SICU – Logistics

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Who's Who?
  • Rotation Education Director: Steve Estime, M.D.
  • Division Lead: Dick Pino, M.D.
Prior to starting in the SICU...
  • Read through this Logistics page and any materials you get from Dr. Estime.
  • Learn about your patients before your first day (by talking with the prior month residents and going through the EMR).
Structure
  • Teams:
    • There are two teams in the ICU (Green and Blue). Each team carries up to 10 patients, and there is no difference in patient types admitted to each team.
  • Shifts:
    • All shifts are 13 hours including signout (6 AM to 7 PM). There is no call.
    • Day shifts: each team has an attending, a fellow and one or two residents (+/- an NP).
      • NPs: Jackie Kennedy-Harte works on the Blue team. Nancy Derosa works on the Green team.
    • Night shifts: one resident from each ICU team will round with one fellow and one attending covering the entire unit
Workflow/Schedule

Typical Day Shift

6am-7am AM Sign-out
-Update responding clinician in Epic
7am Pre-round
~8:00am Start Rounds
~9:30am Radiology Rounds
11am-1pm Lectures
-Check lecture calendar schedule
~4pm PM rounds
6pm-7pm PM Sign-out

* Tuesdays 7:30-8:00am are resident-protected lectures. The fellow/NPs will cover your pager and rounds will start ~8:30am.

Typical Night Shift

6pm PM sign-out
-Update responding clinician in Epic
7pm Pre-round
~8pm PM rounds
-Specific timing attending dependent
-Generally more condensed & focused than day shift rounds
9pm Break for 9PM meal
6am-7am AM sign-out


Weekends/Holidays

  • Shift hours are the same.
  • There is only one resident per team, and typically only one fellow and attending for the whole unit.
  • There are no radiology rounds.
EPIC "Pro-Tips" for SICU
  • Notes
    • Use “dot Phrases” to template notes. They save a lot of time. (The NPs and previous residents are a great resource for this.)
    • Don’t copy-paste. Remove irrelevant information and revise what’s left. Focus on the big picture.
  • “Patient lists”
    • Use them. They help a lot.
    • Under “lists” (one of the top tabs in Epic), go to “Edit List” > “Create My List”
      • Useful columns to consider: Patient, MRN, Room/Bed, RN, Responding Clinician, New Result / New Note (these flag new labs/micro as they come in)
    • Add patients from available lists: MGH Entity > Admit Teams > MGH SICU Blue or Green
  • Results Review
    • If you use “Time Mark” under “Results Review” then any time you click “New Results” you will only see data you haven’t previously reviewed.
Workflow "Pro-Tips" for SICU
  • Calling Consults
    • Use “dot Phrases” to template notes. They save a lot of time. (The NPs and previous residents are a great resource for this.)
    • Don’t copy-paste. Remove irrelevant information and revise what’s left. Focus on the big picture.
  • “Patient lists”
    • Use them. They help a lot.
    • Under “lists” (one of the top tabs in Epic), go to “Edit List” > “Create My List”
      • Useful columns to consider: Patient, MRN, Room/Bed, RN, Responding Clinician, New Result / New Note (these flag new labs/micro as they come in)
    • Add patients from available lists: MGH Entity > Admit Teams > MGH SICU Blue or Green
  • Results Review
    • If you use “Time Mark” under “Results Review” then any time you click “New Results” you will only see data you haven’t previously reviewed.
Didactics
ACGME & Program Requirements