Juggling act: Balance short- and long-term goals to see tangible results

It's officially fall. And if we didn't feel so already, the earlier sunset reminds us that there are hardly enough hours in a day to accomplish everything on our lists.

For me, with work and home life all jumbled under one roof, some days I need to put all of my energy into achieving the bare minimum (i.e., meeting the day's deadlines and keeping the kids in one piece). On days that are more open (feasibly because I forgot to be somewhere), it takes discipline to use that time wisely. The kids will probably live on their own by the time I truly get it down, but the gist of what I try to do is find the most productive way to balance short- and long-term goals.

The tremendous list of work to do at your medical practice can be less overwhelming with a similar approach. For example, the content of this weekly email briefing alone bombards you with at least five weekly action items. It's my job to deliver you a steady dose of advice, but I can understand how the help part might get lost in the cacophony of voices telling you to get ready for ICD-10, build your medical home, join an accountable care organization, try out block scheduling, use Twitter, deliver better customer service and improve how you communicate with patients. With all of that, when are you supposed to see patients?

You likely already sort these into immediate priorities and "other." But what I found over years of talking with physicians and office managers, is that items tend to stay in the "other" category until or slightly after a deadline or regulatory enforcement pushes them onto the urgent list. This dynamic is understandable, but it holds many practices back from performing optimally.

So, if you haven't done so already, create a formal grid of your practice's short- (daily) and long-term (strategic planning, regulatory) tasks, and update it weekly. It may look something like this:





EHR conversion

Jan. 2015

Ruled out vendor A, B

ICD-10 switch

Oct. 1, 2015


Enhance physician-patient communication



Improve employee engagement



Earn NCQA medical home designation

Jan. 2016




Meet with vendor X, Y



ICD-10 internal testing

Tuesday, Thursday


Communication workshop



Anticipate special scheduling needs



Managers walk around and check in with employees

10 minutes daily, rotating departments



Your daily huddles and weekly or biweekly staff meetings are good times to review and update this tool. Even though my charts are made up, many of your large long-term goals will appear more bite-sized, on your short-term list as well. While the correlation between some will be obvious (e.g., steps to ICD-10 readiness), others may be more subtle. For example, your target date for certification as a medical home is so distant you don't have check-offable tasks on your list every week. But the focus you place on improving office function, morale and patient-centeredness every day will help contribute to that larger goal. Similarly, steady attention to physician-patient communication should, in theory, help improve patient compliance, thus helping your practice achieve its quality metrics.

So even on the days it's all you can do to get through the patient visits on your schedule, doing so in ways that align with goals will noticeably count toward your progress. - Deb (@PracticeMgt)