Happy day to you! The leaves are blowing around like snow here in Virginia and it is gorgeous.
I was prepping for clinic this week and was thinking about how I learned how to prep for clinic. I learned the hard way by good old fashioned experience. No one really taught me in school or out in practice. You just have to figure it out.
I figured it was time to share what I’ve learned and offer some tips to those new midwives out there.
Here’s the bottom line: when you prep for clinic, you have a much better idea of who you are seeing, what they need, what you need to know from them and what you need to have your team prepared to do.
I think most providers will tell you their clinics are night and day different when they prep for their patients and when they don’t prep.
I hope these tips help…please comment below if you have your own tips so we can truly let iron sharpen iron.
Tip #1: Start at the beginning.
Look at why the patient is here. If it’s a GYN patient that’s here for “STD testing,” that visit doesn’t require a lot of preparation except for a quick glance at the labs to see if there is a documented history of STDs. If it’s an OB patient, the gestation should guide a lot of the visit. Sometimes we get into a chart and start down the rabbit holes of electronic medical records before we really look to why the patient is coming that day.
Tip #2: Make dual to do lists.
This tip saves me the most time. I will jot down what I need to do for a patient but also what my tech/medical assistant/nurse needs to do for the patient. This saves so much time and improves communication among the team. It also helps to make the care for the patient more efficient. The other benefit is this: you have written a to do list that speeds up the morning huddle between you and your team. Instead of verbally telling them a list and waiting while they write it down, you have already done the work.
I like to do my list on a sheet of computer paper. I fold it in half and write the to do lists next to each other but on different sides of the fold.
I also find that this tip helps to catch the swiss cheese holes in patient care. No EPDS on the chart…ever? And your patient is 38 weeks? Well, no time better than the present! You get the idea.
Here’s an example (or check out the picture at the top of the post…no HIPPA here!):
1400 New OB
My list: Pap current (NIL-M 9/21 > due 9/23 for pap/HPV)
Tech: EPDS, no pap, ask about vaccine history flu/covid
Tip #3: Have your handouts ready.
If you’re new around here. you may not know this…but I love a good handout. I find when I prep for clinic that I am better prepared because I have an idea of what’s coming. Here’s an example…I have 5 new OB visits scheduled. I make sure I have 5 new OB templates ready to go to make the education and follow up that much faster. I also like to give out the over the counter medication list at the new OB.
Another example is IUD placements. Sometimes my entire afternoon is taking out and putting in IUDs. (I love those days!). I love this IUD handout from SFMFM for IUD comparisons and common questions.
And this is my favorite IUD Aftercare Instructions.
Tip #4: If you have time, check labs, rads and the last note.
Want to find out even more information? The labs, rads and last note will paint a nice picture for you. It may even offer more information about what you recommend and don’t recommend to the patient. For well woman exams, I find that knowing the last pap and last mammogram saves me ALL THE TIME. It also helps lead into when we recommend the next screening for each intervention.
That’s all I have for tips. I have gotten faster and faster at clinic prep over the years. But in my first two years out of midwifery school, it used to take me 1-2 hours. Yes, hours. It was a very slow skill to learn. And a slow EHR system to boot.
These days I prep for two main reasons. One, it maximizes the visit for the patient while reducing the time I’m hunting through the chart. And two, a timely clinic gets the patient in and out in a timely fashion, while getting me home to see the kids and family in a timely manner as well.
That’s it for clinic prep tips! If you love it, let me know on the insta. If you want something more for tips, let me know too 🙂 We’re all about making more midwives around here!
Hugs,
Jamie
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