LIVEN UP YOUR EXAM ROOMS

After seeing so many cold, lifeless exam rooms, I was inspired many years ago to decorate my exam rooms with different “themes.” Here are some of my current and past themes:

• Kid's room: When obstetrics was part of my practice, I decorated a room with bright colors and kids' decor, including cardboard gingerbread people hung near the ceiling. Each had the name of a child I had delivered.

• Pheasant room: I am an avid pheasant hunter, so I decorated this room with beautiful prints of pheasants and other related items.

• Airplane room: I am a commercial-rated pilot and do a lot of flying. This room has photographs of some of the planes I have flown, models of some of my favorite planes, and a huge aviation map with small pins marking spots around the country where I have landed.

• Dog room: I train bird dogs, so in this room I have sketches of these dogs, some puppy photos, a few dog-related signs, and a bulletin board where patients can add photos of their own dogs.

• Alaska room: I went on a cruise to Alaska and do quite a bit of nature photography, so I post those pictures here.

I also line the hallways with photos of my family, including my five children. These photos and the theme rooms themselves often spark great conversations that provide opportunities to better connect with patients.

USE “NUDGES” TO ENCOURAGE BEHAVIOR CHANGE

Physicians may resist coaching if they feel these efforts are patronizing, manipulative, or interfere with their sense of professional autonomy. Here are three ways to more effectively “nudge” physician colleagues or those you supervise toward change:

• Transparency. Don't hide your purpose. Explain that you are not seeking to subvert the physician's professional purpose or medical evidence but rather to reduce unwarranted variations in care that occur despite these things.

• Cocreation. Involve physicians in developing behavioral interventions. This can reinforce their autonomy and sense of purpose, ensure that the process matches the situations they see in practice every day, and even inspire other process improvements.

• Constructive framing. Use interventions that champion professional ideals, as opposed to ones designed to prevent physicians from making mistakes.

BE PREPARED FOR LAST-MINUTE GYNECOLOGIC EXAMS

Unplanned Pap smears and other gynecologic exams are valuable services but can be a speed bump for clinics. When these needs emerge, it can impede an office's efficiency as the physician or staff members have to scramble to collect the necessary supplies. To minimize this, our clinic developed “Pap bundles” that contain all the tools needed to provide a Pap smear.

Our medical assistants (MAs) create these bundles, wrapping each one in a sheet and taping it closed to seal the components inside. They label each bundle with their initials and an expiration date that corresponds to the items in the bundle that will expire the soonest, such as the formaldehyde container or gonococcus/chlamydia swabs, and store them in a central location.

When a bundle is needed, the MA grabs one and completes the exam setup in less than a minute, reducing waiting time and frustration for everyone involved. MAs replenish the bundles during their downtime just like they do our other supplies.