New Admissions - Who's Doing Admissions and When:
WEEKDAYS
5am-8am: Day Team
8am-11am: Platinum - Meant to protect resident rounds, learning, education
– Attendings may exercise judgment in assigning admits to resident teams
– Depending on Volume/census, good learning cases
11am-5pm: Day Team
5pm-630pm: Housestaff
630pm-5am: Night Team
WEEKENDS
5am-5pm: Day Team (Eyeball/place general orders 5pm-6pm)
5pm-5am: Night Team (Eyeball/place general orders 5am-6am)
5am-8am: Day Team
8am-11am: Platinum - Meant to protect resident rounds, learning, education
– Attendings may exercise judgment in assigning admits to resident teams
– Depending on Volume/census, good learning cases
11am-5pm: Day Team
5pm-630pm: Housestaff
630pm-5am: Night Team
WEEKENDS
5am-5pm: Day Team (Eyeball/place general orders 5pm-6pm)
5pm-5am: Night Team (Eyeball/place general orders 5am-6am)
PICU and Specialty Primary Admissions
1) Dial x15588 to reach PPC and do 3 way call with PPC for admissions
2) Send photo of White Card back to admitting group text for your attending to review. (Opportunity for attendings to review and check vitals, look for any red flags)
3) Proceed with Admission Process (See next section for details)
2) Send photo of White Card back to admitting group text for your attending to review. (Opportunity for attendings to review and check vitals, look for any red flags)
3) Proceed with Admission Process (See next section for details)
Admission Process
- Place name on ED tracking board under ED All Beds "Covering Physician"
- Place name on Medical Sign Out (Ad Hoc)
- Put your last name AND pager # on the whiteboard
- When interns are sending a consult to specialists, please include/CC your senior. If you are away from the computer, your senior can let you know that the specialist replied, and you can log into a computer to read the recommendations and reply.
- See patient, perform H&P
- Use sensitive notes when appropriate
- Review H&P and plan with senior resident
- Place orders - Use order sets
- IPR vs. OPO
- Med Reconciliation - Patient Safety Issue
- H&P Note
- Discharge Summary
- Ensure diagnoses are updated. Tip Sheet Here
- Huddle with RN at bedside once arrived to floor
- Staff with Attending
Floor Arrival Communication - MD to RN
Acknowledge arrival texts via Voalte
Huddle with RN at bedside to discuss plan of care
Discuss using 5 P's
Checklist (Bottom right hand corner of SummaryM), Click "RN Updated", Change from Red to Green Bear
CLICK HERE FOR FULL DOCUMENT ON INSTRUCTIONS
Huddle with RN at bedside to discuss plan of care
Discuss using 5 P's
Checklist (Bottom right hand corner of SummaryM), Click "RN Updated", Change from Red to Green Bear
CLICK HERE FOR FULL DOCUMENT ON INSTRUCTIONS
Care Guidelines
Utilize care guidelines for majority of diagnoses
–Order Set (Contains)
–Pre-checked nursing/patient care phrases
–Management suggestions: Antibiotics, treatments, consults
–VTM and Ketogenic Readmission Care Guidelines
Can be added on at any time
Can use more than one (ie. febrile neonate, pyelonephritis)
–Order Set (Contains)
–Pre-checked nursing/patient care phrases
–Management suggestions: Antibiotics, treatments, consults
–VTM and Ketogenic Readmission Care Guidelines
Can be added on at any time
Can use more than one (ie. febrile neonate, pyelonephritis)
PACU Admits
Needs admission order in Cerner prior to being able to move patient out of PACU
-Admit To: Hospitalist order
-Diet
-Pain meds
-Admit To: Hospitalist order
-Diet
-Pain meds
PICU Transfer
Clean up PICU orders
–Change Admit To: Hospitalist
PICU transfers “bounce back” to a team if intern still on service
–Change Admit To: Hospitalist
PICU transfers “bounce back” to a team if intern still on service
Heme/Onc
Residents cover Heme admits on weekdays 1630-1800 and 0600-0800
Residents cover Heme/Onc admits on Saturday/Sunday 0600-1800
Residents cover Heme/Onc admits on Saturday/Sunday 0600-1800