Hospitalist Workflow and Priorities - Revision history

JenniferH: /* Signing out a service */

2020-12-16T21:25:49Z

Signing out a service

← Older revision		Revision as of 21:25, 16 December 2020
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	[[:category:Inpatient\|Hospitalist Main Page]]		[[:category:Inpatient\|Hospitalist Main Page]]
	<br/>[[:Category:~~Pediatric~~\|Pediatric Main Page]]		<br/>[[:Category:Pediatrics\|Pediatric Main Page]]

JenniferH: /* Signing out a service */

2020-12-16T21:25:13Z

Signing out a service

← Older revision		Revision as of 21:25, 16 December 2020
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	[[:category:Inpatient\|Hospitalist Main Page]]		[[:category:Inpatient\|Hospitalist Main Page]]
			<br/>[[:Category:Pediatric\|Pediatric Main Page]]

JenniferH: /* Getting the Day Set and Organized */

2020-12-16T21:22:59Z

Getting the Day Set and Organized

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 ** New admissions
 ** Finish rounding as early in the am as possible to leave time for RMT, consults (peds), emergencies, OB (FM), follow-ups, etc.
 ==Admissions==

JenniferH: /* Signing out a service */

2020-11-10T19:35:38Z

Signing out a service

← Older revision		Revision as of 19:35, 10 November 2020
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	If a patient is admitted for longer than five days or has a complicated course, an off service note should be completed when ending your wards rotation. In place of the above, a detailed daily SOAP note should suffice.		If a patient is admitted for longer than five days or has a complicated course, an off service note should be completed when ending your wards rotation. In place of the above, a detailed daily SOAP note should suffice.

	[[:category:Inpatient]]
			[[:category:Inpatient\|Hospitalist Main Page]]

JenniferH: /* Discharges */

2020-10-09T01:08:43Z

Discharges

← Older revision		Revision as of 01:08, 9 October 2020
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	'''E&M Charges''': An E&M charge order must be placed for each day a patient is seen. If you come on service and charges have not been entered by the proceeding physician, please back enter them for them :)		'''E&M Charges''': An E&M charge order must be placed for each day a patient is seen. If you come on service and charges have not been entered by the proceeding physician, please back enter them for them :)
			==Hospitalist Documentation ==
			Providers are encouraged to review other provider’s pre-completed notes in their free time and modify/create their own pre-completed notes when time allows.

			Freetexting HPI and Plans is encouraged in all provider notes. A freetexted brief description in the HPI of the chief complaint and pertinent history plus a free text A/P with decision making info, plan and needed f/u will make the next provider’s job easier. Providers are also encouraged to use “Other Diagnosis” field to pull the Diagnoses in the note. This will be important for ICD-10.

	==Discharges==		==Discharges==
	Remember that discharge planning should begin early to anticipate equipment, follow up, travel and other challenges. Interdisciplinary rounds can help with this process.		Remember that discharge planning should begin early to anticipate equipment, follow up, travel and other challenges. Interdisciplinary rounds can help with this process.
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	'''Note''': For pediatric discharges there is a peds custom patient education sheet documenting this information that should be given to the parents/caretakers.		'''Note''': For pediatric discharges there is a peds custom patient education sheet documenting this information that should be given to the parents/caretakers.

	'''Update the Problem List''': It is important to update the diagnoses and problem list for each patient on discharge. Think about what you would like to know, at a glance, about this patient for a future ER visit, RMT, admission etc. You can add additional to any diagnosis or for further detailed information. A well kept problem list, with notes on plan of care/therapeutic goals/important follow up needs etc provides ongoing continuity and good patient care.		'''Update the Problem List''': It is important to update the diagnoses and problem list for each patient on discharge. Think about what you would like to know, at a glance, about this patient for a future ER visit, RMT, admission etc. You can add additional to any diagnosis or for further detailed information. A well kept problem list, with notes on plan of care/therapeutic goals/important follow up needs etc provides ongoing continuity and good patient care.

	==Signing out a service==		==Signing out a service==
	If a patient is admitted for longer than five days or has a complicated course, an off service note should be completed when ending your wards rotation. In place of the above, a detailed daily SOAP note should suffice.		If a patient is admitted for longer than five days or has a complicated course, an off service note should be completed when ending your wards rotation. In place of the above, a detailed daily SOAP note should suffice.

	[[:category:Inpatient]]		[[:category:Inpatient]]

JenniferH: /* Getting the Day Set and Organized */

2020-10-09T01:00:56Z

Getting the Day Set and Organized

← Older revision		Revision as of 01:00, 9 October 2020
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	==Getting the Day Set and Organized==		==Getting the Day Set and Organized==
	* Get Sign Out from ~~NF Doc~~		* Get Sign Out from Night Float Doctor
	* Meet with Nurses and RT to check on patients		* Meet with Nurses and RT to check on patients
	* Let Charge Nurses know of any discharges		* Let Charge Nurses know of any discharges

JenniferH: /* Special Situations */

2020-10-09T00:55:55Z

Special Situations

@@ Line 53: / Line 53: @@
 '''E&M Charges''': An E&M charge order must be placed for each day a patient is seen. If you come on service and charges have not been entered by the proceeding physician, please back enter them for them :)
 ==Discharges==
 Remember that discharge planning should begin early to anticipate equipment, follow up, travel and other challenges. Interdisciplinary rounds can help with this process.

JenniferH: /* Common Pediatric Admissions */

2020-10-09T00:51:32Z

Common Pediatric Admissions

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 In general, vital signs on the unit are done every four hours. Diapers can be weighed for strict I’s & O’s if necessary. The nurses are able to place IV’s and draw blood. Parents typically room in with their children; however, siblings under the age of fifteen are not allowed on the ward overnight. Children who require high flow O2, continuous IV drips, central lines, close monitoring, imaging or evaluation not available at YKHC or who require NICU or PICU level care are transported to ANMC or Providence Hospital in Anchorage. Occasionally we will admit a patient that is pretty sick, but is felt to have a good chance of improving. If this is not happening in the expected length of time, the nursing or RT staff is uncomfortable with the patient or if you feel the patient is getting worse—do not hesitate to transfer the patient to Anchorage. YKHC PEWS scores should be completed and reviewed on patients who worsen during their admission. This is done to identify, as early as possible, the patients who may need a higher level of care.
 ==Rounding==
 '''Progress Note''': Every patient must be rounded on daily and have a progress note completed. Daily progress notes must be written in a SOAP note format. There are templates and shared SOAP Note/Progress Notes to choose from and modify if desired.

JenniferH: /* Common Adult Admissions */

2020-10-09T00:39:06Z

Common Adult Admissions

Show changes

JenniferH: /* Signing out a service */

2020-10-09T00:38:20Z

Signing out a service

← Older revision		Revision as of 00:38, 9 October 2020
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	If a patient is admitted for longer than five days or has a complicated course, an off service note should be completed when ending your wards rotation. In place of the above, a detailed daily SOAP note should suffice.		If a patient is admitted for longer than five days or has a complicated course, an off service note should be completed when ending your wards rotation. In place of the above, a detailed daily SOAP note should suffice.

	[[category:Inpatient]]		[[:category:Inpatient]]