What's your *system*?

[soysauz]

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As a third year about to begin the wards, I have been told a billion times that I need an organization system. Clipboards, index cards, binders..... where should I start?

What's your system? Please share. 😀

 

[CallawayDoc]

I used a different system for every rotation.

For medicine I used a small binder that I kept track of labs on some tables that I made. Our attending would ask every day about the previous days and the trends for the week. It just made it easy to keep track of things that way. I also kept patient notes and info sheets for their entire hospital stay.

Surgery, I kept about a weeks worth of ward patient lists that our team printed out and made notes on those. The amount of detail wasn't quite as pertinent and they valued conciseness.

Really it's all about finding out what works best for you and adapting to your teams needs and attendings preferences. The people who seem to have trouble are the ones who don't learn to adapt to the individual rotations and different settings.

 

[luckystar]

I used a different system for every rotation.

For medicine I used a small binder that I kept track of labs on some tables that I made. Our attending would ask every day about the previous days and the trends for the week. It just made it easy to keep track of things that way. I also kept patient notes and info sheets for their entire hospital stay.

Surgery, I kept about a weeks worth of ward patient lists that our team printed out and made notes on those. The amount of detail wasn't quite as pertinent and they valued conciseness.

Really it's all about finding out what works best for you and adapting to your teams needs and attendings preferences. The people who seem to have trouble are the ones who don't learn to adapt to the individual rotations and different settings.

That's almost exactly what I did too! I used one of those composition books for IM. Very easy to look back at patients' progress.

For ER, I used index cards. Sometimes, the attending would just take my card after I presented. It worked well.

 

[loveumms]

http://www.medfools.com/downloads.html

 

[soysauz]

great site!

Thanks!

 

[Blade28]

I started out using cards/sheets similar to the onese on medfools - would carry them around in my pocket. I've never used clipboards, as I'm sure I would leave it behind somewhere. It's also easier to just have everything in your pocket. I never carried anything heavy (besides a small handbook), so my white coat was manageable.

Now, during residency, everyone uses "scut sheets" - every service has a list of patients that we print out daily, and we write important vitals, labs, to do lists, etc. on them. Much easier that way. Eventually, you'll remember most of the details on all your patients. I'm always amazed at chief residents who can instantly recall minutiae on any one of 20-35 patients.

 

[angel80]

I've found scut sheets very helpful to keep track of the patients on a daily basis. Also, if you have to do the discharge summary/dictations, then it can be difficult to remember exactly what happened with each patient, and on what days things happened. All that info is available on the scut sheets, and it becomes much easier to dictate the discharges.

 

[DOctorJay]

does anyone use a PDA to keep track of this info or do you find it to be too clumsy/difficult to input info? can anyone recommend any specific programs? i seem to remember one good free program but don't recall the name but it looked like it would be easy to input all kinds of info.

J

 

[Sammich81]

I tried a million things and this is what works for me:

When I do the initial H&P on someone I keep a copy of that with me and write a small box of each day's info (vitals, labs, imaging results) on the back so I have their important info all in one place. Frequently attendings will say, "So what's the trend been in her creatinine, or how has it changed since we started that gent"...and how the heck am I going to know someone's creatinine on admission once they've been there for 24 days?

I also keep my to-do list for each patient on their sheet so I know what I have to follow up on and for whom.

I also keep a stack of index cards in my pocket and write down stuff I have to look up, am likely to get pimped on the next day, etc. You'd think you'd remember what you need to read about but at the end of the day it's all a blur for me.

 

[Sammich81]

What are scut sheets by the way and does anyone have a good template?

 

[mysophobe]

Takes me a LOT longer to enter something into a PDA the way I like it than it does to just scribble it on a scut sheet or card.

 

[deleted87716]

Takes me a LOT longer to enter something into a PDA the way I like it than it does to just scribble it on a scut sheet or card.

Ditto. The best program I found for managing ward scut is WardWatch. It has the smallest data-entry requirement, and unlike most of the other Palm OS patient trackers out there, doesn't try to be all things to all people. The second-best option would be a home-grown database using HanDBase, but that's getting a little more advanced.

 

[Joel Fleischman]

Anybody use these Molskine Notebooks?

http://www.amazon.com/gp/product/B00069DKVG/002-9690679-8977659?v=glance&n=1064954
definitely small, harder to loose,
the only thing i dont like is having the crutch of having the pre-typed form....makes it much harder to ever forget anything...

 

[pillowhead]

What are scut sheets by the way and does anyone have a good template?

check out www.medfools.com and click on downloads

 

[loveumms]

Anybody use these Molskine Notebooks?

http://www.amazon.com/gp/product/B00069DKVG/002-9690679-8977659?v=glance&n=1064954
definitely small, harder to loose,
the only thing i dont like is having the crutch of having the pre-typed form....makes it much harder to ever forget anything...

Or the cheaper route is to use the 25 cent small spiral notebooks found at WalMart.

 

[deleted87716]

Or the cheaper route is to use the 25 cent small spiral notebooks found at WalMart.

Gah...! 😱 I'll bet Hemingway is rolling over in his grave. 😉

 

[Joel Fleischman]

my sketches definitely aren't picassos either...

I used to use the spiral books but I keep destroying the spiral -- thus the whole book.

 

[DOctorJay]

anyone try this one? it's what i was referring to above.

http://www.erecordsystem.com/

-J

 

[Blade28]

When I do the initial H&P on someone I keep a copy of that with me and write a small box of each day's info (vitals, labs, imaging results) on the back so I have their important info all in one place.

Yikes that can add up to a lot of pieces of paper. You keep all of your patients' H&Ps in your pocket? For some of our busy services, that can be 20-40 patients.