Connect Care StreetSmarts - Rounding Workflows
This section summarizes recommendations about how to use Connect Care to support ward rounds for inpatients. The focus is on prescriber accountabilities when tasks may be shared by more than one individual. Prescribers can hand off to one another during the day. Prescribers may also work in teams, including trainees, where tasks are assigned to different individuals.
Daily information review and documentation tasks take advantage of interactive charting stills and the structured data initiated during recommended admission workflows. In turn, use of the tools described here will speed and simplify discharge workflows.
Workflow Sequencing
There are many different styles of inpatient rounding. The following sequence of steps assumes that the primary prescriber team goes from patient to patient for bedside assessments of status and progress. Simpler "running the list" rounds usually do not involve documentation and proceed with fewer steps.
Work from Ward Round Patient List
Create and use a "My List" configured using the "++AHS IP MD WARD ROUNDS TEMPLATE++", "vitals" default report and "room/bed" default sorting; populating this with an appropriate facility system list (e.g., ward, provider team, consulting service).
Use the list columns, with iconographic indicators, hover reports and double-click actions to optionally set priorities affecting the order of bedside visits.
Heed any "Notes to MRHP" in the report area of the Ward Rounds Patient List
Open a patient chart and use sidebar links to review developments
"Recent Results" sidebar index entry displays latest information in the sidebar, with links to helpful chart activities
"Views" sidebar index entry displays sidebar list of chart areas most useful during rounding
Generate hypotheses to be checked in bedside assessment
Perform Bedside Assessment
Use Haiku (Smart Phone) app to capture any relevant images or dictated notes
Enter orders for tasks arising from assessment
Students should Save orders or flag for co-sign
Document new Subjective and Objective Note observations
Open "Problem Oriented Charting" activity, confirm correct charting service selection and initiate a new S&O note with "Subjective/Objective" menu entry
Use interactive charting and dictation to complete using a "Basic" or "Advanced" template
After completing bedside rounds, review and new investigation results and complete a shared progress note
Using the "Problem Oriented Charting" activity, edit the pulled-forward Assessment & Plan note for any problem that will be charted on for that day (no need to chart on all problems, only where there are significant developments).
Use the "Generate Note" button at the bottom of the Problem Oriented Charting problem list section to initiate a standardized progress note that pulls in the latest Subjective/Objective findings and any newly revised problem assessments and plans.
Consider updating the patient's "Hospital Course", a wiki-like high-level summary of how the hospitalization is progressing.