Jason Haag Intern Conference

 Plan ahead  Use Resident Assistants to  Make follow up appointments  On WebCis f/u lists  Fax discharge summaries/patient information

 Plan ahead  Talk to your patient  How do they pay for meds?  Who is going to pick them out?  How long will the hospital stay be?  Who do they live with at home?  Do they have home health/home PT already in place?

 Start your discharge summary  Can put in procedures  Secondary diagnosis  Follow up appointments  Pertinent labs  Start the hospital course

 Brief Discharge Summary  Most important take home message to patients  Diagnosis  what you have/had done  Medications  ***reconciled with home list***  Discharge instructions  What to do/what to look out for  Follow up appointments  Does not have to be exact date

 Talk with Social Worker  Be very nice to these people…  About  Ride  They can provide one (ambulance, taxi, bus)  Medications  They can help pay for them (pharm assistance)  Home Health/Home PT  They can arrange it

 Talk with the Nurses  Keep them in the loop  Nurses will provide  Patient education  How do I administer lovenox, do accuchecks?  They will decipher your discharge summary into patient talk  Make sure they understand what’s going on with the patient

 Talk with Home Infusion  Talk early and often  They provide home IV therapy  Can arrange IV therapy on Saturday  Can arrange acute changes in antibiotic choice  IF they know about the patient ahead of time

 Communicate with PCP  Don’t have to call  Send phone message with dx/tx  Not a novel (they can read your d/c summary), just give them a heads up

 TALK WITH THE PATIENT!!!!!!!!!  They will have questions that they want their doctor to answer  The more time you put in early in the day answering questions will save you later

 Key Points  Carry over all diagnosis  Reconcile medication list  Procedures/imaging  No need to list every CXR, KUB  Pertinent Labs  Admission Chem-10, CBC  Special labs

 Hospital Course  List by problems  Overview of hospitalization  Not on HD#1…then on HD#2…  Express the maximum amount of information in the minimum amount of space  Be clear, concise, and coherent  The longer it is, the less likely someone is to read it

 Must do Brief Discharge Summary  To dictate or not to dictate  +/- of dictation  If you start falling behind  They will find you…  Medical Records keeps a log of physician of record and will track you down for delinquent d/c summaries  If you are too delinquent they won’t let you work (i.e. won’t pay you) till your caught up