Dr. I.M. Mindful has just attended a seminar that spoke to the importance of protocols and how they can improve practice performance and outcomes by streamlining the staff training process, promoting an anticipatory staff to increase flow and efficiency, providing more patient-focused care and also well-defined standards of care among other things. Everything he learned, he thought made good practice and clinical sense; however the effort to develop his own protocols was just not something he claimed he could invest his time into right now - because "time," he says (like most people) "is scarce to begin with." Upon returning to his office Monday morning, one of his first appointments was a new patient c/o heel pain. I'd like to paint two pictures for you in the treatment of this patient; the first (following his "normal" routine) without written protocols and the second, with. Keep the time factor in mind.
Without: Dr. Mindful introduces himself to Mrs. Day, takes her H&P and recommends diagnostic x-rays as a first step, explaining that his qualified assistant, Amy, will prepare and take them. He leaves the room to find Amy, but she is no where to be found. He opens several doors to try to find her and when he finally does, begins to relay his orders to her. Amy takes the x-rays and the doctor returns to Mrs. Day to review them with her. Based on his findings, he decides that an injection and a night splint would be in her best interest and again, he opens the treatment room door, sticks his head out and (to avoid wasting any more time) attempts to page Amy from his chair to initiate these next steps. "Amy?" No response. "AMY?" (a little louder). Still no response. Frustrated, he again turns to his patient and says, "Excuse me, Mrs. Day, while I try to find Amy to get things started for you." And the search begins all over again. This happens several more times before Mrs. Day's visit is over after which he escorts her up to the front desk, tells the receptionist when to see her again and (if he remembers) also mentions the products dispensed that the patient needs to pay for.
Let me reconstruct this very common scene with protocols put in place: Upon bringing Mrs. Day in the treatment room, Amy has already reviewed some basic information about her condition with her (while Dr. Mindful was with another patient). She is aware that Mrs. Day has heel pain and after placing an assistant order sheet* on the counter, she immediately begins to put the heel pain protocol that Dr. Mindful has developed into motion. (*The order sheet allows the doctor to check off or circle items in the event that he wishes to deviate from his normal protocol; therefore acting as a non-verbal communication tool for staff to prepare accordingly.) As the doctor reviews the chart with Mrs. Day, Amy is busy setting up the x-rays and also grabs the items/products that she knows Dr. Mindful requests for a "typical" heel pain patient, including educational materials (e.g. stretching exercises, heel pain brochure), an Rx for an oral anti-inflammatory, a tube of Biofreeze, one (or two) night splints and their preferred Airheel for temporary mechanical control. When she finishes, she enters the treatment room, leaves her items (so everything the doctor might need to follow his heel pain protocol is readily accessible) and transfers the patient to the x-ray station. At the conclusion of the visit, Dr. Mindful circles any products dispensed and when and how much time to reschedule Mrs. Day for on a form that she personally brings to the front office, says goodbye and moves on to his next patient.
Taking the time to write out your protocols and allowing staff to have an active role in their implementation increases:
office efficiency from a time management and flow standpoint, DOCTOR'S efficiency by providing better focus and detail of patient's condition, office professionalism, staff performance and education, patients perception of their medical care TEAM and builds patient rapport, confidence and compliance.
It's about time you don't waste any more of your valuable time. Those wasted minutes add up; so develop your protocols and make each minute count. It makes perfect sense!
