How Physicians Can Improve Charting Efficiency and Reclaim Nights and Weekends

One of my newer physician clients is working on charting efficiency. I asked her to time and record who much time it takes for her to complete documentation for a patient. This week, she came back and reported that, on average, it took her about 10 minutes to complete a patient chart. She sees 25 patients a day, which translates to 250 minutes a day used just for charting. That is more than 4 hours a day. Imagine after seeing patients for 8 hours and you still have 4 more hours of work. The idea of it is so exhausting that I do not even want to imagine!

This simple exercise allows her to realize how much time she is actually spending on charting alone. Is it possible to cut the charting time down? Sure. There are three main approaches: mindset, technical skills related to the EHR program, and technical skills related to how the charting is done.

First, believe that it is possible to be more efficient than what you are doing. Resist the temptation to figure out how before you start believing. The more you believe that you can do it, the faster you will achieve that goal.

Many of us are trained to be perfect. We are supposed to know it all. We are supposed to write these very detailed notes with impeccable paragraphs, spelling and grammar. Why? Did someone make those rules, or did we impose them on ourselves? Back to the basics – patient documentation is used to document findings, your opinion about the patient and your plan about the patient. The documentation is used as a reference for yourself, for other clinicians and for insurance reimbursements. Anything that will not add to those things are not necessary. In other words, allow ourselves to be good enough – and that is good enough. It is okay not to be perfect. The less you write, the less time it takes.

Another very important mindset to work on is keeping yourself on schedule. Yes, punctuality is important. Most of us want to do our best to keep the scheduled patients on time. Ask yourself – by keeping your patients on time, are you sacrificing anything? I used to. For years, it was difficult for me to finish each patient’s chart before moving on to see the next patient. My “solution” was to finish my charts later, which meant after hours. How many minutes would the next patient have to wait if you finished the previous patient’s chart? When you are sacrificing the charting time to keep up with the schedule, you are abandoning your well-being. You are not respecting your own time, not to mention that it will take you longer to finish the same chart later. Give yourself the permission to let patients wait for an extra few minutes so that you can finish the previous patient’s chart. With the previous patient’s work done, you can give full attention to the next patient. Better focus elevates efficiency.

As for the technical skills related to your EHR, first and foremost, know your EHR well. Ask for help when necessary. Understand its functions, shortcuts and limitations. Learn a more efficient way to do the same thing.  

One of the best ways to be more efficient is to use templates or smart texts. If you find yourself writing the same things over and over, create smart texts or text expanders. For example, if you are a colorectal surgeon, you discuss the risks and benefits of the surgery you propose. You explain in a certain way that is “standard” to you. That is something you can create as a smart text. Caution that you are not making so many smart texts that you do not remember which acronym is for which texts. Then you will end up spending more time figuring out which is the correct one to use than to actually type it out long-hand.

Keep it simple. As I mentioned before, good enough is good enough. Document to the point, literally. Use point forms that are clear to read. Think about if you were the physician reviewing someone else’s patient chart. What are the essential things to document? Do your best to keep those only.

No matter where you are in charting efficiency, what EHR program you are using, believe that it is possible for you to be more efficient. Let go of perfection. Keep things simple, to the point, easy to read. While you are doing your best to keep patients on schedule, allow a few extra minutes of wait time so that you can finish the previous patient’s chart. Get to know your EHR really well. Explore the quicksteps and functions which help with efficiency. Create shortcuts, smart texts. Minimize redundancy. You will gradually find yourself reclaiming more and more time.