Wednesday, February 24, 2010

There's an interesting discussion on the use of check lists

---over at DB's Medical Rants.

On a hectic and busy medical service the checklist can be an important housekeeping tool for the tired, distracted and constantly interrupted hospitalist. I'm trying to develop my own, and these are the items I'm considering for inclusion:

Have today's labs been addressed and appropriate action taken?
Is chemical VTE prophylaxis being given where indicated?
Is discharge planning underway (including order entry for case management consultation and entry of the anticipated discharge date)?
In patients on steroids for asthma or AECOPD is tapering proceeding apace?
Is it time to modify antibiotic orders based on culture results, clinical status or duration of therapy?
Are medications properly reconciled, i.e. are home medications being held that should be and are those being continued (statins, beta blockers) that should be?
Is the patient's activity order appropriate and has PT been ordered if needed?

This list may not be appropriate for everyone, but reflects things that don't have reminders built in at my institution.

Related post at Wachters' World.

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