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Typical Workflow

Rounds

  • Every morning, rounds are between 6-6:30pm. The most junior person on the team will generally make a lists

  • Lists should include

    • General ranges of vitals

    • Drain outputs

    • Any significant overnight events

    • Labs if significant

  • There is a dressing bag that students will typically carry to rounds 

    • Writing dressings needed per patient on lists can be helpful to ensure rounds go smoothly​

Weekly Schedule

  • Cases start at 7:30 am almost every day

  • Wednesday and Thursday--8:30am start 

  • An email is sent on the weekend prior to any week, detailing the schedule for each day, who is on call, and what cases/clinic everyone is assigned to

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  • Mondays

    • Dr. Purnell typically operates—typically facial trauma, free flaps, etc.

    • Dr. Maduekwe clinic--mostly hand patients

    • This is the day to ensure any add-ons from the weekend are on the board

    • Ensure follow-ups for weekend discharges/consults have been made

    • Email Lynette for Thursday indications code

    • View and update Sinai Tracking Sheet--continue throughout week

  • Tuesday

    • Dr. Maduekwe operates—hand trauma

  • Wednesday

    • UIC Morning conference—cases don’t start until 8:30am

    • Dr. Lew operates—hand trauma

    • Clinic: Lew/Madeukwe--typically staffed by Dr. Maduekwe and Tony 

  • Thursday

    • Sinai Indications—more info on that in its own section

    • Dr. Patel operates 1st/3rd weeks—typically Max/face trauma

      • Lew Clinic on Patel operative days​

    • Dr. Niknam operates 2nd/4th—typically breast

      • Niknam clinic on these days​

  • Friday

    • Dr. Ranzer operates—typically breast/body

    • Sinai Clinic—everything but hand

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Make sure you are referring to the Sinai Tracking Page document often--this facilitates our service's ability to deliver care--seen below in "scheduling and tracking"

Scheduling, and Tracking

The Sinai Tracking page is the main page used to facilitate our service

​

  • There are a few main areas of the first page

    • Plastic Surgery cases for next 2 weeks

    • Hand Surgery cases for next 2 weeks

    • Archives--running history of prior cases

    • OR Waiting List--pending development

  • Our job is to coordinate filling out and updating this sheet to organize ​patient care

  • Try to do this earlier in the week to fill in the case schedule efficiently

​

The 1st and 2nd pages are respectively Plastics OR schedule and Hand OR schedule

  • Use these pages to view the OR schedules and proposed OR times

  • Good reference to ensure nothing is being overbooked

    • Can refer to OR time on the sheet to see how much time used for a case, and make informed decisions when scheduling​​

Contact Numbers

Mt Sinai Hospital 

1500 S Fairfield Avenue 

Chicago, IL 60608 

773-542-2000 

 

General Hospital Numbers 

To return a page: 773-257-****  

To page someone: 773-257-2222  

Operator: 0 

 

Spanish interpreter: 855-469-5225  

 

Hand Clinic (Crown Ortho 1st Floor) 

Hand clinic Appointment: 773-257-4770, 773-257-6663 

Tony (PA): 847-226-7408 (personal); p19127 

Schwab Rehab (for pt to schedule OT appt): 773-565-3900 

 

Plastic Clinic (SCI Building 3rd Floor) 

Plastics Surgery Clinic Appointment : 773-257-6701 

Cristina (RN): 773-499-9541 (personal) 

Cristina.coreno@sinai.org 

 

Wound Care Center (4th Floor)  Appointment: 773-257-4940

Caitlin, Wound Care NP: 708-951-8417 

 

OR Front Desk: 773-257-6520 

Surgery Scheduling: ext. 4243, 2118, 6206, 6597 

 

Emergency Department  773-257-6241 

General Surgery: p19469    773-257-1615 

Trauma Service:  p16446 

SICU:  p16081 (junior resident) 

 

Family Medicine:  p26702   773-257-6612 

Internal Medicine: 

