Here are some imporant reminders from this month’s resident meeting:

Clinic/Outpatient

• Keep up with patient messages, result updates and nurse communications on off-clinic weeks
• Get coverage for your inbox and forward your pager to a co-resident when you’re on vacation, preferably to someone who’s not on service. Please do not forward your pager to 9203, to avoid overwhelming the on-call resident.

Stroke Updates

• We need to use RAPID for every stroke code, specifically as a means of communication to facilitate workflow, reply to attending messages, verify that orders are placed etc. Ideally we should be using this to provide a clinical picture of the patient as well.
• Dr. STROKE Notes need to completed for every hemorrhagic or ischemic stroke, or consults in which stroke is on the differential. Ensure that times are in military time. Ensure that LKW, AICT (for LVO), BEFAST, swallow screen s documented.
• On the days that the seniors are off, attendings will need to more closely oversee the ervice. On Friday evening, seniors should check in with the attending about important things that need to be followed up over the weekend for the primary patients, and they should touch base with the junior about things to follow up with the consults.
• We will meet with APP serviced about having the Stroke Team formally taking stroke codes on the weekend.

Admissions/Consults

• Use the admission tab in EPIC to place orders, reconcile meds etc.
• Perform a med rec on each admitted patient using every possible avenue (call 24 hr pharmacy Walgreens/CVS which can access any patient’s record, even if they do not use that pharmacy; talk to the family or patient about their meds; query CareEverywhere). If it’s not possible to do a med rec, make sure to sign it out to the incoming team. This can also be added to the H&P, in the FENA section.
• When you are on call, add patients to the ON-CALL list as soon as you receive a consult. Once you have signed out the patients, remove them from the ON-CALL list and put them on the appropriate list at the end of the shift. Patients can be added to the appropriate list via Haiku as well. Consider making the ON CALL list your default list when on-call.
• For ED consults received before 1PM that need dispo, the first option would be to staff with the attending in the morning either in person via early rounds or via phone. An alternative would be to staff with the PGY-4 on service. Dr. Lee will work on letting attendings know to be available for ED consults in the morning.

Sign-outs and Handoffs

• Hand-offs from admitting to receiving team: Ensure that pts being admitted are clinically stable (VS, labs, neuro status,  resp/CV status) and that receiving teams are aware of high risk patients. Someone from the receiving team should eyeball the patient as soon as possible. For stroke codes that will be followed by the general consult team, the general consult team is expected to write the initial consult note.
• Shifts start at 7AM. Please arrive at 7AM or a little earlier to receive sign out from the overnight person. For the night person, please arrive a little before 8PM to help relieve the on-call person especially if there is a shift-change stroke code. If you are not able to arrive at 7AM, please call the overnight person to receive sign out on your patients.
• Please complete sign out for each patient and update exams, to-do’s and IF/THENs after each shift. This will help ensure continuity of care overnight, and make the night shift resident’s life easier by having important information accessible and giving them anticipatory guidance on potential problems.
• Ensure that ICU transfers have med recs, transfer recs, transfer notes and clear plans on problems that are active. Refer to the neuroICU tab on the clinical service rules: https://www.neuroresidents.uchicago.edu/clinical-resources/service-rules.

Retreats

• Let’s tentatively plan for the PGY-2 retreat in March, start planning what you want to do!
• There will be a resilience half-day for PGY-2s in January, we will send out the schedule soon.
• No official Holiday party but there can be an unofficial holiday hang– there is a nice dinnner and house party in the works. Keep an eye out for invites!