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No matter the size of the department, all patient education managers struggle with too many responsibilities and not enough time. When University of Missouri Health Care in Columbia went through a redesign process last year, administrators created a centralized education department that covered community, patient, and staff education.
"One of my biggest struggles is the fact that the department has three distinct areas of responsibility and I must balance multiple priorities. I can’t just focus on a top priority because each section has top priorities," says Ceresa Ward, MS, RN, manager of the Center for Education and Development.
Soon after taking the position of patient education coordinator at Great Plains Regional Medical Center in North Platte, NE, Barb Petersen, RN, realized she could not do every task that staff throughout the health care facility brought to the education office. "When I took on extra jobs as needed, I was working terrible hours and stressed out beyond belief," she says.
To meet these challenges, both Petersen and Ward developed time management strategies that work for them. They are not alone. Each person who takes on the role of patient education manager must create ways to effectively manage his or her workload.
As a one-person department, Carol Maller, RN, MS, CHES, patient education coordinator at the New Mexico Veterans Affairs (VA) Health Care System in Albuquerque, found technology extremely helpful. She embraced as many of the computer applications that were standard for her health care institution as possible. One of the most helpful is a database she uses to manage projects that have many of pieces of information.
For example, medical center staff write most of the patient education materials because it is more cost-effective, the information can be tailored to the institution’s patient population, and the material is customized to fit policy. Maller uses the database to manage more than 300 titles of teaching materials, enabling her to keep track of the date each piece was developed so the information can be kept current. She also can organize the materials by subject matter for cataloging purposes.
All clinical areas receive an updated catalogue four times each year or when orders are filled. In addition to listing materials by subject category, the database makes it easy to include a page of discontinued titles and new titles so staff don’t have to review the whole catalogue to find these items. "Unless I can automate some of these routine tasks, they eat up all my time and I never have any time for planning or consultant work," says Maller.
Managers must invest time up front learning the computer programs and also building the databases, but it is time well invested. While volunteers could be used in the task of creating databases, they must be carefully selected because it is often more time-consuming to correct their mistakes than enter the data yourself, says Maller.
A handheld, computerized calendar helps Ward keep from overcommitting herself by tracking appointments and time commitments. The electronic calendar is one of the techniques that she uses to organize her workload. "The electronic calendar allows you to put to-do’ items on it and track them with reminders so it is almost like a pending file system for workload," says Ward.
It’s important to put time on the calendar to work on projects, whether it is electronically tracked or simply the paper version. Otherwise unexpected meetings or a crisis will consume every hour of the day, and it will be impossible to complete or manage projects," says Ward.
Blocking off on the calendar the estimated time it will take to get a task done is important, agrees Petersen. She has a stack of to-do items on one side of her desk that she tries to prioritize and then schedules a time to complete them. "This helps me to get tasks done before deadline and it keeps people from scheduling my day full of events or meetings," she explains.
Through the institution’s e-mail system, people can look at her calendar to determine if she has free time that day. If an event or meeting comes up that takes priority over the task, she reschedules the time to work on the project rather than simply canceling it.
A good e-mail program can be invaluable, says Maller. These programs can provide the technology needed to set reminders, notify senders when you are out of the office, provide an alternate contact number, and create folders for special projects, she says.
While Petersen keeps pressing to-do projects on her desktop, she created a multiple file system to make sure there is workspace on her desk. One file contains items that she needs to read but does not have time at the moment to review. She pulls this file out during lunch, while being kept on hold on the telephone, or when she has other downtime, such as while traveling on a business trip.
A second file contains items that Petersen has a meeting in place to discuss. In that way, she doesn’t have to waste time looking for the materials she will need at a meeting, ensuring that she can be sure she has done her part to move the project forward. A third file is titled "Waiting for Reply." These are items that she has completed and is awaiting approval on or waiting for another party to complete its portion of the project.
Delegation is an important part of time management, says Gwen Thoma, EdD, RN, CNA, director of educational services at Southeast Missouri Hospital in Cape Girardeau. "I quickly realized I get a lot more done through other people than trying to do it all myself," she says. Members of the patient education committee, which meets once a month, share the workload. For example, a committee member might be assigned to develop an education piece on a particular topic.
To keep focused, the committee sets five or six primary goals it wants to accomplish each year, selecting the most pressing needs at the time, says Thoma. For example, the goal was to assess all patient education materials to determine if there were any duplications one year. Each month, committee members looked at handouts in a particular subject category, and when duplicates were uncovered, they were all evaluated to see which ones the institution should keep.
Strategic planning and prioritization is an important element of time management, says Ward. "You really have to decide what is important to accomplish and how you will use your resources to accomplish those priorities," she says.
Due to financial cutbacks, the education department had to take a hard look at community outreach projects to determine where dollars would be most beneficial. A decision was made to focus on the senior market and most of the outreach activities target that population, says Ward. Determining where dollars can be best spent helps eliminate some of the projects that eat up time. Some of the projects done in the past may no longer be important, priorities change all the time, she says.
The technology used to save staff time often works to a manager’s benefit and should not be overlooked. With all patient education materials at Southeast Missouri Hospital on a computer database for easy access by staff, Thoma can quickly see what pamphlets are available in a particular category and if duplications are beginning to crop up. Also, when a test is ordered, the educational sheet pertaining to it automatically prints out so the health care provider can discuss the information with the patient. This can save distribution time because when the teaching sheet automatically prints out, staff don’t need constant reminders to make use of it.
New technology to aid staff that is being implemented within the VISN-2 Veterans Affairs Upstate New York Healthcare Network should prove to be a timesaver for management as well, says Diane Wonch, PhD, CHES, CHi, patient education director. The on-demand type of closed-circuit TV and personal computer system allows patients or nurses to dial up educational videos via the telephone; it can be used as a patient education survey tool, staff development tool, and customer service recovery tool.
The Healthcare Network is working to have information generated from this technology go directly into the patient’s record, such as information from the customer service survey or information on the type of educational videos the patient watched. When completed, time-consuming chart reviews will no longer be needed to retrieve information. "As a manager, I won’t have to do a lot of hands-on chart reviews with teams. I can just go into a computer system and call up a video, a program, or a patient population and get my numbers and statistics. That will be quite a timesaver," says Wonch.
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