Mia Hamm is considered one of the greatest athletes in women's soccer history. When she retired in 2004, she held the record for most international goals by a man or woman, and today still has more goals than male superstars Lionel Messi or Christiano Ronaldo.
But what made Hamm so impactful was she understood the value of a team.
“I am a member of a team," she famously once said, "and I rely on the team, I defer to it and sacrifice for it, because the team, not the individual, is the ultimate champion."
That same mantra is one all physicians can follow to improve workplace efficiencies. Physicians cannot— and should not—do all the work needed for most office visits. By relying on other team members to execute advanced rooming and discharge protocols, physicians can save time, reduce costs for practices, and focus on helping patients get better.
A recently revamped AMA STEPS Forward® toolkit, "Advanced Rooming and Discharge: Optimize Team-Based Workflows for Ambulatory Visits," provides practices with a four-step guide to implementing standardized processes that allow nonphysician team members to take on additional responsibilities at the beginning and end of a patient visit.
The toolkit also features an interactive calculator that helps physicians or practices measure how much time and money can be saved by implementing advanced rooming and discharge protocols.
As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine®.
Identify current workflows
The first step to introducing advanced rooming and discharge protocols is to document the existing tasks and workflows already being performed by nurses, medical assistants and other clinical support team members during the rooming process. This list should be all encompassing, including actions such as obtaining patient vital signs and documenting reasons for the visit.
This may seem overly simplistic, but it is important to understand who is in charge of what steps during a patient's visit before introducing changes or new protocols.
Discover how one family clinic saved eight hours per week by allowing team care assistants to lead the rooming process.
Create an advanced rooming checklist
Once current workflows are documented, the next step is to create a list of tasks that clinical support team members can do before a physician needs to be involved.
The toolkit includes a sample of advanced rooming tasks that can be included, such as:
- Perform medication reconciliation and ask about medication changes since the last visit.
- Review and update health history since the patient's last appointment.
- Order labs or other tests based on standing orders.
Practices should implement one or two of these tasks at a time, rather than trying to overhaul the rooming process all at once. Once those initial tasks become routine, two new ones should be selected and added to rooming protocols.
These rooming checklists will vary by specialty, and they should routinely be refined based on team feedback.
A common question about rooming tasks is how leadership can measure team member completion of advanced rooming tasks. Rather than relying on subjective feedback, leaders can collaborate with their internal informatics teams to create a dashboard within the EHR that identifies and tracks rooming tasks.
Hear how one family medicine physician explains how improving his practice's workflow led to increased patient satisfaction, improved access to care, and reduced physician burnout.
Create an advanced discharge checklist
With a list of advanced rooming tasks complete, it is important to complete a similar collection of discharge tasks. These tasks can include steps such as reviewing updated medication lists, printing out and going over after visit summaries, reviewing patient to-do items, and providing health coaching or other patient education.
It is important to note that in some practices, medical assistants may not have time to go back into an exam room once a physician is finished with their patient. Still, documenting this list of tasks can offer a glimpse into what activities could be streamlined or redistributed to other practice team members.
Provide ongoing team training
Offering continued team training is the last step for implementing advanced rooming and discharge protocols, but it could ultimately be the most important for a practice or health system. It should be no surprise that people are more comfortable completing tasks when they understand the task.
Providing the training to develop that understanding is critical for physicians and practices or health systems to experience the greatest benefit from advanced rooming and discharge protocols. Training can take many forms, from physicians demonstrating how to perform a task to nonphysician team members completing skills assessments.
The important thing to note is that training should be an ongoing process. Like Mia Hamm discovered on the soccer field, you never stop practicing. In order to grow and become a better team member, you need to put in the work.
By doing that, you and your team—or your practice or health system—can grow to reach its fullest potential.
Learn more about improving the health care workforce by watching this AMA STEPS Forward video about how a health system provides professional development for medical assistants.
Additionally, listen to this STEPS Forward podcast about the impact of team-based workflows.
AMA STEPS Forward resources offer innovative, physician-developed strategies that allow physicians and their organizations to thrive in the new health care environment. These resources can help you prevent burnout, create an organizational foundation for joy in medicine and improve practice efficiency.
