How to admit patients to the hospital efficiently

[chromaticscale]

I'll be starting fellowship soon and was wondering what tips y'all have for admitting patients (or seeing patients, writing notes and putting in orders in general) efficiently. The program I'll be going to is a safety net hospital. We are spoiled at my residency program because the majority of our patients are members within the system so it's easy access to their medical history, medications etc; chart checking is very easy to do.
However, with a safety net hospital I'm assuming records are not going to be easy available so it would take more time to prepare to present the patient during rounds. For those who trained at rigorous programs or at county, what tips do you have to be efficient while still being accurate and effective?

---

Members don't see this ad.

 

[chessknt]

I'll be starting fellowship soon and was wondering what tips y'all have for admitting patients (or seeing patients, writing notes and putting in orders in general) efficiently. The program I'll be going to is a safety net hospital. We are spoiled at my residency program because the majority of our patients are members within the system so it's easy access to their medical history, medications etc; chart checking is very easy to do.
However, with a safety net hospital I'm assuming records are not going to be easy available so it would take more time to prepare to present the patient during rounds. For those who trained at rigorous programs or at county, what tips do you have to be efficient while still being accurate and effective?

You do the best with what you have. A lot of people wont even know where their records are--oh well just start from scratch. If they do then make the ward clerk fill out paperwork to get them sent to you and manually review them. If the ward clerk wont support you then get ready for a lot of scut doing it yourself (or, as above, just start from scratch).

You also don't need complete medical records for every person. If someone presents in DKA because they couldnt afford their insulin, get it under control, figure out how much insulin they need, get SW involved to try to get free/low cost insulin, and discharge. You dont need to see what oral meds or their historical A1C, or the number of times they tried to quit smoking because none of that is relevant to their hospital problem. Remember you aren't there to replace their PCP, you are there to get them out of the hospital.

 

[Elixir6]

I'll be starting fellowship soon and was wondering what tips y'all have for admitting patients (or seeing patients, writing notes and putting in orders in general) efficiently. The program I'll be going to is a safety net hospital. We are spoiled at my residency program because the majority of our patients are members within the system so it's easy access to their medical history, medications etc; chart checking is very easy to do.
However, with a safety net hospital I'm assuming records are not going to be easy available so it would take more time to prepare to present the patient during rounds. For those who trained at rigorous programs or at county, what tips do you have to be efficient while still being accurate and effective?

Unless you are doing a year of general medicine/hospitalist medicine, won't you have interns/residents doing this anyways? Otherwise, ditto to above.

When I did moonlighting as a hospitalist during my fellowship, I was surprised how much easier it was to admit someone than when I was a resident and worried about having to catch every little detail and document it with a plan.

 

[chromaticscale]

Unless you are doing a year of general medicine/hospitalist medicine, won't you have interns/residents doing this anyways? Otherwise, ditto to above.

When I did moonlighting as a hospitalist during my fellowship, I was surprised how much easier it was to admit someone than when I was a resident and worried about having to catch every little detail and document it with a plan.

We still have to admit some patients. For instance at my current hospital, the fellows will write the admission notes and orders especially for overnight admits when they take over during the wee hours.

 

[aafisahar]

We still have to admit some patients. For instance at my current hospital, the fellows will write the admission notes and orders especially for overnight admits when they take over during the wee hours.

Cards? Get em stable on the meds they need for the night and let the day team handle the rest

 

[IMGASMD]

Didn’t you do this three years?? You treat the essential stuff. Everything else will just come in due time. Has medicine changed that much?

 

[NITRAS]

We still have to admit some patients. For instance at my current hospital, the fellows will write the admission notes and orders especially for overnight admits when they take over during the wee hours.

If you didn’t write admission orders/notes, your residency did it poorly.
Hope they have order sets. Follow the darn order sets, write a problem list/assessment. Don’t forget to include social, family history in your notes.

And don’t forget the golden rule of fellowship. Forget your general medical knowlege as quickly as possible and dump all the **** you can on others. . .. . .

I mean the real golden rule. Your fellowship overlords are using you. But you are using them, too. It is only 3 years. . . ..

 

[NonNocere]

I'll be starting fellowship soon and was wondering what tips y'all have for admitting patients (or seeing patients, writing notes and putting in orders in general) efficiently. The program I'll be going to is a safety net hospital. We are spoiled at my residency program because the majority of our patients are members within the system so it's easy access to their medical history, medications etc; chart checking is very easy to do.
However, with a safety net hospital I'm assuming records are not going to be easy available so it would take more time to prepare to present the patient during rounds. For those who trained at rigorous programs or at county, what tips do you have to be efficient while still being accurate and effective?

Is there someone at your workplace you could ask these questions directly?