Intern Workflow

Pre-rounds

• • Grab phone and pager

  • Print out List(s)

  • Review patients:

    • Call nurse about overnight status

    • MD to MD notes

    • IP Snapshot 24-hr vitals

    • I/O

    • Drains and outputs

    • MAR - pain meds

    • Check Meds and Orders

    • Check Imaging and Results

    • Prep note for rounds (.pn or copy over)

Rounds

• • Supplies: gauze, tongue blades, cotton swabs, 14 French suction, suture removal kit, 18-gauge (flaps), scalpel, ABD pad, Kerlix, alcohol pads

  • Note exam and plan in patient's chart

    • Dispo plan (new meds, SNF, f/u appts, etc.)

  • Make to-do list

  • Update MD to MD

Consults

• • Get patient name, MRN, room, urgency of consult

  • Add patient to HNS Team List

  • Determine if urgent or non-urgent

  • Bump up immediately if urgent (i.e. airway, etc.)

  • See patient (refer to Consult Guidelines)

  • Present to upper year or attending (p-phone, on-call)

  • Write note

Pre-op

• • Go over meds, labs, notes

  • See patient, go through pre-op EPIC flowsheet (review PTA meds, review allergies), and add interval H&P (.inteb)

  • Check in with OR (grab gloves, headlights, etc.)

  • Review case (refer to Surgical Cases)

Intra-op

• • If scrubbing into case, inform circulator of phone and pager

Post-op

• • Write brief op note (w/in 30 mins) and/or long op note (w/in 24 hrs)

  • Review meds and place transfer/discharge orders

  • Log case

Discharge

• • Reconcile meds and orders

  • Complete Discharge summary

    • Inpatient (.dcsumm)

    • Outpatient/23 hours (.dcsummas)

  • Discharge instructions (.dcihns)

Downtime

• • EAT AND HYDRATE!

  • Chart check and follow up with any new results

  • Work on Discharge Summaries

  • Pop into an interesting case