Controlling Your Chaos

A female wearing glasses, a yellow shirt, and jeans, sitting at a desk in front of a computer while also looking at a phone.

Essentialism is the art of saying “no.” The goal is to discern what is absolutely necessary and then eliminate everything else. If you're reading this article, you likely said goodbye to Essentialism long ago or, like many in laboratory medicine, saying “no” is not an option in the picklist of your day.

The overwhelming amount of work we all take on in the name of patient care is a fact of life, so this article is focused on providing you survival skills to control the chaos that is inevitably coming your way. Like many aspects of life, we have control only over our own actions. For that reason, we will start with how to control the chaos of our own making.

START WITH YOURSELF

Discipline goes a long way when it comes to successful time management. Having a routine and sticking with it is key to making any combination of time management approaches successful. Beware, the tips and tricks in this section are geared towards those who embrace technology. But even if you are a pen and paper individual and rarely turn to technology to solve problems, there are still concepts to extract from the information below.

KEEPING TRACK OF NEW TASKS

A major challenge is that new tasks come from many avenues. We get requests via email, phone, unplanned conversations (digital or in person), and scheduled meetings. Takeaways that require action or follow-up can be incorporated in real time with note-taking and are easier to capture. Setting aside time at the end of the day to review notes and collect to-dos is a valuable way to end the day.

Try to categorize tasks into three categories: 1) immediate response required, 2) not urgent and minimal effort, and 3) not urgent but substantial time required.

The first category gets acted on immediately, requiring little to no focus on scheduling and tracking. For these types of issues, it's important to assure they are urgent and document them after the fact if required. Although the task itself may get taken care of, it may be necessary to submit a report, notify several teammates of a decision, or take an action. For these reasons, this “immediate” task could easily flow into the second or third category requiring additional steps.

For non-urgent and minimal effort issues, the biggest challenge often is keeping track of them. If the task arrives via email, simple flagging of the email is a nice approach—assuming it does not get overused. It can be useful to set expectations around flagged emails, such as all requiring follow-up the same day.

It is important to note that “follow-up” does not necessarily mean completing the task. Any action that moves the issue closer to resolution or into the larger issue tracking process can be a follow-up. Sometimes, even a simple reply to say, “I received your request—I’ll take a look,” can go a long way toward maintaining healthy communication.

SWEATING THE SMALL STUFF

Small to-dos from phone messages or unplanned conversations are often best served by having a lightweight list program available. Many email providers feature an integrated task program that can track flagged emails and create lists based on them. More specialized or curated lists can help you avoid losing items in the shuffle. For example, a list specifically for your direct supervisor is always a good way to ensure needs are met in a timely manner and the small things are not forgotten.

Direct reports, volunteer organizations, and specific projects are all examples of lists that can help to organize your thoughts and the demands that come your way. The risk with this strategy, however, is that tasks are not tracked beyond simple due dates. For that reason alone, it is best to use this approach for short-term needs and bump larger efforts to another system for tracking.

For time estimating purposes, leave items on these short-term lists only if the total time will be 15 minutes or less to complete.

TACKLING THE LARGER TO-DOS

The larger, more demanding tasks are where we often run into trouble. Depending on your work style, you may enjoy the sense of fear that comes from a deadline approaching. Or perhaps you truly believe you do your best work under pressure. It’s important to work in the manner that is most sustainable for you. For the purposes of this article, we’ll assume a more measured approach and introduce the use of task-management software.

There are numerous ways to keep track of larger efforts, and for tasks that are solo efforts, you have considerable latitude. If your organization has a task-management software system, it may be easy to get a spot within that ecosystem. These often are free to you, feature-rich, and integrated with existing tools.

Regardless of the program, there are several key components to track: 1) due date, 2) estimated time, 3) priority, 4) start date, 5) time spent, and 6) dependencies. Most of these are obvious and require little explanation; however, it is important to highlight the value of a few concepts.

First, estimated time is the amount of time in minutes or hours the task is anticipated to take, and should not be confused with duration of the task. You may estimate a task due by the end of the day on Friday will take 2.5 hours to complete. If it is only Tuesday, you might work 1 hour on Wednesday and Thursday and finish up the task on Friday before it is due. The duration is 3 days, yet the time devoted to the task is only 2.5 hours. This distinction is valuable for tasks due weeks or even months out that might only take a few hours to complete. For this reason, the start date plays a useful role and will make sure there is sufficient time to devote based on the estimates you made.

