Topics covered include communication, leadership, quality assurance, patient safety, and providing a patient-centered environment.
For each scenario:
1. What went wrong? What problems are you specifically addressing?
2. From an administrative perspective, what should be done (specifically, what programs, interventions, training, policies, procedures, etc.)?
3. What would you do to determine the success of the interventions?
Dr. Klinger: Chief Resident
Scenario: You've barely begun your rounds when you run into your first hurdle. One of your patients is missing. You ask Clara the clerk if Mrs. Harris went home. Clara responds that she should be in 7A, but you know that room is empty.
Scenario: Your next patient is Lila Gonzalez...She's 22 weeks into her pregnancy and is having palpitations. You ask the patient if this is her first pregnancy and she glances nervously over at her husband Ivan and nods. Her chart seems to say that she's had an earlier miscarriage.
Scenario: Lila Gonzalez asks a question you were not expecting, she says, "I don't wanna lose this baby... Is it going to happen again?" She's upset, but the fact of the matter is that this is really outside of your area of expertise and your time is limited.
Scenario: Your next patient is Ben and has had the second seizure this morning coming back from EEG. Since you've now ruled out a number of possibilities, alcohol withdrawal is looking like the cause of his seizures. You'll have another chance to speak to him this afternoon but looking at his hand tremor and rapid heart rate, you're pretty sure he's not being straight with you about his alcohol consumption.a second seizure this morning coming back from EEG. Since you've now ruled out a number of possibilities, alcohol withdrawal is looking like the cause of his seizures. You'll have another chance to speak to him this afternoon but looking at his hand tremor and rapid heart rate, you're pretty sure he's not being straight with you about his alcohol consumption.
Scenario: Although your paperwork for the day is piling up, you decide to search out the nurse for Ben Collins. You would feel better if you knew she understood the severity of his alcohol withdrawal and how quickly he might still deteriorate. You ask the clerk for the nurse's name. It is Wanda Ellis, but you certainly couldn't pick her out of a crowd. Technically, your written orders should be sufficient.
Scenario: Your Department Chair, Dr. Rogers stops you in the middle of the hall to talk but you notice a Transporter Emilio coming down the hall with an empty bed. You step out of the way against the wall, but Dr. Rogers stays put.
Scenario: You got the results from Mr. Collins thyroid tests back from the lab and as you expected, everything is normal. You ask him how he is feeling, he says better and that his wife wants to know when he'll be able to get back to work.
Scenario: It's the end of a very hectic day and you are in your office trying to catch up on charting. Now you have been do lumbar puncture because none of the residents are available. This is the last thing that you have time or energy to do. a lumbar puncture because none of the residents are available. This is the last thing that you have time or energy to do.pagpag
Scenario: The patient did not understand your explanation of the lumbar puncture procedure and is unwilling to sign the patient consent. Kimberly, the nurse asks that you explain the procedure further in order to obtain the patient's consent?