On Efficiency

Hi everyone,

As an intern, I struggled with efficiency. I lost track of notes to write and labs to check, logged too many hours, and returned repeatedly to the hospital to finish work I forgot to do. But when your skills are lacking, there are more ways to improve. So, this morning, I want to share what I’ve learned:

1. Slow down: Working too fast means more mistakes, more fatigue, and more corrections to make. Slow and steady…
2. Practice: The more patients you admit, the more notes you write, the more procedures you do, the more efficient you’ll get. Remember how long it took at first to tie your shoelaces when you were six? How about your first paracentesis when you were twenty-six? Practice makes perfect.
3. Be systematic: As an intern, I improved my efficiency by creating a grid with checkboxes for notes to write, patients to examine, and calls to make. Create a system that works for you.
4. Study: No Google search will ever be as efficient as searching your brain. The more you study, the more you’ll know, the more efficient you’ll become.
5. Use templates: Among their virtues, templates for H&Ps, progress notes, and oral presentations breed efficiency (see attached).
6. Don’t multitask: Don’t try to listen to lectures, enter orders, write notes, and text at the same time. Multitasking slows you down.
7. Avoid distractions: This is hard when you’re bombarded with calls from consultants, attendings, and hospital staff, so get as much work done as you can before the calls start coming. As a fellow, I came in every day at 6AM, reviewed the charts, saw my patients, and wrote as many notes as I could before anyone knew I was there. Residents can help interns by holding their Mobile Heartbeats when calls become overwhelming.
8. Tap into your morning energy: Write your notes early in the day when your mind is at peak effectiveness. It takes longer to get things done later in the day, especially when you’re tired and trying to reconstruct thoughts and plans from hours before.
9. Care for yourself: Wellness and efficiency are partners. Sleep, eat, and exercise. Take it from an expert- exhaustion makes you scatterbrained.
10. Filter: Write short, targeted notes, highlighting the key issues; you’ll be done faster, and more people will read what you write. And don’t order unnecessary labs; they don’t help patients, and they add to your work.

I hope these tips will help those of you struggling with efficiency as I once did. If I can improve, so can you. And the rewards are endless: more time to spend with patients, to teach and learn, and to recharge when you get home.

Enjoy your Sunday, everyone, I’m going to take a long, slow ride on the canal. Stay cool.

Mark