Admissions time savers Prepared by: Ameen Al-Aghil PGY-2- Categorical

Overall Admission steps Check Vitals- Chief complaint – Triage if you have multiple admissions Quick chart review: ED note- last H&P/discharge summary Print latest med list available See patient, go over med list/pharmacies, don’t forget code status Admission orders – Pre-hold if still in ED Medication reconciliation Additional orders Consults H&P- note

Flowsheet

Overall Admission steps Check Vitals- Chief complaint – Triage if you have multiple admissions Quick chart review: ED note- last H&P/discharge summary Print latest med list available See patient, go over med list/pharmacies, don’t forget code status Admission orders – Pre-hold if still in ED Medication reconciliation Additional orders H&P- note

Overall Admission steps Check Vitals- Chief complaint – Triage if you have multiple admissions Quick chart review: ED note- last H&P/discharge summary Print latest med list available See patient, go over med list/pharmacies, don’t forget code status Admission orders – Pre-hold if still in ED Medication reconciliation Additional orders H&P- note

Admission orders Today- add the following order sets: Admission order sets General: Admit order set CMC and ICU admission Cardiology: ACS order set Pulm: COPD Heme: Sickle cell crisis acute cmc Useful disease specific order sets Emergencies: Hyperkalemia, cord compression 911 and upper GI bleed Cardiology: Heart failure Pulm: Asthma, PE, Thoracentesis ID: Pneumonia, acute diarrhea, Neutropenic fever, acute meningitis and acute septic arthritis Rheumatology order set

My favorite sets

Overall Admission steps Check Vitals- Chief complaint – Triage if you have multiple admissions Quick chart review: ED note- last H&P/discharge summary Print latest med list available See patient, go over med list/pharmacies, don’t forget code status Admission orders – Pre-hold if still in ED Medication reconciliation Additional orders Consults H&P- note

Medication Rec! Very Important! 1- Outpatient Medication Review 2- Obtaining Accurate Medication list Patient/family EMR/ Pharmacy- next slide If came from SNF- Call SNF to FAX the list 3- Order Reconciliation

Overall Admission steps Check Vitals- Chief complaint – Triage if you have multiple admissions Quick chart review: ED note- last H&P/discharge summary Print latest med list available See patient, go over med list/pharmacies, don’t forget code status Admission orders – Pre-hold if still in ED Medication reconciliation Additional orders / Consults H&P- note

ISBAR tool Identification: “ Hello, My name is Ameen with Weisman Team calling for a New consult, Pt is Name, location and MRN (three identifiers) Situation: Consult question, What is going on with the patient? Background: Context and relevant hx Assessment: State what you think the problem is. Recommendation: State your recommendation about what could be done to correct the problem.

Overall Admission steps Check Vitals- Chief complaint – Triage if you have multiple admissions Quick chart review: ED note- last H&P/discharge summary Print latest med list available See patient, go over med list/pharmacies, don’t forget code status Admission orders – Pre-hold if still in ED Medication reconciliation Additional orders / Consults H&P note: Chart review

Chart review Specialty Teams: State who the Primary oncologist, nephrologist, cardiologist…. Refer to Student handbook for rotation specific instructions Physician portal- notes, EKG, prior Echo, EGD, Scopes (relevants) Clinical summary Medications received- useful for MICU/CICU transfers

Clinical summary

Medications

Acronym expansion

Questions?