Updated 7.8.25
Transition of Care Pharmacist
“Pharmacy – Misc Consult” order for any patients who are going home soon and may struggle with medications
Consider for: IV/SQ meds, medication weans/tapers/ titrations, keto diet, TPN, rare meds, meds needing prior authorization, family who struggles with resources, understanding, or compliance.
When you place the order, put in the details why you feel this patient needs pharmacist support and anticipated discharge.
Available M-F 8a-4p and is on Voalte.
WhiteBoards
More space - Please use daily
Use when huddling
Update daily
Sepsis Alert
-Alerts only for severe sepsis - truly sick kids
-Expectation for bedside huddle for all alerts
-Must complete risk mitigation form
Consults
OMFS Option - Dr. Doug Olson, Orthodontist - For contact info, check with Hospitalist on call or Doc of the Day
Dermatology Consults - Click here for tip sheet
New Asthma Inpatient Guidelines - Click here for flowchart
Bronchodilator Protocol with Details
Discharge Checklist
-Use of discharge checklist - for your hyperbili and AGE patients this week, please check in with your team/nursing on patient admission (arrival huddle or first rounds are good opportunities) to ensure the discharge checklist is filled out to help our teams focus on discharge readiness from day 1. Example checklists attached—nursing should have a paper copy already on the chart (except 5E—not participating yet). Send any comments/concerns to Dr. Britanny Wincklerdischarge_criteria_for_hyperbilirubinemia.docx
Virtual RN
-Pilot on 5E at this time
-Click here for PDF
Senior Reminders
1) Make sure day attending name is updated on the list
2) Keep an eye on the list. If approaching 20 patients, notify Doc of the Day for redistribution to Platinum. Identify a few patients with your day attendings which patients may be good candidates for off loading.
3) Triage your patients for rounds, round on new ones/sick patients first
4) Update attendings in AM which patients can be seen early prior to rounds for discharge. Can be on the same group text with case management and SW so everyone is aware
5) Weekend residents holding phone should keep attendings notified of new admits to prevent delayed staffing (and overflow into night shift)
6) Keep ED Covering MD boards updated
9) Admissions - Use order sets - IPR vs OPO
Additional Tips:
1) Ensure logged into Voalte at start of shift. Incorporate this into your verbal sign out
3) Huddle with nursing at bedside upon arrival to floors, discuss patient plan of care using 5P's, document in Cerner Checklist
4) Discussions regarding non urgent orders with floor charge nurses
5) Use consult templates!
“Pharmacy – Misc Consult” order for any patients who are going home soon and may struggle with medications
Consider for: IV/SQ meds, medication weans/tapers/ titrations, keto diet, TPN, rare meds, meds needing prior authorization, family who struggles with resources, understanding, or compliance.
When you place the order, put in the details why you feel this patient needs pharmacist support and anticipated discharge.
Available M-F 8a-4p and is on Voalte.
WhiteBoards
More space - Please use daily
Use when huddling
Update daily
Sepsis Alert
-Alerts only for severe sepsis - truly sick kids
-Expectation for bedside huddle for all alerts
-Must complete risk mitigation form
Consults
OMFS Option - Dr. Doug Olson, Orthodontist - For contact info, check with Hospitalist on call or Doc of the Day
Dermatology Consults - Click here for tip sheet
New Asthma Inpatient Guidelines - Click here for flowchart
Bronchodilator Protocol with Details
Discharge Checklist
-Use of discharge checklist - for your hyperbili and AGE patients this week, please check in with your team/nursing on patient admission (arrival huddle or first rounds are good opportunities) to ensure the discharge checklist is filled out to help our teams focus on discharge readiness from day 1. Example checklists attached—nursing should have a paper copy already on the chart (except 5E—not participating yet). Send any comments/concerns to Dr. Britanny Wincklerdischarge_criteria_for_hyperbilirubinemia.docx
Virtual RN
-Pilot on 5E at this time
-Click here for PDF
Senior Reminders
1) Make sure day attending name is updated on the list
2) Keep an eye on the list. If approaching 20 patients, notify Doc of the Day for redistribution to Platinum. Identify a few patients with your day attendings which patients may be good candidates for off loading.
3) Triage your patients for rounds, round on new ones/sick patients first
4) Update attendings in AM which patients can be seen early prior to rounds for discharge. Can be on the same group text with case management and SW so everyone is aware
5) Weekend residents holding phone should keep attendings notified of new admits to prevent delayed staffing (and overflow into night shift)
6) Keep ED Covering MD boards updated
9) Admissions - Use order sets - IPR vs OPO
Additional Tips:
- For early AM admits - Seniors to eyeball/ put in orders, have a med student do admit. Ok if not fully ready to present new admit at the end of rounds
- For weekends – post call senior should sign out and leave, but expectation is that the intern can stay a few hours longer to continue to tie up loose ends. Intern to message covering senior with updates and that they are leaving. Attending also around to help support intern wherever needed.
- For weekend rounds – in an effort to improve efficiency, the expectation is that whole team will not round bedside on every patient if high census. Can “table round” on most patients and go to bedside of acute and actively changing patients. Make sure to update RNs on all plans and that attending will be by later for those not rounded at bedside
1) Ensure logged into Voalte at start of shift. Incorporate this into your verbal sign out
3) Huddle with nursing at bedside upon arrival to floors, discuss patient plan of care using 5P's, document in Cerner Checklist
4) Discussions regarding non urgent orders with floor charge nurses
5) Use consult templates!
