34, 23 Right, Hut, Hut . . . Go!
To maximize practice efficiency, huddle up.
If every morning were the same and patients came to the office in a neat and orderly fashion, running a medical practice would be easy. Unfortunately, patients do not present with the same symptoms, problem list and medications, and they do not fit neatly into their scheduled slots.
Patients come in all sizes, shapes and varieties, and sometimes they present with emergencies. The practice has many exam rooms, ancillary services and employees of various skills, but some days, staff members are on vacation, sick or tied up with other duties.
With all the variables, how do you organize a busy, complex practice for maximum efficiency? Sometimes we need to look to other organizations for ideas. Let’s try a football team.
Any given Sunday
From September through Super Bowl Sunday, you can watch a highly effective management organizational tool right on your own TV: the huddle. (And, immediately afterward, you can watch the deployment of an organizational lineup known as a “formation,” with every player carrying out his given assignment. Or so the coaching staff hopes.)
In football, the purpose of a huddle — offensive or defensive — is for a coach to relay a play to the 11 players on the field who must then integrate their respective routes and movements to accomplish the desired result. After assessing the down, field position, score, wind and likely strategies the other team will employ, a coach sets his play. It will give those 11 playmakers clear instructions on how and where to move — and what to do when they get there.
In contrast, a busy physician’s practice will typically pull patient charts one or two days before the scheduled visit. The charts are usually prepared to reflect the expected lab and test results the physician may need based on the patient in question. But often, very little discussion takes place on the day of the visit, leading to all sorts of unpleasant and self-defeating surprises.
Consider adding something new to your procedural playbook: a morning huddle. Such staff meetings should last 10 minutes or less and include the physician, front desk staff, and physician’s nurse or medical assistant. If possible or necessary, also include the office manager along with key medical records, lab or radiology staffers.
The agenda should include review of the patient schedule for the day and any important directions for the appropriate staff. Ask a physician and medical assistant/nurse to review clinically challenging patient charts. Verify that the correct diagnostic tests have been ordered and that front desk personnel are ready to direct patients to the appropriate exam rooms.
The huddle should also discuss the day’s staffing needs. Take into account patient volume as well as which staff members are on vacation or out sick. Adjust schedule templates based on the anticipated needs of any patients scheduled to visit that day.
Initial morning huddles may take longer than the ideal 10 minutes. In fact, it may take up to four weeks for staff to be able to quickly and concisely present the necessary information. Remember, this isn’t a meeting to discuss strategy or practice issues. It should serve only to discuss that day’s schedule, staff adjustments and clinical issues specific to the patients you’ll be seeing.
Emphasize to staff that they must be punctual and ready to begin the huddle at the start time. The meetings should be mandatory and not canceled for any reason. Above all, staff and physicians must understand that morning huddles aren’t a “feel-good” exercise but a new and important part of practice operations.
Readiness to Play
So how does a physician find 10 minutes (or one patient slot) to huddle up in an already busy day? A well-organized practice will invest the time to establish a more efficient, less stressful and more profitable operation.
After all, physicians manage planned emergencies much easier than unprepared ones. A morning huddle can help you hold the line on defense against waste and errors while scoring extra points with patients, who will no doubt appreciate your “readiness to play.”