Handover in the intermediate care

[Dr-Junior]

In our intermediate care unit we face a problem which is that every two days the in-charge physician is being changed and that not a proper handover over the patients' info is being done.

How do you do the handover when the next colleague is not yet present? Do you recommend using a special list?

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[jdh71]

If only there were these things called phones.

 

[SurfingDoctor]

Why can't the overnight coverage provide adequate handoff to the daytime person? But to @jdh71 point, why can't the person taking over just directly talk to the person who is coming off?

 

[jdh71]

For the record I ****ing HATE "lists".

If you have an EMR. There(!) is your "list". Print it. Write your own notes during a voice to voice (or face to face hand off). Lists are a huge waste of time outside of early trainees.

 

[AdmiralChz]

For the record I ****ing HATE "lists".

If you have an EMR. There(!) is your "list". Print it. Write your own notes during a voice to voice (or face to face hand off). Lists are a huge waste of time outside of early trainees.

THIS! EPIC has functionality to auto populate your own "list" by unit or service - you can include free text on things and even have it print off labs (in diagram format) and vitals/I&Os. We recently got this "upgrade" and have finally retired the online clunky list - talk about a titanic waste of time writing all that BS down.

Some surgery services haven't moved to this system though, so sucks for them. So glad I'm not an intern anymore.

 

[Hernandez]

In our intermediate care unit we face a problem which is that every two days the in-charge physician is being changed and that not a proper handover over the patients' info is being done.

How do you do the handover when the next colleague is not yet present? Do you recommend using a special list?.

Why every 2 days? And why is a phone signout not done?. It isn't that difficult......

 

[kemper6036]

THIS! EPIC has functionality to auto populate your own "list" by unit or service - you can include free text on things and even have it print off labs (in diagram format) and vitals/I&Os. We recently got this "upgrade" and have finally retired the online clunky list - talk about a titanic waste of time writing all that BS down.

Some surgery services haven't moved to this system though, so sucks for them. So glad I'm not an intern anymore.

we need this, badly

 

[WheezyBaby]

THIS! EPIC has functionality to auto populate your own "list" by unit or service - you can include free text on things and even have it print off labs (in diagram format) and vitals/I&Os. We recently got this "upgrade" and have finally retired the online clunky list - talk about a titanic waste of time writing all that BS down.

Some surgery services haven't moved to this system though, so sucks for them. So glad I'm not an intern anymore.

How? Labs on our handoffs come out looking like crap. Fishbones would be amazing

 

[AdmiralChz]

From what I understand, the pediatrics group at our hospital had it built in for the signout list - we have it print CBC, BMP and ABG. It's a little buggy (gets confused if a repeat K is ordered, for example) but overall a huge time saver. Comes complete with history and To Do sections, which is nice. We tried settings for vitals and I/Os as well but it didn't work very well, especially since numbers weren't tallied by 5:30 when the lists were printed.

 

[Hernandez]

Do you really need labs for a sign out?

 

[AdmiralChz]

Well, just about all of us use the signout list as a mobile "brain" for a shift and the night person used to spend/waste 45 minutes writing down labs on a master copy for completeness... Yes. I can't answer how much this option cost, but it's very helpful.

 

[WheezyBaby]

Do you really need labs for a sign out?

No. Epic handoff works as a rounding sheet as well though

 

[Hernandez]

I personally don't use rounding sheeting if I have a cow, especially in the ICU where we tend to get lots more than daily labs and where it's important to look at trends.

 

[jdh71]

How? Labs on our handoffs come out looking like crap. Fishbones would be amazing

JFC. Can your partners not look in the computer? All the labs are there. I promise.