Home Forums Discussions Problems DEEP THOUGHHTS by Walter Handy

This has been facinating. I don't remember a post that has gained so many and so lengthy responses in a 48 hour period.

I read it yesterday, thought about what I might add and came back and there is a whole lot more. I am another who does not leave the room without completing the note.

Much of what I would say echo's the others here.
1) Try to get the MA's to do some of the work. Even just putting a generic template in place to modify will help. Using checklist forms can make it easy for ROS and some disease processes, then she reviews the information and does not have to enter it in the computer.

2) Seriously look at old notes and see what repetitive text can be converted into a template. Especially look at the top 10 dx. You can cut and paste the text then right click and alt button will create a new template.

Even if she modifies it more, it will cut down on typing.
Easy to make a 99214, use it more. I forgot about the 9905x codes, I will have to use those more as well.

3) She should start timing herself as to how long it takes her to do a note. Perhaps even break it down by section (of course having someone else doing the timing) to figure out where the bottleneck exists. Once you know the problem you may be able to attack the solution.

4) Hardest thing to do is realize you cannot solve all the issues in one visit. There are times with a complex patient I will put in chief complaints x 4-6 and then fill in the blank later in the day, but this is probably 1-2 times a week. the rest needs to be in the room. Sometimes you need to have them come back to tackle some of the problems. This not only generates another visit, but it will make the patient understand that you will only deal with so much at one visit. With the especially long winded multi problem patients, they will begin to see that they cannot keep dumping multiple problems when they have to come back.

5) Learning how to type, talk and look at the patient will help a lot. Perhaps changing the angle of the computer screen or the layout of the room will make it more condusive to achieving this.

That's my 2 cents worth. Some are other's pennies as well, but bear repeating.

More sleep makes your brain work better. I like sleep.