10. Allow the oncoming clinician/team the chance to ask questions. As long as they are in your department, the oncoming clinician/team should be aware in case last-minute problems or patient questions arise. ![]() This seems intuitive, but this includes even those patients already flagged for discharge. Be sure to sign out all patients in the department. This also refers to completing discharge instructions in advance (if possible). This includes additional diagnostic testing, therapeutics, procedures, and/or consultations, unless both parties agree that this is necessary and to leave the work for the oncoming clinician(s). Disclose why you are uncertain and what additional information you need. Is the patient likely to be discharged or being admitted? This does not mean that you have to have arrived at a diagnosis by sign-out rounds, but ideally share your decision-tree plan about disposition and diagnosis. YES: The patient has hypotension with systolics in the 90’s and an initial lactate of 4.6.įor the oncoming clinician, it helps to know if the patient has a unique knowledge base (e.g., is a healthcare provider) or has special needs (e.g., hard of hearing, speaks only Farsi but daughter can translate).NO: The patient has a low blood pressure and elevated lactate.If it is important enough to mention at sign-out rounds, it requires clarification. ![]() When describing abnormal values, avoid ambiguity.
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