Source / episode info
- **Episode:**354
- **Title:**Divine Intervention Episode 354 – Residency Skills: How to Pre-round Efficiently.
- **Published:**2021-12-01
- Source:Episode page
One-liner
This episode provides a comprehensive guide to optimizing clinical workflow, emphasizing punctuality, performing a "chart biopsy" focused on trends and the Assessment & Plan (A&P), respecting interprofessional roles by speaking with the overnight nurse first, and structuring progress notes efficiently.
High-yield summary
- Punctuality is Key: Arrive 15–30 minutes before sign out to gain control over the day's chaos and avoid being caught off guard.
- Chart Biopsy Focus: Review three areas: (1) Overnight nurse notes/vitals, (2) Previous day’s A&P section (highest yield), and (3) Trends in vitals/labs (e.g., urine output).
- Interprofessional Etiquette: Always meet the overnight nurse before receiving sign out from the overnight team; nurses are at the bedside and hold critical, immediate information.
- Note Writing Structure: Start writing the progress note with the Assessment & Plan first, drawing content from your chart biopsy findings (problems/trends). Keep notes concise ("short, sweet, and to the point").
- Post-Rounds Workflow: Maintain a sense of urgency; do not "daily dali" (waste time) after rounds until all notes are completed and signed.
- Monitoring: Implement a separate checklist tracking daily goals and use "hourly rounds" (2–5 minutes every hour) to monitor patient status and ensure tasks are completed.
Learning objectives
- Describe the optimal sequence of activities during pre-rounding to maximize efficiency and information gathering.
- Identify the highest yield sections in a patient's chart for rapid review, focusing on trends and problem statements.
- Articulate professional etiquette regarding communication with nursing staff during handoffs.
- Structure a progress note by prioritizing the Assessment & Plan section before detailing subjective or objective findings.
- Implement systematic monitoring techniques (e.g., hourly rounds, checklists) to ensure comprehensive patient care throughout a shift.