Embedded Files
VIR WORKFLOW Minutes
Date: 03/23/2026
DHE (hospital efficiency group) changes that will be implemented in a few weeks:
DHE (hospital efficiency group) changes that will be implemented in a few weeks:
PRU consent and H+P 7-7:10 (residents, fellows, APP, V1, V2)
Run board 7:10-7:35
Education 7:35-8:05
Inpatient H+P updates done the day before
Orders: post orders before case, PRNs into order set
Own dressing
Reminders
Reminders
PRU consents throughout the day
Don’t forget to do the H&P!
Every patient needs post-procedural orders (this includes discharge order)
E-Consents
E-Consents
Please start doing e-consents for all consents (clinic, PRU, HBR, consults)
Hospital goal to be fully electronic by 7/1
iPads
There are 6 in charging box in reading room (Courtney working on getting these functional)
Airway for Moderate Sedation
Airway for Moderate Sedation
Must have Mallampati 1, 2, or 3 to receive moderate sedation
Patients with Mallampati 4 or documented critical airway cannot receive moderate sedation
Discuss single agent or GA options with patient
Premixed Vancomycin
Premixed Vancomycin
Central inpatient pharmacy has been dispensing ready-to-use Vancomycin in IV bags for the following strengths (and now in PRU Pyxis): 750mg/150ml, 1.25gm/250ml, 1.5g/300ml
Mandatory LMS
Mandatory LMS
San-I-Pak LMS
Course code: UNCHCNESANIPAK26
Teammates now use yellow bags in addition to red and white bags to keep our waste streams separated
Kelly Devine has assigned everyone this LMS activity
VIR WORKFLOW Minutes
Date: 12/08/2025
Time-Outs and Debriefs
Time-Outs and Debriefs
Must happen for every single procedure before starting a case and before leaving the room.
Please take this seriously.
Include indication for procedure, specific line being placed, specimens being sent, etc.
Include drain/wound care instructions, follow-up plan, additional imaging needed, Rxs sent to pharmacy, specimens sent, etc.
Time-outs and debriefs must be closed-loop communication (repeat back the above).
Updates
Updates
No longer need separate consent for pregnant patients; the risks associated with radiation in pregnancy should be discussed during the normal consent discussion.
Patients are now arriving 90 minutes before the first start time.
Please put in pre-procedure orders the night before to prevent delays.
Enteral Access Team Changes
Enteral Access Team Changes
EAT to perform initial “triage” and then place a consult order if needed to come to VIR.
VIR team to do full work-up, consult note, consent, and order placement.
Reminders
Reminders
Do not use metal/Kelly clamps on Coolief procedures. Dr. David Mauro (Division Chief) is looking for an alternative.
Please listen for overhead announcements and respond promptly (consents, H&P updates, pre-scans, room ready, and attending needed for time-out). We recently had a patient wait 70 minutes for a pre-scan despite multiple overhead announcements.
If an attending performs a procedure without a resident or fellow, don’t forget to arrange follow-up for drains and/or place the next outpatient order (e.g., neph tube exchange).
Created by Courtney Evron, PA
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