ED Attending Playbook

 

Volleyball huddle
Mary Wise instructs the team during a time out.

You are the team’s internal coach, supervising the management plans for each patient on your team

  • Should communicate his or her expectations to the team at the beginning of shift using first names, emphasizing team work, as well as the importance of two-way communication, and establishing an environment where everyone feels safe to share their ideas (see Basic Principles of Gatorounds)
  • When time permits quickly see the new patient with the resident and nurse to assess the severity of the patient’s illness and to introduce yourself.
  • Once the patient is evaluated by the resident discusses the differential diagnosis with the resident and with the resident creates a management plan.
  • When time permits, once the management plan has been created, reenter the room with the resident to relay the plan to the patient and nurse, and assist in answering questions.
    • Make sure that the nurse understands the management plans. The nurse is your customer and if he/she does not understand the management plan the patient will not receive the care that you intended.
    • Be open to questions from both the patient and the nurse.
  • Calls frequent huddles with the resident and nurse when conditions change or the management plan does not achieve the expected improvement.
  • Guides communication with the nurses (specifically asks the nurse for their input for each patient.
  • Makes sure that the patients are satisfied with their care and that their needs are being met
  • Creates many teaching moments and encourages active discussion and active learning. Emphasizes improving the systems of care, use of internet for the latest diagnostic and management, and utilizing consultants to assist in care. Provides guiding principles for care including differential diagnosis and cost-effective management.
  • Maintains a positive attitude and maintains good morale among the team members and watches for fatigue and overwork.
  • Expects and provides the highest possible care for his/her patients