Unnecessary walking costs you time, money

Elizabeth W. Woodcock, M.B.A.

Time and motion studies aren't just for assembly line workers. Unnecessary walking is a prime time-waster in many physician practices.

Don't think it's happening in your practice? Put a pedometer on tomorrow when your first clinic starts. At the end of the day you'll be amazed at how far you've walked. The exercise may be good for you, but the inefficiencies that those extra steps represent are costing you time and money.

Clinical workstation

During clinics, you should be with patients in your "clinical workstation," not walking the hallways looking for nurses or forms.

Your clinical workstation, also referred to as a 'pod,' may be three or four exam rooms, a procedure room and a personal work area. Evaluate the steps you take between the various areas of your clinical workstation. Also look at how much walking you do to get tasks done outside of your work area. You should be able to move from one area to another, and from one task to another, as efficiently as possible.

Examples of ways to change work processes to improve efficiency include:

• Establishing a personal work area in which to dictate or document without leaving your clinical workstation;
• Developing an electronic communication system with your staff to avoid the time it takes to locate someone and relate your request;
• Placing an inbox in your personal work area so messages, forms and other paperwork come to you, not vice versa, preferably all in a secure, manageable electronic version; and
• Creating a protocol so you know which exam or procedure room to enter next.

Your style of work will largely dictate the solutions for the composition of your clinical workstation, as well as the tools and resources you place in it. Focus on integrating everything you need in clinic into your workstation, and you won't waste precious time.

Stay in the zone

Although it may seem obvious, it is inefficient to leave your work area. But that's what you may be doing dozens of times each day.

Don't think so? Watch how often you leave your clinical workstation during your next clinic. Each time you do, ask yourself: Where am I going? Why am I going there?

For example, if you carry your charge tickets to the check-out counter after each encounter because your staff needs them, then you're a nice person but also a very expensive courier. Give the charge ticket to the patient to take to the check-out counter (but keep a copy). Or, place a charge ticket bin in your work area and tell your staff to pick up the tickets throughout the day. Better still, capture the charges electronically.

Don't leave your workstation. Evaluate every step that takes you away from your clinical workstation and you may see ways you can redirect that precious time back into seeing patients.

Exam and procedure rooms

Take time to evaluate your steps within each room in your clinical workstation.

Where do you go first when you walk into the exam room? Do you have to step around patients' coats and purses? Where else do you typically walk during the exam? Must you walk around the patient to throw away your gloves after a physical exam? Other questions to ask yourself are:

• Do I have to walk back and forth during the encounter to document at an EMR terminal?
• Do I continually have to turn away from the patient when I'm documenting?
• Do I have to walk across the room to access equipment and supplies?