Anesthesiology

OB Anesthesia Morning Report

Weekday Morning Report (0700-0800*, 4203 VUH) is the sacred hour that anchors our workday:

• Before 0700* – Very Important: Night call team must prepare clinical service in order to help preserve the integrity of the education hour (optimal when all faculty & trainees are present):
  
  • Round on all ongoing labor blocks on L&D, to minimize likelihood of interruption of conference. Inadequate blocks should be remedied & PCEA infusion bags should be adequately full.
  • Perform any needed L&D consults on newly admitted parturients, incl. in 4E triage unit.
  • Round on 4 East antenatal patients & update the clinical census.
  • Apprise float CRNA of any potentially problematic patients - Float CRNA will cover service during Morning Report, including coverage of on-going OR case.
• 0700* - Outgoing on-call attending attends beginning of OB-sign out rounds (4137 MCE).
• 0700-0745* – Core Topics Conference (4203 VUH): This 40 min session addresses core topics . All participants must prepare in advance by studying the 10-20 page reading assignment & accompanying study guide.
• 0745-0800* – Clinical Report: Ongoing blocks, post-partum cases, & antenatal inpatients are reviewed and clinical care is transferred to incoming team.
• 0800* – Clinical duties begin.

[*Note: Late starts on Wednesdays & Fridays frame-shift all times 1/2 hr later, i.e. 0730-0830]

Early Morning Work

 After Morning Report, the following tasks are attended to:

• Meet up with OB residents & charge nurse on L&D to
  • review potentially problematic patients,
  • prioritize work schedule, as applicable, and
  • promote positive team communication & collaboration, and thereby safety.
• Round on all patients with ongoing blocks - introduce new anesthesia team, assess analgesic blocks & parturient status, troubleshoot problem blocks, confirm pt understanding of plan... 
• Post-partum rounds & documentation - This is essential.  We are proactive in seeking out
  • the potential complications that may require out attention/intervention, and
  • feedback on our work, in order to adjust and improve.

Late Afternoon / Evening

• 5:00 PM - Review pt census board with outgoing & incoming attendings.
• 6:00 PM - Inter-disciplinary rounds at back nursing station on L&D (near rooms 9 & 10). Ideally our entire team, but at least one of us should be there, preferably the senior call resident.
• 7:00 PM - Review pt census board with outgoing & incoming junior resident/SRNA.

Weekends & Holidays

• Before 7:00 AM - outgoing team prepares for handover of service:
  • check in with L&D resident and charge nurse for pt updates
  • round on all ongoing blocks
  • review all ante-partum patients
• 7:00 AM - Review pt census board with outgoing & incoming teams.  
• 7-8AM - "early morning work" - see above
• 8:00 AM - Inter-disciplinary rounds in 4137 MCE (4E conf rm). Ideally our entire team, but at least one of our team should be there.
• 6:00 PM - Inter-disciplinary rounds at back nursing station on L&D.
• 7:00 PM - Review pt census board with outgoing & incoming junior resident/SRNA.