1. National Practice Management Meeting Saturday 21 st April 2012 Efficient systems of Work – less resources, more results!

2. More, Faster, Harder, Cheaper? Ever increasing demands of the GP workplace Diminishing resources – less from more? How can I really fit everything in? Feelings of frustration or being overwhelmed Guilt, stress & exhaustion!

3. Effective Systems of Work – The Lean Model “Lean” Principles Value in Lean is considered to be what is of value to the patient, i.e. Right service at the right time in the right place Waste is anything which takes up resources which doesn’t add to the value of your services. Examples of waste – wasted time on transporting items / searching for items / over-ordering stock / over-producing stock or services / time lost to errors and mistakes etc.

4. “Lean” Efficient Systems – in a Nutshell Thoroughly examine and list, step by step, how a process is carried out Check to see if each step adds value or is it wasteful / inefficient Eliminate any waste, so you are left using all time and resources as efficiently as possible

5. Patient Collects A Prescription 1.Greet patient 2.Ask name 3.Walk across room 4.Check drawer for prescription – can’t find it! 5.Walk back across room and check patient details again 6.Walk back to patient 7.Tell patient to take a seat in waiting room 8.Take a phone call from Mrs. Bloggs 9.Make an appointment for Mrs. Bloggs 10.Go & check drawer again 11.Go back to desk 12.Check patient chart to see was prescription issued on PC – no! 13.Phone GP (interrupting his current consultation) 14.Wait for GP to finish consultation 15.Go to GP’s room where he prints prescription 16.Return to waiting room and hand over prescription

6. Patient Collects A Prescription 1.Greet patient 2.Ask name 3.Walk across room 4.Check drawer for prescription – can’t find it! 5.Walk back across room and check patient details again 6.Walk back to patient 7.Tell patient to take a seat in waiting room 8.Take a phone call from Mrs. Bloggs 9.Make an appointment for Mrs. Bloggs 10.Go & check drawer again 11.Go back to desk 12.Check patient chart to see was prescription issued on PC – no! 13.Phone GP (interrupting his current consultation) 14.Wait for GP to finish consultation 15.Go to GP’s room where he prints prescription 16.Return to waiting room and hand over prescription

7. Exercise 1 What aspects of your surgery work really well? Why? What’s not working well for you? What aspects are currently draining your time and energy? Are any of your staff doing a great job? Are any of your staff possibly underperforming or have any of them skills or potential you aren’t using? What have you done about the issues you’ve identified? What could you do about it?

8. Limitations of Lean & other Time Management Models Suggests that with by higher & higher organization that we can gain control over our lives and businesses. Living “by the clock” doesn’t necessarily take account of the value of what we are achieving Easy to focus on “busy-ness” or quantity of throughout, more than on prioritising and return on investment or quality of results? Effective in dealing with things but very ineffective when dealing with people – would you like to be dealt with in this way? Systems at work depend on the people running them. What does this mean for the effectiveness of time management systems?

9. Efficiency v. Effectiveness How urgent is it? How important is it? How much of your time is spent on the urgent - but less important - stuff? How much of your time is spent on really effective planning or projects, and on developing the people around you?

10. How Can It All Fit In? Start by fitting in the biggest stones, then the sand. With projects at work, try to prioritise the important ones – urgent but less important things will fill up the gaps like the sand. Ultimately, the ‘glass’ is finite– which is why prioritising the right content is vital.

11. Effective Teams – Effective Leadership Leadership is a responsibility, not a rank. Effective leaders spend more time guiding and serving their staff - not doing the work themselves. Effective workers have stewardship over their work and assume responsibility for their actions so leaders have to create an environment for this to happen.

12. Exercise 2 Go back to your list of problems and possible steps you could take to address them from Exercise 1. Put them in order of what are the most important ones to address. Consider any issues you feel are important but which you just don’t feel happy to tackle – why is that? What could you do to overcome your trepidation? What do you need to do??