Clinical Scorecard: How to Avoid Burnout in a High-Volume Clinic

At a Glance

Key Highlights

• Pre-charting several days before clinic shifts cognitive work to quieter moments, improving decision-making quality.
• Prioritize visit pacing by assessing if new decision-making is required; slow down for complex cases and move efficiently for routine follow-ups.
• Redistribute tasks among team members to maximize skill utilization and reduce physician clerical burden.

Guideline-Based Recommendations

Diagnosis

• Recognize signs of cognitive overload and burnout related to clinic workflow and volume.

Management

• Implement pre-visit chart review to prepare for patient encounters ahead of time.
• Use a triage question to determine visit complexity and allocate appropriate time.
• Delegate clerical and routine tasks to trained staff to preserve physician focus for complex care.

Monitoring & Follow-up

• Continuously assess clinic flow and cognitive load to prevent defaulting to habits or deferring decisions.
• Monitor physician well-being and quality of clinical decision-making throughout the clinic day.

Risks

• Ignoring cognitive bandwidth constraints can lead to missed subtle findings and decreased care quality.
• Absorbing incomplete tasks personally may cause exhaustion and burnout over time.

Patient & Prescribing Data

Patients in high-volume ophthalmology clinics with varying visit complexity

Efficient clinic design and team-based care improve patient encounter quality without compromising care.

Clinical Best Practices

• Review patient charts several days before clinic to prepare for visits.
• Assess each visit for need of new decision-making to guide pacing.
• Delegate routine tasks such as record retrieval and follow-up calls to clerical staff and technicians.
• Maintain consistent and efficient workflows to preserve cognitive resources.
• Design clinic days intentionally to protect quality of thinking from first to last patient.

References

• Real World Ophthalmology