Of course, those estimates are not useful if they’re inaccurate. This is why time tracking is vital, offering real-time feedback of how accurate our time estimates are. Being able to mentally think through what will go into an effort, assign a time estimate, and then track how accurate our estimate was is invaluable.

Often, we don’t have all the pieces to make a completely accurate estimate, and this is the art of time management. If we’ve tracked other efforts, we can use similar tasks to refine our estimate rather than using generic fudge factors like 1.5x the original, unfounded estimate.

PUTTING ALL THE PIECES IN A BOX

One of the most valuable strategies for managing time is timeboxing. At its core, timeboxing is converting that long to-do list into blocks of planned time on your calendar.

Getting started with timeboxing is easy. Just start blocking off focus time or work time on your calendar more regularly. If your schedule allows, you may be able to keep a regular cadence and block recurring times for independent work, keeping interruptions and meetings to a minimum. The limitation to this approach is that it does not ensure you will be devoting sufficient time daily to planned tasks.

To use timeboxing efficiently, it helps to explicitly plan out the work you’ll be doing each day. How far into the future you plan is up to you. Like the end-of-day ritual described above for collecting to-dos, a valuable morning routine is to timebox new tasks, adjust proposed plans, and review what is coming up.

If you are worried about filling up too much of your calendar, consider scheduling your task-related work as “tentative” and alerting your teammates that tentative time is available as needed. Scheduling tasks as “free” keeps your calendar wide open but can be a dangerous path towards never having enough time allocated to your to-dos.

WORKING WITH OTHERS: CONTROLLING ORGANIZATIONAL CHAOS

When managing a specific project, most of your time will be spent on the execution phase. But before you begin, there are three key questions to ask. 1) Is there a clear understanding of what we need to get done by all involved? 2) How much time do we have to complete the project? And 3) how many people or resources do we have available?

A project manager can combine these questions with a stepwise approach to develop the overall plan. Once you have a project plan defined and agreed upon, a regular cadence of reviewing the plan, following up on tasks, and reporting on status can start (see sidebar).

MAKING IT OFFICIAL: STARTING AND LEVERAGING TRUE PROJECT MANAGERS

If you are considering a project management office (PMO), it is important to understand the difference between project management and a PMO. Though these two are interlinked, they can be mutually independent of each other. The Project Management Institute (PMI) defines the landscape of project management as “the use of specific knowledge, skills, tools, and techniques to deliver something of value to people.”

PMI also provides Project Management Professional (PMP) Certification, which is typically obtained by project managers. There are two criteria to be able to qualify to take the PMP test: one based on education and the second on project management experience. More information can be found on their website, www.pmi.org.

Of note, an organization does not need PMI-certified project management professionals to be able to set up and start a PMO. The PMO also can be independent of individual project managers and be comprised of cross-functional leaders that come together to define and share best practices that will lead to successful project completion and value creation. However, having project managers as a part of the PMO will be beneficial, as they will be the ones executing and enforcing the best practices and processes defined by the PMO.

PROJECT MANAGER BACKGROUND, SKILLS, AND PERSONALITY

There may be existing team members who already perform duties of a project manager or have the necessary skills to become one. Key skills include well-rounded operational experience, communication, and time-management.

On the operational side, it is critical that the project manager understand the components that make up the project. An alternative would be an individual who understands the process in its entirety and can spend a week or a month learning each process step to gain deeper understanding and experience. Communication and time-management skills ensure team members don’t become overwhelmed but work efficiently to achieve the project goals.

Last but not least is a desire to help others. Every project manager and his or her team members will face roadblocks. A successful project manager not only reports the issues, but also works with team members to solve the problem and deliver value.

WRAPPING IT ALL UP

Like all careers, success in laboratory medicine depends on a person’s career path, training, and personality traits. But even the brightest star can burn too bright if time is not well managed.

One may have the experience, skills, drive, and certifications required to be successful but ultimately fall short if stretched too thin. Learning to say “no,” having the discipline to stay on track, and working successfully as part of a team are all critical for success. Whether officially managing a project or just managing the project that is your career, the tips and tricks above will help you burn both bright and steady through all the inevitable chaos.