients anymore. But I used to try to carve out time in the late morning and again at the end of the day.

5) epic inbasket- are you checking throughout the day?

Constantly. I probably spend 5-10 minutes at the end of the morning and the end of the day clearing it out.

6) notes- are you pre-charting at all the day before or writing all the day of?

See above. I carry forward my hem/onc history but the rest of my note is done fresh each time.

 

[osprey099]

Hi, question for EPIC people, but I guess anyone can chime in;

What are you doing to increase efficiency?
Specifically:
1) do you review next days patients in advance?
2) are you charting while in room with the patient at all?
3) let’s say a chemo pt keeps going on and on, what’s your strategy to get out of the room on time?
4) hospital consults- do you see them at the end of the day?
5) epic inbasket- are you checking throughout the day?
6) notes- are you pre-charting at all the day before or writing all the day of?


Thanks and any general pointers?
I’m fine so far but always like tips to improve…

Notes are for yourself and billing. You don't need to impress anyone with your note or write an essay about your thought process. Your HPI does not need to be complete sentences. Plan can be bulleted phrases.

When I read a cardiology note or GI note, I don't care about anything they write in their HPI or PE. I only want to know what their impression and plan is. Same is true for us.

 

[gutonc]

Notes are for yourself and billing. You don't need to impress anyone with your note or write an essay about your thought process. Your HPI does not need to be complete sentences. Plan can be bulleted phrases.

When I read a cardiology note or GI note, I don't care about anything they write in their HPI or PE. I only want to know what their impression and plan is. Same is true for us.

I can't emphasize this enough. If there is something you need to get you, or another physician, to pay attention to, make it a bullet point. Anything that's not a bullet point gets ignored by me. I'm busy AF...I'm a pretty smart person...if I need context for your recs, I'll go digging for it, but usually, I just need to know what you're recommending, make that easy to find.

I think we do our trainees a disservice by making them write essays in their progress/consult notes. Sure, an intern, or first year fellow, should "show their work", but by the time you're finishing up your training and getting ready to go out in the world, you should be able to summarize your assessment and recommendations in 2 lines of free text and a series of bullet points. If you can't do that, you either weren't well taught, or didn't learn what you were taught.