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Weekend sign out template

Call Cases 
Any procedures or GJs completed – please include name, MRN, and procedure. If an inpatient is staying on our list, please add them to the EPIC inpatient list. 

Consults 
Please include the patient's name, MRN, a brief medical history, and the consult details.  
If the patient is likely to be added for a procedure, please use the template below:
​
 
Patient (age) 
MR# 
Diagnosis: 
Procedure: 
Attending: 
Approved by: 
Anesthesia or local:  
If GA time added: 
NPO status: 
HCG: 
Guardian available for consent:  
Other: (inpatient, fluid orders, relevant allergies, etc.) 

Inpatients 
Please update the EPIC inpatient list with outputs over the weekend. Please include any significant changes/concerns in weekend sign-out as well.  

Care Coordination 
Please use for any patients that require f/u phone calls or care coordination.  

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  • Home
  • Procedures
  • Protocols
  • Online Library
    • Pediatric IR Papers
    • Presentations and Webinars
    • IR Equipment and IFU
  • BCH IR Fellows Homepage
  • About Us