Docs Answer: How Can I Stay Organized on the Wards?

Dear Doctors,

I need help keeping my patients straight on my wards rotations. Many of my Senior Residents and Attendings have made negative comments about my performance in that area. Do you have any advice on organizing all the information?

– Disorganized on the Floors

Dear Disorganized,

First off, know that your organization will improve and evolve in time as you move through your training. Be kind to yourself as you’re finding your grove!

What you need on you as an M3/M4 vs an intern vs a senior resident with change as your roles evolve. Overall though, most people trend toward simplicity and a “less is more” attitude. I am definitely a minimalist when it comes to data management. The method that got me through residency, where as a senior I was overseeing 2 interns and the care of sometimes 25+ patients during 12+hour shifts is as follows:

First fold a sheet of computer paper into 4’s or 8’s (depending on census size/complexity of each individual patient). It should look something like this:

Fold a paper into quarters if the census is low
Fold a paper into eighths for a higher census

Each square represents one patient under your care. Fill out each patient square with the same information, always in the same position in the square so you know where to look. I numbered each patient so I could cross check with the census and confirm that I was accounting for every patient under my care. I arranged and formatted my patient blocks as follows:

Here’s an example patient square filled in with made-up patient information:

Benefits of this method are:

  1. Holding info for up to 16 patients on a single sheet of paper
  2. You can keep track of new tasks as they come up by adding a new box in real time
  3. To do check boxes for all patients on the same sheet helped me see my overall progress at a glance
  4. Never forget to order AM labs as an intern again
  5. All major events make it to sign out

I hope that’s helps!

– Dr. Brittani

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Dr. Brittani James

Brittani James, MD is an Attending Family Medicine Physician who practices on Chicago's South Side. She co-founded Med Like Me with her twin sister, Dr. Brandi, as a passion project. She is dedicated to working with underserved and vulnerable populations and mentoring the next generation of diverse physicians.

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