Note: The Department of Medicine has secured exam rooms in Annenberg to serve as workspaces during your time on service. For more information, click here.
Pre-Rounding Routine (7am-8am):
New patients should have been added to your service team list by 7am. The two Front Line Providers (FLPs) should divide new admissions based on current workload.
FLPs should make sure they are assigned to their patients and should make sure the appropriate attending is assigned as well.
Review the chart for overnight events, consultant notes, vitals, laboratory data, etc. (Tip: Nursing notes is a good source for identifying any issues that come up, like a patient refusing medications or reporting that a patient’s pain is not under control, etc.)
At the start of the day, you can find the BA or nurse manager to get your PPE for the day.
Rounding (8am-10am):
There is no set structure for rounding on patients. Feel free to decide as a group when and where you would like to meet.
We do not encourage seeing patients as a team, both to decrease exposure and to save PPE.
Miscellaneous Daily Tasks:
New ID consults must go through the "COVID ID Consults" identified in AMION. BMT and solid organ transplant patients should still be followed by the BMT and transplant ID teams.
In the event that a Team 7000 is called on a patient on your floor, please respond and assist, even if you are not the primary team. You can find additional guidance on how to navigate Team 7000 during the pandemic here.
There is a dedicated team handling admissions in the ED. In the event that a newly admitted patient is transferred up to your floor, please assess the patient for stability. An H&P and all necessary orders should already be in place. The attending does not need to see the patient until the next day. However, between 12pm and 6pm, if a patient is assigned a bed prior to the ED admissions team starting the admission, the floor team will be responsible for completing the admission.
Interdisciplinary Rounds (10am-11am):
Each floor has a dedicated case manager and social worker. The purpose of these rounds is to briefly discuss patients that are active or those that may be improving and nearing discharge.
You can give a very very brief clinical history about the patient, and highlight any potential barriers to discharge that you are concerned about.
The social worker will also alert you to any barriers to discharge (needing services reinstated, transportation issues, etc.).
Afternoon Huddle (2pm-4pm):
The structure and timing for the afternoon team huddle is at your own discretion.
Consider this a chance to “run the list,” identify any issues that come up, patients you are worried about and would like to sign out to the night team, and identify any anticipated discharges for the next day.
Note: You do not need to see patients as a group in the afternoon.
End of Shift (4pm-7pm):
Use this time to finish up notes, start discharge summaries, review consultant recommendations that come in, and plan for any tasks that need to be done overnight.
Take this time to ensure the Handoff tab is updated for your patient.
If you have patients you are worried about, please provide verbal signout to your corresponding night coverage. (Nightly assignments can be found here).