In order to assure the coordination of care the physicians need to follow a set schedule. The schedule should be created by the physician team in close collaboration with the floor nurses. Once created all members of the team should follow the game plan so that the nurses can adjust their schedule to join each physician on rounds. For more details see the individual playbooks. Predictability is critical for achieving coordinated teamwork.
7 DAYS PER WEEK (including weekends)
- 7:00-9:30 Hospitalists review laboratory data, see new admissions, complete discharges.
- Reviews the new laboratory on all patients using the EMR.
- Sees all new admissions from the evening and night shifts
- Completes paperwork and orders for patients to being discharged by 10 AM in coordination with the case manager and bedside nurse.
- 9:30-10:30 Hospitalists, Nurses,and Case Manager conduct bedside rounds
- Bedside rounds for all established patients (newly admitted and discharged patients seen before 8:30AM should include the patient and family (when available), hospitalist, bedside nurse, the charge nurse (as needed when the bedside nurse unavailable), and when possible the case manager (particularly helpful for complex patients) and pharmacist.
- Average duration 5 minutes per patient. (see specific playbooks for recommended communication template). By having a set schedule if the patient or family have too many questions or concerns the hospitalist can explain that he or she is scheduled to see other patients on the floor, but will return at 11 AM (after bedside rounds) to address additional concerns.
- One hospitalist should start at the entrance to the ADTU and the other start at the back of the ADTU. This prevents the bedside nurse being required to be with two hospitalists at the same time.
- Remainder of the day devoted to writing discharge summaries, progress notes, and coordinating consults.