Before 3pm- 

Use pager number on note, or chat person on note 

After 3pm- 

On-call Floor 5N: p26956 

On-call Floor 2N, 3N, 6N: p26957 

Hospitalist:   p16985 

 

Orthopedics  p19308  773-257-6663 

Podiatry    p16115 

Radiology 

Radiology reading room: 773-257-2770 

CT scan: 773-257-6503; p19458 

Vendors

For Maxface Fractures we use 3 vendors and rotate them so that each has an opportunity. It is good for the residents to learn the various system 

  1. Zimmer-Biomet  

David Henry  773-633-6380 

Drake 330-904-1485 

Laura  630-430-6181 

  1. KLS 

Trent Grimes 224-465-9689 

  1. Stryker  

Brett Morse 630-926-9625 

 

Also we use ImmersiveTouch, Inc for ALL fractures for visualizing, VR reduction, 3D printing and PreAdapting the plates from ANY of the above companies. 

 

The CT must be specially ordered 'thin cuts 0.5mm slices DICOM 3D volumetric Stryker Protocol'  

 

 

Mel--OR nurse--keep track of what vendor is next

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All operative facial fractures are posted in the "Sinai Fracture Project" group chat. The engineers will reduce and print pre and post reduction models. 

  • Time depending, you may coordinate with one the vendors to pre-bend plates

​

Wound Care Products BTM: Kathy: 630-936-1133

Thursday Conference

​

  1. Review upcoming scheduled cases for the next two weeks (hand and general plastic) 

    • Discuss upcoming schedules: faculty and resident out dates that will impact clinical care/productivity  - vacations/meetings 

    • Resident assigned to hand presents the Hand Service 

    • Resident assigned to general plastic presents the Plastic Service

    • Discuss patients that need to get added on to the board

  2. Discuss any anticipated problems

  3. Review relevant patients in the hospitals​

  4. Sinai Short Talks--5 min each for plastics and hand​

    • St​art with a patient problem, and then introduce a relevant topic for discussion

    • The topic of discussion is the "main entree". Make sure to discuss-- ​

      • Photos/images ​

      • Relevant background

      • Surgical and post-operative courses

Wound Care

  • There is not currently a wound care nurse

  • We get paged, typically on Thursday mornings, when wound care has a patient they believe is ready for reconstruction​​

  • We see if patient if able, or review chart, and if ready for surgery, they are added on the schedule

    • Typically staff with chief resident, and then added on schedule, typically for Dr. Patel

      • ​If this is a new patient, staff with the next available PRS attending

    • Wound care should facilitate all pre-op care of the patients​​

​​

  • For any patients for whom we apply BTM, skin grafts, or fix a similar wound care issue, we schedule them for follow up in the wound clinic, NOT in the PRS clinic

Staffing Consults

  • Junior residents should typically be staffing with their senior resident, prior to staffing with the attending

  • For Plastics

    • Staff w/ service chief, who will either staff with the attending who is on site and operating that day, or will send in the Sinai consult chat​

      • Once it is determined that a patient needs operative intervention, facial fractures will typically just be sent in the Sinai fracture project group​

  • For Hand

    • Staff w/ service chief, who will almost always staff with the hand attending on call that day. If case is simple or non-op, then will occasionally staff with the hand attending around that day​

  • When Cook County is on call

  • For wound care: refer to that section of this 

​​

  • For any patients for whom we apply BTM, skin grafts, or fix a similar wound care issue, we schedule them for follow up in the wound clinic, NOT in the PRS clinic

Resources

  • Patel's OneNote--holy grail to be used for reference for almost all cases, especially facial fractures​

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Epic/IT Stuff

Access to Epic/Tech Issues

    You will receive an email from the coordinator to set this up

    patricia.holden@sinai.org — this is her email, if you don’t hear anything a week prior to starting, please reach out to her

    (844-408-0003) — For issues with access or confirming access, call point core

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