How 3 orthopedic surgeons prepare for a busy day

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For some orthopedic surgeons, an upcoming busy day could mean getting extra sleep, prepping materials the night before and making the most out of each minute at the office.

Three orthopedic surgeons recently spoke with Becker's to share the steps they take to make sure they are ready to take on a busy day. 

Editor's note: These responses were lightly edited for clarity and length.

Question: How do you prepare for a busy day?

Elizabeth Arendt, MD. Professor and Vice Chair of the  Department of Orthopedic Surgery at the University of Minnesota (Minneapolis): Get a good night's sleep and eat something for breakfast, even if it is on the run. Go over the steps of your day the night before, whether it is surgeries/clinical/meetings or a combination day. 

Chris Cornett, MD. Orthopedic Surgeon at University of Nebraska Medical Center (Omaha): As a spine surgeon at a busy academic institution, I have hectic or busy days. Oftentimes, we are trying to balance a busy surgical or clinical day with outside conflicts or pressures. We are often on call as well and are trying to manage and handle things that come in and consults, while still managing our regular daily schedule.

I have found the best way to prepare for these days is to try to stay in my routine. Get a good night's rest, get my regular exercise early in the morning prior to work. Before bed, make sure I am prepared and have all necessary materials with me. I think it’s helpful to pack a mobile office so to speak, making sure I have access to any necessary charts or information that I need to deal with throughout the day, that way I can be efficient in between surgeries. I try to plan my day, and during short breaks do my rounding tasks, phone calls, follow ups, dictations and things of that nature. I try to be as efficient as I can throughout the day so I do not have a large volume of work to do at the end of the day.

Jonathan Hughes, MD. Assistant Professor of Orthopedic Surgery at the University of Pittsburgh: The keys to successfully navigating a busy day are preparation and efficiency, whether in the operating room or clinic.  

For busy clinic days, I will quickly review all my scheduled patients the day or evening before.  This ensures I know what they are presenting for and am not surprised if a complex or urgent case is being seen, as these surprises can derail an already busy day. Additionally, either my team or I will place all radiology orders so the patients are automatically sent to radiology before being brought back to the exam room. We will pend all physical therapy prescriptions for postoperative patients, adding in the protocol, so they are simply signed when the patient arrives. For all potential operative patients, we will pend a surgery order and all required preoperative testing, which can always be canceled if the patient isn't a surgical candidate or chooses to continue nonoperative care. Lastly, I try to keep up with notes, which means pausing every five to six patients and writing the notes to ensure I complete all notes prior to the clinic day ending.

For the operating room, I always plan for all aspects of the case in advance, including the worst case scenario, to ensure all equipment is available and ready so there is no delay. I ensure the room is set up appropriately and speak with the OR staff before the case starts to ensure everything is available and on site. I also verify the staff is aware of my plans for each case, and many times will write down the steps of the case, especially with complex cases, on the board so everyone can refer to the steps. For any cases requiring biplanar fluoroscopy to find anatomic landmarks, I will paste an article or picture on the wall that depicts the appropriate position. I have radiography in the room when the patient arrives to ensure set up and positioning is appropriate, as well as the ability to obtain an adequate radiograph intraoperatively. Once the patient enters the room, I place all orders and outpatient medications to save time. Once the case is complete, I write my operative note while the patient is waking up. These steps ensure I have minimal to no leftover work after the day is complete.

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