How to help physicians cut pajama time, have “more great days”

Melissa Reily, MD, a rheumatologist at Bozeman Health Rheumatology Clinic, and AMA member Melissa Wolf, MD, an OB/GYN at Bozeman Health Women’s Specialists, became friends at a point in their careers when they were both experiencing some level of burnout.

That’s when they decided at Bozeman Health in Montana to find ways to change that for themselves, primarily by reducing the time they spent working outside of work. Often referred to as “pajama time,” these intrusions into doctor’s nights and weekends affect their relationships with others and contribute to burnout.

By setting out to make changes their own way, Dr. Eventually, Reily and Wolf became Co-Directors of Physician Health at Bozeman Health and embarked on a journey to help physicians across their organization create situations that help them work more efficiently, reduce off-hours work, and enhance their happiness to regain medicine.

By moving to a system where patients’ prescriptions are renewed at the annual visit for the maximum time allowed, Dr. Reily increased the prescription messages in her nurse’s inbox by 65%, and with it her own work. One colleague who was frustrated with the time it took him to go to the printer to retrieve the summaries after the visit estimates he’s saving the organization $10,000 annually now that he has a printer in every exam room .

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The efforts of the physician friends helped Bozeman Health become a recipient of the AMA’s Joy in Medicine™ Health System Recognition Program, which aims to inspire and guide organizations interested, committed, or already committed to improving physician satisfaction and reduce burnout.

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dr Reily and Wolf recently spoke about their journey to reducing slumber time by 25% over 10 months during an AMA STEPS Forward® Reducing Pajama Time and Working Outside of Work (WOW) Podcast. Listen on Apple Podcasts or Spotify.

Here are three key initiatives that Dr. Reilly and Wolf have stated that they believe physicians in other organizations can easily replicate to make changes that reduce pajama time.

dr Reily and Wolf coined their group the “More Great Days Group”. The goal is to find ways to have more great days by leaving work feeling like all of the day’s work has been done, the team worked efficiently and the patients received great care.

The small groups of doctors, usually five to ten people, meet four times over a period of eight weeks. Doctors are asked what they consider to be “a little pebble in their shoe” – something that makes them feel like they’re wasting their time.

They then discuss a plan for how to make this change, determine what best practices can be implemented, and use AMA STEPS Forward® Toolkits to support solutions so clinicians don’t have to reinvent the wheel.

“It empowers our colleagues to see that there are things they can change about their day that will really lead to more great days,” said Dr. Reily.

dr Reily and Wolf ask their fellow physicians and advanced clinical practitioners the top three things they would like to see changed about the “stupid things” the EHR system asks of them every day. Every time dr. For example, when Reily added a lab, she received a notification that she had to click before she could see the lab itself.

Some of the changes are simple and can be made instantly to eliminate wasteful things for a doctor’s day. Others sometimes require a longer process for the transformation to take place.

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When Bozeman Health transitioned to a new EHR, training sessions were conducted providing tips on how to use the system efficiently.

dr In turn, Reily and Wolf shared these with others, and they also shared information from the AMA STEPS Forward toolkits, which include quick tips on how physicians can save time by improving in-basket efficiency, setting up pre-visit lab tests, and creating one Annual prescription renewal system.

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