Dates Needed:
Site 1: 11/28-30 12/27-31
Site 2: 11/21-29

Schedule:

• 24 Hr Shift/On Site
• Admits and Rounding

Morning Rounds

• Hospitalists typically begin morning rounds between 7:00am and 8:00am (facility dependent)

Informal Evening Rounds

• Informal evening rounds are a great way to make yourself available and preempt issues before turning in. By interacting with ED staff and nursing staff between 9:00 pm and 10:00 pm, you might save yourself some work - and a 2:00 am wake up call - which will help ensure you get the rest you need!

Admissions

• ED skillsets vary, and considering the limitations posed by rural settings, we want to ensure that we avoid admitting patients only to have them immediately transferred once you've had the opportunity to evaluate them.
• While we encourage the use of transition orders overnight and during busy clinical times during the day in order to augment ED throughput, we want to ensure you're in the ED evaluating patients as much as possible.

Overnight Admissions

• Between 11:00 pm and 6:00 am, transition orders will be used to admit patients. Transition orders are written by the ED physicians to facilitate admission and prevent you from having to enter the order yourself. Overnight admissions should be rounded on the following morning after ICU patients.

Note: all high acuity level ICU patients require immediate bedside evaluation at the time of admission, regardless of time of day.

Rounding on overnight admissions enables you to:

Discharges

• You should know which patients are awaiting discharges when rounds begin. These patients should be identified in the interdisciplinary team meetings from the preceding day, and case management should have all needs addressed in preparation for discharge.
• The patients are told the preceding day that they'll be discharged as well, so they will be anticipating seeing the provider early and being out of the hospital by noon if possible.
• Prioritizing discharges is intentional so the nursing staff can get all their paperwork completed for the patient, the patient can physically leave, and EVS can do a terminal clean on the room preparing for another patient to be admitted from the ED in the afternoon when admissions begin to come in.