Sign-out Help

[EJS]

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I am starting residency at a hospital I did a sub-I at and was incredibly frustrated by their sign-out method. We (as med students) sat around waiting for one computer in which to type information into a word document table about our patients. The file was stored on that hard-drive, and even crashed and we had to put it all back in. It was frequently not updated, etc... and then we had to print out one copy and make 20 other copies every morning and afternoon. So... I am trying to find alternatives, what does your program do? Any palm programs? online programs??? We need help!

 

[southerndoc]

We use the hospital's computer system for signout. It's actually a big deal at my hospital.

When a patient is admitted, a brief history is entered into the computer (usually two or three lines). Drug allergies are also entered (this is required before you can enter orders, including admission orders). There is a spot for updates for patients who have been there for a while.

When you signout, you print two lists: one with meds, and one without. The one with meds is attached to the one without. The reason being is that the med list is provided in case it's needed, otherwise it's easier to flip through the list without meds. All drug allergies are there. The typed signout is also there. When a team prints a list, the signout intern/resident usually boxes in things to do -- 8pm labs, followup imaging, etc., and this is most often marked in a different color (the box) so it stands out.

Finally, when you sign out, it is a hospital requirement that you change the contact pager for all the patients you just signed out. When you receive signout the following morning, it's your responsibility to change your pager back. This eliminates a nurse needing to track down who is covering a patient. He/she can look in the computer, see the pager number, and just page that person instead of looking up who is covering who.

EDIT: Forgot to mention, all of this is done through our computer physician order entry system and not through Word, Excel, etc.

 

[NinerNiner999]

I would get a jump drive and keep it with you, that way you can update YOUR list as you go throughout the day, cut and paste, and be done with it. Of course, this only works with word or excel files. As with most things in intern year, you will find that the more you stay on top of things throughout the day, the easier your life will become....

 

[Daniel Rosentha]

We had the same issue -- check out spam link deleted -- online, secure, great PDF printouts -- works with IE, firefox, safari, pc and mac. We got it for about $100/team.

 

[hippiedoc13]

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[dragonfly99]

OK, your hospital's signout procedure IS JUST STUPID. any method that relies on 15 people standing around 1 computer trying to do stuff...

Our signout at VA was just a list we typed (word or RTF) and would hand to the on call intern. It was a patient list, allergies, current plan, meds list, and things to do.

Our signout @main teaching hospital could be printed off ANY computer terminal and was part of the computerized ordering system (similar to the one mentioned above).

Your chief resident and/or program director needs to be addressing this issue, BUT don't make yourself the sacrificial lamb by complaining about it (alone). Perhaps you can get all the interns as s group to politely inquire about creating a better, more efficient signout process. Also, WTF do they need 20 copies of your signout for?

Until things are improved, I like the jump drive/USB drive idea, especially if the signout thing is just an Excel file.

 

[mdphd2b]

I am starting residency at a hospital I did a sub-I at and was incredibly frustrated by their sign-out method. We (as med students) sat around waiting for one computer in which to type information into a word document table about our patients. The file was stored on that hard-drive, and even crashed and we had to put it all back in. It was frequently not updated, etc... and then we had to print out one copy and make 20 other copies every morning and afternoon. So... I am trying to find alternatives, what does your program do? Any palm programs? online programs??? We need help!

This sounds like the surgery sign-out at Pittsburgh (UPMC)-brings back horrible memories

 

[Hurricane]

The best signout method I've seen was the one the internal medicine program used at my med school. It's old school though. Every patient got a 3x5 index card with basic info, one-liner history, meds, allergies, warnings, to do, etc. When you were ready to leave, you paged the on-call resident or night float and checked out and handed them the cards. If any issues arose or they got called on your patient, they wrote it on the card. Then in the morning there was a designated time and place where the night float would be so you could get your cards back and discuss any issues that came up overnight. If you had a patient for a long time and the card got full, you stuck white address labels over the old stuff and wrote over it.

Like I said, old school and not very fancy, but it worked better than any of the computer systems I've since had to use. And I'm a technophile, so it's not often that I'd say something like that. I think the key was getting your cards back in the AM. The internal medicine program here uses index cards, but they're less rigorous about what goes on the card and you don't get them back in the AM, and it totally sucks.