ED / DWHA Handoff

2 months before your rotation, put in any shift requests at https://www.shiftadmin.com/login.php.

• •Create an account.
• •Time blocks open throughout the year. When the block with your rotation weeks opens, put in your requests — you can specify desired days off and shift requests.
• •If you do not do this, you will be scheduled for unwanted shifts by default.

• •First day: arrive ~10 min early and ask someone to show you the ED Board and how to organize it for more efficient use.
• •Your pod sees people in the hallway too — know where your beds are.
• •Don’t pick up new patients 20 min before shift change unless someone is decompensating or in acute distress.
• •Have disposition or plan for any patients that are incomplete by shift change.
• •Call services for consultations and admissions:
• ◦Start with your ask clearly: “Calling for X… hoping to admit person for X.” Then go over the specifics of the patient case.
• ◦Tell attending if consulting service rejects or punts to another service.
• •You can tell attending you want to see all the GYN patients in your pod — up to you based on the experience you want.
• •No one knows you’re an OB/GYN resident — inform the team each shift.

You’ll receive a cell phone to use for all calls, including your callback number.

• •When calling services, add in consult order.

When you present for shift, you’ll get sign out from the off-going team. You take the patients of the other junior member of the team (may be another resident or PA).

Patient admitted and awaiting inpatient bed:

• •Technically the patient isn’t yours, but your name will be assigned to them.
• •If patient decompensates, you manage. Otherwise, inpatient team manages them.
• •Write down a power statement / blurb about the patient in case you need to sign them out to the next oncoming team.

Patient without a dispo:

• •If patient is still undergoing workup and disposition is not final, you take ownership of the patient and continue care.
• •Write a note to “assume care.” Take dot phrase from Jasmine Arrington: .accassume

• •H&P template automatically populates when in ED context.
• •Ask about “Time course” notes → have someone show you how to comment on labs/imaging and document ED time course. Very helpful for notes, especially when assuming care of unfinished cases.
• •Open a note when you see a patient to start a timestamp.
• •Try to leave with all notes done.

Context: DUHER

• •Sign in: at the beginning of each shift, sign into Epic and include the phone number for the cell phone you’ll carry (Jr Phone).
• •Sign out: at end of shift, select sign out in the ED trackboard so you don’t continue to get messages and are no longer first call.
• •Pick up patients by selecting Assign me.

• •Ask about the CEU protocol list.
• •Examples: electrolyte supplementation, syncope protocol, chest pain, etc.

In clinic 5 days a week.

• •DWHA Attending will send an overview of your clinic schedule when you start.
• •Go to Pelvic Floor Physical Therapy clinic on Thursdays [source says “for two days” — verify intent with chief].