One way to optimize staff abilities is to establish protocols for conditions and processes that can be clearly delineated. The following are some examples:

• Develop a standard process for flu and pneumococcal vaccinations so that a nurse or other appropriate provider can administer shots according to established guidelines.
• Develop nurse-run or pharmacist-run hypertension, allergy, or INR clinics based on protocols.
• Ask physicians to sign off on standard advice protocols for home care.
• Write protocols for ordering an initial lab or radiology for certain symptoms (such as urinary tract infection, strep throat, or suspected broken bone) at the office visit, or to replace a physician visit with a nurse visit.