Time Management in Time Management in GPGP

Dr Katherine Teare Dr Katherine Teare

GP Educator FellowGP Educator Fellow

Time managementTime management

In consultationsIn consultations OOHOOH For paperwork and adminFor paperwork and admin Spending more time with Spending more time with

patients….more stress?patients….more stress?

ConsultationsConsultations

Patients with a listPatients with a list Doctors speed, patients problem and Doctors speed, patients problem and

patients age all have an effectpatients age all have an effect UK research shows trainees and new UK research shows trainees and new

partners spend average 1minute less with partners spend average 1minute less with each patienteach patient

Women seeing women = longer Women seeing women = longer consultationsconsultations

Significant practice to practice variationSignificant practice to practice variation Who your allied health care professionals Who your allied health care professionals

are e.g. Nurse practitioners, specialist are e.g. Nurse practitioners, specialist nurses etcnurses etc

The list…The list…

2 goals – keep patient and doctor 2 goals – keep patient and doctor ‘happy’‘happy’

Explore after the initial presenting Explore after the initial presenting complaint – avoid a surprise at the complaint – avoid a surprise at the endend

E.g. anything else you came to see E.g. anything else you came to see me about today?me about today?

Prioritise red flags and acute Prioritise red flags and acute problems, then try to get patient to problems, then try to get patient to prioritise with ICEprioritise with ICE

Explaining yourselfExplaining yourself

Give it a positive spinGive it a positive spin ‘‘The tummy pain is clearly quite The tummy pain is clearly quite

upsetting to you. You have upsetting to you. You have mentioned a sore wrist and an itchy mentioned a sore wrist and an itchy ear as well but I wonder if it is okay if ear as well but I wonder if it is okay if we spend today focussing on the we spend today focussing on the tummy pain and then we arrange tummy pain and then we arrange another appointment for us to another appointment for us to discuss the other problems in order discuss the other problems in order that we can make sure we have that we can make sure we have covered your tummy pain fully’covered your tummy pain fully’

StrategiesStrategies

Double appointments when Double appointments when neededneeded

Break in surgeryBreak in surgery Consider how surgeries Consider how surgeries

structured when applying for structured when applying for jobs – is there flexibility?jobs – is there flexibility?

Start as you mean to go onStart as you mean to go on Ending the consultationEnding the consultation

Out of HoursOut of Hours

Time pressures vary according Time pressures vary according to role (telephone triage, visiting, to role (telephone triage, visiting, centre based)centre based)

More awareness of targetsMore awareness of targets More isolated workingMore isolated working

AdminAdmin

Referrals – when do you do Referrals – when do you do them?them?

Reviewing resultsReviewing results Dealing with lettersDealing with letters Medication reviewsMedication reviews Insurance reports, DWP reportsInsurance reports, DWP reports Extra bits – eportfolio, WPBAExtra bits – eportfolio, WPBA

ReferencesReferences

http://www.bradfordvts.co.uk/http://www.bradfordvts.co.uk/online-resources/0200-online-resources/0200-consultation/consultation-time/ consultation/consultation-time/

http://www.gponline.com/http://www.gponline.com/Education/article/972407/Education/article/972407/consultation-skills-control-consultation-skills-control-length-consultation/ length-consultation/