1. A typical day on the inpatient Medicine team What do I need to know?
Naseema B Merchant, MD, FCCP, FACP, FHM
Department of Medicine
Yale University School of Medicine
VA CT Health Care System

2. Objectives Inpatient care Processes Clinical Care
Patient and family communication
Electronic Health Records
Patient flow
Resource utilization

3. Objectives (contd.) Balancing clinical responsibilities with education
- Point of care learning
- Managing time between patient work and scheduled educational activities

4. Inpatient Care Processes Clinical Care
Gathering patient data
Physical exam (during admission and daily visits)
Presenting on rounds
Writing notes
Patient admission process
Patient discharge process
Patient hand off

5. Clinical Care -Gathering patient data
Communication with night float team
Communication with the night nurse
Reviewing notes from the previous 24 hours( nursing , allied services, consults etc.)
Reviewing new orders entered on your patient ( while you were gone)

6. Clinical Care-Presenting on rounds
Communicating with the team prior to presenting on rounds
Presenting a new admission
Presenting daily progress on an existing patient
Use of templates for oral presentation

7. Clinical Care- Note writing
Daily progress notes
Admission note
Discharge note

8. Clinical Care- Admission, rounding and discharge
Admission checklist
Daily rounding checklist
Discharge checklist

9. Inpatient Care Checklist

10. Inpatient Care processes-Patient hand-off
Admission team and ED
Admission team and PCP
Day team to night team and vice versa
Weekday team to weekend team and vice versa
Primary team to consult team and vice versa
Primary team to patient and family
DC handoff -Discharging team , patient, family and outpatient providers
SBAR model

11. SBAR model
S- Situation
B- Background
A- Assessment
R- Recommendation

12. Patient Care processes-Patient/family communication
First meeting with the patient
Follow up visits
Use of the white board in the patient room
Family communication ( timing and frequency)

13. Patient Care processes-Patient flow
Definition
Significance
Physician role in patient flow

14. Inpatient Care processes-Resource utilization
Definition
Significance
Role of the physician in the appropriate use of resources and limiting inpatient costs

15. Balancing clinical responsibilities with- educational activities
Point of care learning Learning on the go!
Managing time between patient work and scheduled clerkship learning activities ( case conferences, EKG sessions, radiology sessions etc.)

16. Care for your patient the way you want to be cared for
Thank you