Workflow 101
Each rotation has a different workflow, but the basic principles of inpatient medicine can be applied to others with some adjustment
Pre-Rounds
This is the time for information gathering. When you come in get sign-out from the night team . Labs are not usually back at this time so no need to check all patient's labs at this time unless there is a critical result. Most importantly check for any new notes and gather vitals before seeing your patient's. See and talk to each once of your patients, perform a physical exam, check weight, check o2 requirements, IV drips, and any drains the patients may have.
AM Tasks
C - consults
O - orders
L - labs
D - discharges
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PM Tasks
S - signouts
A - admissions
N - notes
D - diet/DVT ppx
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AM Tasks:
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Consults – call your consults early (preferably before noon, if not before 1:30 at the very latest) to make sure you give your consultants enough time to review charts, see patients, and provide recommendations
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Orders - place orders as soon as you’re able to (even on rounds) to try and expedite patient care
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This is also a great time to review any current orders, renew any expiring meds/foleys
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Labs - order any labs that need to be done in the afternoon and your labs for the next morning
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Discharges - discharge anyone for whom everything has been done and the attending has signed off on the discharge
PM Tasks:
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Handoffs - Create/update the handoff for your patients as things happen throughout the day so that you’ll be able to safely hand them off to your night team. This includes anything that needs to be followed up on, or things to watch out for
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Admissions - Touch base with your senior about the new admissions, anything that needs to be done to tuck them in so that you can hit the ground running for the next day
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Notes - Daily progress notes should be finished before you leave to ensure adequate communication between all providers
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Diet/DVT ppx - Ensure that anyone with a procedure the next day is NPO and that all patients have appropriate DVT prophylaxis on (or off, if appropriate!)