1. CSI-RI Best Practice Sharing Conference February 18, 2011
Marcus Welby, Robo Doc or
Someplace in Between:
Creating Clinical Sessions That Work For You

2. What We Don’t Talk About
Why Do Some Providers Run On Time and Others Are Always Behind?
Is It Personal Style?
Is It A System Issue?
Be Ready To Take Notes

3. Why am I having a bad day?
You don’t have the information you need when you step into the exam room?
Your EHR isn’t facilitating the visit with prompts and a simple documentation process?
Your network or EHR or related programs (e.g., SureScripts) is going down too often?
Your patient isn’t informed / motivated / activated?
You aren’t compensated enough to provide the care you want to?

4. Why am I having a bad day? You have too many interruptions?
You aren’t focused enough, e.g, you socialize too much with pts., staff, other Drs.
You’re too sleepy to be efficient
You haven’t created an effective clinical team so that you can concentrate on more complex medical issues?
You just haven’t allotted sufficient time for the visit?

5. Coastal Redesigned Workflow
Goals: - Maximize time Drs. doing doctoring - Minimum patient downtime - Have information available
Tactics - Team formation (appropriate tasks)
- Redesigned space (handed over to pts.) - New process

6. Coastal Redesigned Workflow
Check-in  Room 1 - Welcome, VS, med. rec./RFs, screening, define CC, documenting all in EHR; labs/tests printed out, EKG/pulse ox./etc.
Provider  Room 2 - Visit has focus; provider can listen / provide care
Complex patients  3 - add’l testing, tx, NCM encounter, counseling, referrals

7. Hillside Physician Constantly monitoring WR/check-in
Reason for visit stated (from prev. appt.)
Transcribing hx as pt. gives it
Consistent flow to routine F/U visits – pts. become familiar w/ it also
Instant from room for help
Move to next room when procedure done
Assures pt. has direct access to her

8. Another Hillside Physician
Previst planning driven by MA Hallway Huddle
Hallway desktops
Direct communication
EHR Facilitation
Reality Check – Need Longer Appts.
Utilization of NCM