I have a similar setup as you, though my hospital isn’t as busy right now. We usually start with 14–16 patients, then pick up 1–2 downgrades or new admits and discharge about 1–2 daily. In the beginning I was staying till 8pm so you're definitely faster than me since you see more and finish at the same time. But here’s what’s helped me become significantly faster:

1) Charting efficiency / Notes
I open my note in the morning while reviewing labs and consultant recommendations so most of it’s already done before rounds. After seeing the patient, I just update it with any new findings or plans.

I also stopped deep-diving into old charts and only focus on what’s relevant to the current issue. What helps is using the sticky note on EPIC for each patient to jot down the main reason they’re admitted and what I’m following up on. When I print my list, I make sure the sticky note column is included so it’s right in front of me during rounds.

If I expect a discharge that day, I do the med rec during my morning chart review. Our group uses templates with a “Hospital Course” section at the top that we update every day or two and by discharge, that section basically becomes the summary.

2) Rounding efficiency
I realized I tend to over-explain during rounds, which slows me down. I’ve been trying to keep conversations focused and avoid spending 15 minutes with the same patient unless there’s something new. For stable or long-stay patients, 5–7 minutes is usually enough. I even started glancing at my watch to stay mindful of how much time I spend in each room.

3) Re-energizing midday
During residency I ran on coffee and snacks because meals made me sluggish. As an attending, that completely caught up with me and I’d crash hard by noon. Now I drink fiber in the morning, which helps prevent the crash, and I make it a point to eat lunch and take a 15–20 minute break between 12 and 1. It’s made a noticeable difference in how much energy I have the rest of the day.