Time Management: how hard can it really be?

1. Time Management: how hard can it really be? Carlos E. Araya, MD Pediatric Nephrology

3. Introduction • Everyone has demands on their time • It is commonly thought that: • Residents and Fellows are overworked and have little time left over • No time for personal lives • Can lead to job/life dissatisfaction • This lecture will give some tips on how to manage your time

4. Inefficient Time Use • Most time management literature is centered in the business area • However, studies have shown the inefficiencies of trainees • Lurie et al. found that most of the time in a clinical rotation was not spent in direct patient care (90 to 180 minutes in a 24hr call). • If time could be spent more efficiently: • Direct patient care • Reading medical literature • Performing research

5. Pareto’s Principle and Time Wasters • Pareto’s 80/20 principle: • 80% of the time is spent to do 20% of the work • 3-4 times the amount of time is used to get the job done • Due to Time Wasters: • Ill-defined goals • Procrastination • Priorities and deadlines associated with poor delegation of responsabilities • Eliminating Time Wasters allows you to accomplish more work in less time.

6. Principles of Time Management • Set Goals: • Knowing what the goal is before you start a task will direct energy and save time • Short and long term goals: • Allows you to define a value and prioritize • Example: finish writing the book chapter by editor’s deadline (long term). Write draft of introduction (short term) • Short term goals may be broken down into daily goals for planning • Update goals and leave room for error

7. Set Priorities • Do the important things first and allow them more time • Sometimes we tackle the urgent over the important things (answering a friends call vs studying for the boards). • The four quadrant method is helpful in prioritizing

8. Four Quadrant Method

9. Quadrant 1: Urgent and Important • Quadrant 1 activities are easy to recognize • Require immediate action and may lead to inefficiency, procrastination of other important projects • However, it is important to prepare for time spent in Quadrant 1 (know ACLS, common floor/specialty problems, etc) • The best way to avoid as much Quadrant 1 are activities in Quadrant 2 (Not Urgent but Important)

10. Quadrant 2: Not Urgent but Important • Most important quadrant • If quadrant 2 is neglected, quadrant 1 crises will cause more disruption • Example: • I neglected to plan for writing the chapter (Quad 2) and spent free time watching football (Quad 4), now I am missing the deadline and are in crises (Quad 1) • Too much time in Quadrant 1 = • Stress, stomachaches, marital problems, poor sleep • Less time = • Less stress, increased life satisfaction, etc

11. Quadrant 3: Urgent but Not Important • It is difficult to determine what falls in this category • It is common to give these activities much more time than they deserve • This may lead to trouble • Example: I spent too much time with a friend yesterday and did not have time to read up on rapid sequence intubation prior to my first PICU call; I got called to a patient with respiratory distress, and now will struggle handling the crisis

12. Quadrant 4: Not Urgent and Not Important • They cause the most trouble • Are easy to define, but difficult if unmotivated to ignore • Pleasant activities like sports, pleasure reading, etc are hard to ignore • They are very important for emotional well being. • However, if given excessive time will cause disruption

13. Communication, Delegation, Supervision • Organize tasks and decide which should be performed by yourself and which by others • Communicate assertively, not aggressively when giving instructions • Delegating does not end by telling someone to do a job • Make sure resources are available to do the job, so that it can be done correctly • Follow up with the progress of the job, give guidance when needed and credit too • Example: a patient needs a kidney biopsy. Have the fellow set up for the procedure, then call you when ready to begin.

14. Dictations and Chart Writing • Writing H & Ps, progress, procedure notes,etc is very time consuming. • Documentation methods other than handwriting are more efficient • Words per minute • Write: 15 • Type: 20 to 60 • Dictate: 65 to 95

15. Getting Started • Daily and weekly “To Do Lists” are helpful • Smartphones or PDAs have applications that help people manage their professional/personal affairs more effectively • Manage interruptions • Avoid procrastination • Primary reason for professional failure • Four main reasons for procrastination

16. 1. Fear of Failure • The most common and least rational cause • Keep in mind that failure is rarely fatal • Through failure we learn to succeed the next time • Break large projects into smaller parts and schedule time to complete the smaller projects

17. 2. Perfection Paralysis • Expecting to achieve perfection in everything • When faced with this, ask yourself: • What does perfection really mean? • How much will it cost to achieve(energy, time, money)? • Is it worth the effort? • A more realistic goal is to do thebest you can with what you have • The process of your efforts and not the outcome is just if not more important

18. 3. Fear of Success • Women: • Successful career at the expense of family life • Make more money than husband = husband feels threatened • Sabotage their own success • Overcome it by learning to feel good about success • Have a sense of purpose or mission in life to get beyond the fear

19. 4. Lack of Self-Discipline • It is hard to do the most important and difficult task first • Set up a reward system • It is hard to change procrastination behaviors or old habits, but it is more enjoyable to accomplish the things you want to do

20. Conclusions • Time management is how effectively time is spent • Succesfull people manage their time very well • Most people need some guidance • Set goals • Delegate when appropriate • Avoid procrastination • Focus your efforts • Remember it is not time we are trying to manage… it is ourselves

21. Thanks for Listening! Questions or Comments?