When the nurse alerted me to the change in status with the patient, I performed actions based on my survey, stabilized the patient, identified a threat, provided supportive care, and contacted the person who would be able to provide definitive treatment. I was able to do this because of the discipline provided to me with time management and by prioritizing an interrupter.
Developing a system to flexibly see new patients and provide quick surveys should be a focus for any hospitalist. By doing this, the hospitalist is providing the plan for how the day will flow, regardless of interruptions. The plan, the objectives, and the priorities are there to ensure a day happens the way the physician wants it to happen.
Time management courses and books usually recommend that people complete a daily log of how and what they do in the course of their day. (Figure 3) The daily log is an honest portrayal of the day as it unfolds and how one responds to events as they happen. Logs include phone calls to friends, stockbrokers, and spouses. Each hospitalist’s log notes when a patient or family conference occurred, when interruptions occurred, and how they were handled. Taking coffee breaks, reading a paper, and talking to a partner are all fair game in the log. Everything needs to be put in the log. Keeping a log for 1 or 2 days is a great exercise with endless ways of showing people where their time and energy is going. I encourage physicians who ask me what some of my secrets are to getting done early to read a book on time management or attend a course.
When I took my first time management course in 1998, I became an instant student of my time and an observer of how others mange their time. I didn’t realize how incredible a force time management was, because I thought it was mainly for business people. A course may range from the implementation of a few basic strategies to a complete revamp of how the day is structured, but any hospitalist can benefit from time management techniques.
Dr. Houser can be contacted at [email protected].
- Mackenzie A. The Time Trap: The Classic Book on Time Management. New York, NY: AMACOM; 1997.
- Lane, B and Rierdan, R. Managing People-A Practical Guide. Oasis Press. 2001.
- Wachter R. The emerging role of “hospitalists” in the American health care system, N Engl J Me. 1996;335:514-7.
- Dries DJ. Initial evaluation of the trauma patient. www.eMedicine.com, 2004.