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Does your performance at work depend on coffee?

Does the time of day determine how you respond at work? Are you tired by mid afternoon? Are you slow to get going in the morning? How does that impact on the decisions you make at that time?

Decision fatigue is the concept that as we make more decisions during the day, they become less and less good quality… I know that I would much rather be one of my first five patient contacts of the day than my last five. Rachel Ali

Remedies for decision fatigue might include time-dependent decision support, modified schedules, shorter sessions, mandatory breaks, or snacks. Further studies could clarify the sources of the problem and test corresponding solutions. Linder et al

Does this resonate with you? What are you doing about it?

Picture by Albert Drobin

What was the journey like?

Do you know what your customer, client or patient’s journey to your office, clinic or shop was like? How did they get there? How long did it take? Who travelled with them? What did it cost? If they drove where did they park? Did you take any of that into account in your dealings with them today? Does it matter?

If you’re lying on a table waiting for radiation, you can’t just jump up and plug your meter,” she wrote to the city. “As someone who has gone through and survived cancer, I can’t tell you the anxiety experienced at finding a parking ticket on my vehicle. Nancy Piling

That patient’s experience was impacted by factors that had nothing to do with the professional care she was receiving. But…..

Picture by lagaleriade arcotangente  

What do you do to unwind?

As a health care professional you are encouraged to have some down time. According to research:

Burnout and satisfaction with work-life balance in US physicians worsened from 2011 to 2014. More than half of US physicians are now experiencing professional burnout. Shanafelt TD et al

In the UK, NHS

More than half of salaried and locum GPs suffer from stress as a result of their work. BMA

So if you are in healthcare how and when do you unwind? How do you know it’s working? Are you too busy chopping the wood to think about sharpening the saw?

Picture by Zach Den Adel

Can you stand to be bored?

Ever since the invention of the smartphone boredom has been banished. But at what cost?

Our results indicate a moderate relationship between smartphone addiction and a self-reported decrease in productivity due to spending time on the smartphone during work, as well as with the number of work hours lost to smartphone use. Smartphone addiction was also related to a greater amount of leisure time spent on the smartphone and was strongly related to a negative impact of smartphone use on daily non-work related activities. These data support the idea that tendencies towards smartphone addiction and overt checking of the smartphone could result in less productivity both in the workplace and at home. Duke E

Can you give that customer, client or patient your undivided attention with one eye on your phone? Is it worth considering if you have a problem?

Picture by Graeme Paterson

Why do you keep me waiting?

We often have to wait in line to be served. In healthcare that happens a lot. If you had to wait an hour or more every time you needed something from somewhere would you continue going there? Why or why not? Does queuing have to be  fact of life in healthcare? How long before someone works out it isn’t necessary and offers an alternative? What will happen to those places that fail to keep up?

Although appointment systems are often designed to avoid doctor idle time (without considering patient waiting time), it is possible to reduce patient wait time without significantly increasing doctor idle time.

Picture by Michael Dales

Could you do better?

Do you think your work could be better? How? If you think it could be improved what are you waiting for?

The intense debate about how to move forward is a sign that overtreatment matters,” Brownlee says. “We want everyone involved and sharing their expertise on potential solutions. There is room for many political ideologies and beliefs about how to pay for healthcare. The crucial step right now is to get the medical community mobilized around the idea that overtreatment harms patients

BMJ Jeanne Lenzer

Picture by Carlos Ebert

Are you ready yet?

What do you do before you interact with your next customer, client or patient?

Gaze and body orientation communicate levels of engagement with and disengagement from courses of action. As doctors and patients accomplish regular tasks preparatory to dealing with patients’ chief complaints, doctors use gaze and body orientation to communicate that they are preparing but are not yet ready to deal with those complaints. In response, patients wait for their doctors to solicit their chief complaint. These findings have implications for research on nonverbal communication, interactional asymmetry, and power.

JD Robinson

Picture by Mad African

I am Joe and I get what I want

As I surveyed the new intake of medical students one student found his way to the front of the room.

Are you the associate dean?

When I confirmed he went on:

My name is Joe ( Not his real name- to spare his blushes). You need to know that I get what I want.

Now two years later here was Dr. Joe graduating, resplendent in his academic gown. He has his wish which I hope is for a lifetime of selfless service to people in distress. So when he is called to the patient in bed 9, on the wards tonight and he is told:

I’m Mr. Smith, and you need to know I get what I want. Tell your boss to come to my room at 11am, I’ll be ready for him then and by the way I’m not happy taking those pill, please take them away.

Joe will know he has got his wish.

Picture by KC

What did you think about on the way to work?

What did you think about as you made your way to work? Were you already at work in your head? Ruminating on the past? Worrying about the future? Did you grumble to yourself about the commute? The unreliable public transport? The traffic jam? The ‘idiot’ who cut you off at the junction? Did you read the ‘fake news’? Did you look at Instagram posts or catch up on Facebook? Were you one of those people yelling into your phone on the bus or tram?

Immediately following their regular commute to work, participants completed questionnaires regarding state driver stress and anger during that commute. Then, immediately following completion of that work day, they completed a state version of the Workplace Aggression Scale. As state driver stress increased, the frequency of both expressed hostility and obstructionism increased (independently) during that work day, but only among male employees. In contrast, overt aggression during that work day was greatest among males who were higher in physical aggressiveness as a general trait characteristic. The present study highlights the interactive nature of traffic and workplace environments, in that negative experiences in the traffic environment may spill over for some individuals to influence non driving events

Journal of Applied Social Psychology Dwight A. Hennessy

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Did this person need those pills?

No matter what business you are in you might ask yourself if whatever you just sold to your customer is what they really needed. If you are a doctor that question cuts deeper- did you really identify  that person’s problem or did your prescription just get them out the door?

Inappropriate prescriptions are known to pose health risks for older adults, leading to unnecessary hospitalisations and undue cost. Budnitz et al

Picture by Brent Matthew Lillard