Another practical idea for emergency physicians is to “tee up the discharges.” One of the most reliable assessments in medicine is a physician’s blink response to patients. Emergency physicians are highly reliable at predicting admit/go home, sick/not sick. We are even good at predicting whether a patient will survive an intensive care unit admission or not. Take advantage of this by getting the paperwork ready for a patient you anticipate will go home. This strategy has been noted among efficient emergency physicians.

In most work settings, there is a period when efficiency and productivity improve, then efficiency levels off with little additional improvement over time. Most physician groups do not assess whether physicians have optimized their workflow and efficiency, and a physician performance coach is unheard of in the ED. But is it an idea whose time has come?

Consider these ideas to improve personal practice performance:

1. Catalog the habits of the most efficient physicians in the group and make them available to the practice at large.
2. Have the most efficient physicians observe other physicians and offer strategic ideas for improving efficiency.
3. Ask the health unit clerk (HUC) for ideas to improve physician efficiency and share these ideas.
4. Survey the nursing staff for ideas that would improve the efficiency of physicians.
5. Meet with information technology experts to review computer support for workflow and identify, at the individual physician level, areas where efficiency could be improved.
6. In particular, explore the possibility of optimizing information technology support for workflow in the form of order sets (including discharge prescription sets for the most commonly treated conditions).

Each of us can improve our practice in emergency medicine. It requires that we be open to the idea of continuous improvement, coaching, and retraining in the elements of our practices. Don’t your patients deserve your personal best?