Tips and Tricks from the Trenches: How to Manage Your Patient Care Time Most Effectively

Clinicians are always looking for ways to manage their patient care time most effectively. You care about your patient and want to hear about their trip to the Grand Canyon/Daughter’s Wedding/List of complaints a mile long, but you still have to maintain your schedule and your sanity!  We got feedback from NPs across the nation, and here are some tips that might help!  

Take Full Advantage of Your Staff
Your support staff acts as the front line to your schedule. Educate and delegate to your support staff so they pre-screen the visit and manage patient expectations. You may even provide scripts for them such as, “I’ll let the NP know that you have several issues to discuss, but she/he might not be able to address them all today. We can always schedule a follow-up visit if needed though.”

As part of this pre-screen process, have back-office staff give patients depression screens, vision screens, etc., as appropriate before you see the patient. Depending on why the patient is there, checklists or templates can be helpful and may be completed by the patient ahead of time or with you. 

A good Medical Assistant/back-office person can help you know what to expect before you enter your patient’s room. A sticky note or message that says, “Pt here for a rash on back but BP 180/100” can help you focus on the most important things. Learn your staff’s knowledge level. Sometimes they know the patient better than you, especially if you’re new to the practice. 

Implement Standard Processes
While some visits require more than the allotted time, others may not fill the entire appointment. 
Use these “simple” visits (if there is such a thing) and refills to help you make up/save time. If someone is just there for a refill, and they are doing well, create a process where you review things as appropriate, give them the refill, and move on to the next patient. “It sounds like things are going well on your current regimen. I’ll give you x months of refills and see you back in X months. Does that sound like a plan?”

Some clinicians find starting the day 30-60 minutes before patients to prep charts can be a time-saver in the end. Review your schedule, review records/labs/imaging, prep notes, including the Plan section to note the things you intend to address, such as a prior complaint, lab work, med changes, etc. In many settings, over time you will get to know your patients and their diagnoses, and this can help in being able to cut to the core of the visit. 

If you find yourself routinely going over on time, using a timer app or timer on your phone/watch can help you keep an eye on the clock. You might even let the patient know that you are doing this to help keep you on time with patients. Set an alarm to warn you of the half-way point and/or when you have 5 or 10 minutes left. Train yourself to cue the patient on the time limit when the timer buzzes. “It looks like we only have 5/10 minutes left for this visit. Is there anything else you would like me to know?” 

If you are in a setting where you see the same patient regularly, during your patient’s first appointment, outline the amount of time you have for visits. Let them know you value their time, and you will do your best not to be late. Along that line, you or your practice setting might want to establish a late patient policy. Do you accept late patients? What is the cut-off? If a patient is 10 minutes late, let them know that you want to provide them the maximum amount of time you can, and if they are late, it may cut into the time you can spend with them. Obviously, this only works if you are generally on time!

End the Charting Time Warp
Charting eats up more time than we’d like, and it’s often left to the end of the day to complete. Use these ideas to chart faster and prevent this task from eating up your precious time. 

• Using Dot Phrases, templates, text expander, or copying forward prior notes and editing can be big time savers when you are following up on a patient.
• Allow time for charting in your visit, if possible. Learn to type while talking but try to keep up the eye contact as much as possible. 
• If you can, consider using a scribe. Scribe services can be a real time-saver for clinicians. Yes, it costs money, but it will save time and sanity!  
• Learn to leave work at a set time even if all the charting isn't finished.

Caring for patients can be extremely rewarding, but it can also be full of challenges. What techniques do you use to help manage your patient care time with quality and TLC?

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