The Usual Suspects

When you think about improving or optimizing shift efficiency, my guess is that the usual suspects come to mind—managing interruptions, structuring tasks to avoid overwhelm, and streamlining documentation. We certainly focus on these in the Out On Time course.

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Yesterday, a coaching client pointed me to research that found something I didn’t expect: Calling coworkers by their names also improves shift efficiency.
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You may see that and think, “Woah, mind blown!” Or the opposite, “Of course it does; Dale Carnegie laid that out in 1936, ‘A person's name is, to that person, the sweetest sound in any language.’”

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Dale Carnegie. The OG of remembering names.
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Yes, people like to hear their name; it engenders respect, validation, and personal connection. But efficiency? Tell me more.

Observing Docs in Real Time

A 2018 study in Academic Emergency Medicine observed community physicians in real-time during their shifts and asked, “What are the things that these docs are doing that lead to either increased or decreased efficiency?”

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For transparency, efficiency was measured as RVU/hour. I can't say whether that's the best marker, but it's what they used.

The 5 Factors

Five factors were observed to be associated with increased efficiency: using a team member's name, conversations with the health care team, visits to patient rooms, average patient load, and running the board.
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Running the board to stay on top of tasks and not being overwhelmed with patients makes total sense, as does keeping lines of communication open so that everybody knows what's going on.
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Nothing says ‘let’s get sh*t done” like a huddle or quick debrief.

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Name Calling

The simple act of calling team members by name or nickname, however, was also an efficiency force multiplier.

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The authors put it this way, "From a social context, an ED provider knowing and recognizing team members by name is much more efficient than trying to deduce who is caring for the patient and shows a mutual respect (which in turn engenders a stronger work ethic and builds trust)."

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I’ve worked in EDs where there were folks I still didn’t know by name, even after a few years. Ugh.

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Unless you’ve got a knack for remembering names, it takes concerted effort. If you’re in a shop with high nursing turnover, this task becomes exponentially more challenging (but still doable).

What Were the Efficiency Killers?

The two efficiency vampires? Non-work-related tasks and documentation on patients no longer in the ED.

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Eating and going to the bathroom were NOT found to be associated with inefficiency. So there you go, license to eat and pee during your shift.
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What I take away from that is to get your charts done in real-time (that’s one of the primary skills we focus on in the Out On Time course) and resist the urge to open social media during your shift.

The Takeaway

Efficiency isn’t just about managing your time—it’s about managing relationships, too. Remembering and using names can make your shifts run a lot more smoothly. It’s not rocket science, but it works.
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Keep on rocking,

Robbie O

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References

Key High-Efficiency Practices of Emergency Department Providers: A Mixed-Methods Study. Academic Emergency Medicine. 2018;25(7):795-803. PMID: 29265539​

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P.S. I'd love to hear your thoughts on this article—just hit reply, and your message will go straight to my inbox.

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