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Managing time pressures

Optometrist and deputy head of optometry at Moorfields Eye Hospital, Dr Vijay Anand, provides advice on dealing with time pressures in the hospital setting

Dr Vijay Anand

The time pressures that an optometrist experiences in a hospital setting will be different to what they may have experienced on the High Street.

With the ever-increasing demand on hospital eye services due to the ageing population and an increase in the medical treatments available for ocular conditions, optometrists working in hospital clinics are facing greater challenges year on year.

In hospitals, while optometrists will see the next patient who is waiting, some patients will require additional support from either a senior optometrist or perhaps an ophthalmologist if you are working in an extended role position.

Requiring input from other professionals can add time onto an already busy schedule, but is imperative for the safe clinical care of the patient – optometrists should never feel that they are a burden to senior staff or ophthalmology colleagues in these situations. Despite knowing that patients may be kept for long periods of time to be seen, it is important to continue to work to the clinical protocols that have been set and to maintain the professional standards that you strive to achieve.

We have all been faced with clinical scenarios where there have been overbooked clinics, and additional factors such as annual leave or sickness may be adding to the bad situation. The task can quickly and easily become more mammoth, with each set of patient notes being added to the pile being an increased burden for the clinic. It is very easy to fall into the trap of clock watching as you try and deal with the impending crisis at hand and keep to time.

These things can impact on the service that you provide to a patient and you must remember not to get too panicked or stressed, and ensure that you take the time to do whatever is clinically necessary for each and every patient.

Tackle it as a team

If you are feeling overwhelmed regularly in a particular clinic, sitting down together as a team to discuss how you could improve things can be beneficial. For instance, if, as a team, you sit down and go through the patient list before the clinic starts, you may be able to triage the straightforward cases to junior staff and the more complex cases to senior staff, meaning the flow of the clinic can be smoother and more efficient. This is something that is very simple and easy to do in a hospital setting because all of the records are there already – and there is a wealth of information to pick through to help the process.

Maintaining stability, even when, it is busy, is very important in the healthcare environment


Reflecting matters

I would encourage hospital optometrists to reflect on the clinic at the end of the day. It is often all too easy to feel bogged down by a busy and stressful day, but stepping back and acknowledging the array of pathology that you have seen and the patients that you have cared for can bring a change in attitude and help lift your spirit.

Managers and senior clinicians should also not underestimate the value of showing their appreciation to members of the team. A small and simple gesture such as thanking someone for a job well done can make a huge difference in lifting someone up and easing the pressure of the day.

Maintaining civility, even when it is busy, is very important in the healthcare environment. Now, more than ever, research is going into this in a healthcare setting. There are some great articles to read about this on the Civility Saves Lives website.  

The bigger picture

In the long-term, data is key for the NHS for bringing improvements to any clinic that you work in, be it core optometry or extended role services.

Gathering data will allow you to demonstrate to senior management that you are doing above and beyond what is clinically safe, for example. In my experience, simply going to managers and saying: ‘We always finish late and we need more money,’ will not wash. Therefore, you must gather output data on patient activity, staffing levels, sickness levels and average patient journey times. This is all information that should be easy to get hold of in the hospital setting.

Speak to your patients to find out what the key things are that they want from the service. These will no doubt be the professional opinion that they are receiving from you, and to be seen in a timely manner.

In the past, by harnessing this data, I have been able to effectively demonstrate to senior board a need for change and improvement.