SignOut

  • sign out / change of shift documentation:
    • identification:
      • initials:
      • room number:
    • status of ed care:
      • aware-
        • admitted, pending admission orders/bed
        • discharged, pending departure
        • transferred, pending transport
      • sign out –
        • pending at this time:
          • labs,
          • imaging,
          • recommendations from consultant,
          • re-evaluation / observation
            • for
    • acuity:
    • patient summary:
      • working diagnosis:
    • action list:
      • follow up on labs,
      • follow up on imaging,
      • follow up on consultant recs,
    • situational awareness for:
      • if , suggested to
    • synthesis by accepting provider / questions
  • explanation of terminology used in this module:
    • signout
      • these patients are not yet dispositioned and need the oncoming provider to follow up on something and intervene based upon it (e.g. f/u on 2nd trop/ekg and likely dc if no recurrence of cp, ekg unchanged and 2nd trop neg).to state the obvious, we should be putting our name on these patients in the tracking board.
      • note indicating acceptance of care: yes
    • aware
      • these patients are admitted, orders have already been placed.signoutfor these can be brief and really just focus on contingency or anticipated problems. if thought to be pertinent, please let the oncoming team know about code status.no need to put your name on these patients.
      • note indicating acceptance of care: no
    • pending
      • admitting, pending orders
        • the admitting team has been requested to evaluate patient and admit but orders by the admitting team haven't yet been placed.for these patients, the oncoming attending should put her/his name on the tracking board to ensure that nothing falls through the cracks and the admitting team does in fact place orders.if you don't see orders in a reasonable amount of time, please nudge the admitting team to do so.i don't think that a coc note is needed if it's just nudging the admitting team to drop orders.if more involvement is needed, a coc note per your discretion.after orders are placed, it should be fine to remove your name from the tracking board if you want fewer patients on your board.
        • note: no
      • discharged, pending departure
        • they have been discharged but yet haven't physically left the department.a heads up on possible issues such as transportation issues should be mentioned if thought to be important.the oncoming attending should place her/his name on the chart so if you notice half way through your shift that they are still there, we can ask the nurse and troubleshoot hold ups.
        • note indicating acceptance of care: no
      • transferring, pending pick up
        • (similar to above)
        • note indicating acceptance of care: no

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