Task Management - Does anyone really have the answer?

I've read a lot of books on organizational skills, time management and project management, and yet I still struggle with task management. Because I'm managing a multitude of projects, I often, despite my best efforts, find myself in crisis management mode which leaves me feeling less than accomplished at the end of the day.

How does one balance working on a project, which for me requires uninterrupted time to focus, with multiple daily interruptions and a bunch of single straggler tasks that also need to be done outside of projects? Some of the books will tell you that you should start saying no to projects in order to lighten your load and to increase the efficiency with which you can complete the projects to which you have already agreed. In health care, this is an inordinately difficult task to accomplish, in my opinion. There is always the risk that if something doesn't get done, then patient care could hypothetically suffer. This is true of directing and maintaining information systems and services just as it is in providing direct clinical service to patients. While the impact of not providing direct clinical service has much more immediate impact to an individual patient, the impact of not correcting information system issues can have both an immediate and far more wide-reaching impact to much larger numbers of patients.

Electronic and paper-based management systems each have their own advantages and disadvantages. Calendars are definitely best left electronic, in my opinion, because of the advantages of others in my organization being able to query my calendar for meeting time. While this may seem like facilitating the interruptions previously moaned about, on the flip side these meetings would get scheduled anyway, and at least this way I don't have to take the time to search my calendar to find potential times for a meeting, e-mail that back to the sender, get the time and date for the meeting from the sender, and then manually schedule it in my calendar. Of course, sometimes we go through multiple iterations of the sending back and forth by e-mail when the electronic scheduling assistant is not used, and this is, quite frankly, highly annoying.

Task management systems, however, are another story. Most calendaring programs provide good task management for people who have less than 100 tasks in their master task list. For people with 40 projects and about 2000 tasks to be completed, these applications are lacking in that they don't have master task and child task capability that is formatted in an indented manner. If you are a Microsoft shop, as we are, then you know that Microsoft provides this capability, but it requires Microsoft Project Server Accounts which many institutions don't have. These have the additional advantage of tying in all of the people on your project to the same project planning file.

So what do you do when you don't have this? More importantly, what do you do to keep up when you don't have access to a computer to keep things up to date? PDAs can be helpful. My PDA is synced to our Exchange server; but I find that looking at tasks on my PDA is frustrating because of the limited view, difficulty in adding new tasks using the stylus (takes a lot longer than typing), and the amount of time it takes to pull 2000 tasks up into view.

I'm still in search of a good task management system that balances trying to complete about 40 projects at one time (some of which are quite large and time consuming; others not) with daily clinical service, teaching and research responsibilities. If anyone who reads this blog has any good suggestions, I'm all ears.