Process for ACS Case Order Designation
Approved- Carter July 2026
The ACS day team is responsible for setting the first case for the following day. On Monday through Friday, the long fellow is responsible for designating the first case for the following day. On Saturday, Sunday, and holidays, the ACS rounding resident or fellow is responsible for designating the first case for the following day. Interns may assist in completing posting sheets and delivering them to the OR board but should not be involved in designating case order. Expectations include:
The night before surgery:
- Patient has been formally posted with the Ryder OR board and placed into first-start slot for OR 83 or alternative designated ACS room
- Patient has been specifically reviewed with the ACS attending surgeon for the following day who has agreed with the operative plan
- Patient has accurate, up-to-date operative and blood consents and that all necessary preoperative workup has been completed
- Patient has an NPO after midnight order
The morning of surgery:
- Pt is re-examined and 23-hr updated history and physical note is sent to the ACS attending surgeon on call before 6:15am
Overnight emergency cases may postpone the designated first ACS case of the day (a relatively common event) but the designated first ACS case should not be swapped out for a different case except in rare circumstances of unanticipated changes in patient condition. The senior-in-house resident should not alter the designated first ACS case of the day except with direct communication with the ACS day team.
Description
The ACS day team is responsible for setting the first case for the following day. On Monday through Friday, the long fellow is responsible for designating the first case for the following day. On Saturday, Sunday, and holidays, the ACS rounding resident or fellow is responsible for designating the first case for the following day. Interns may assist in completing posting sheets and delivering them to the OR board but should not be involved in designating case order. Expectations include:
The night before surgery:
- Patient has been formally posted with the Ryder OR board and placed into first-start slot for OR 83 or alternative designated ACS room
- Patient has been specifically reviewed with the ACS attending surgeon for the following day who has agreed with the operative plan
- Patient has accurate, up-to-date operative and blood consents and that all necessary preoperative workup has been completed
- Patient has an NPO after midnight order
The morning of surgery:
- Pt is re-examined and 23-hr updated history and physical note is sent to the ACS attending surgeon on call before 6:15am
Overnight emergency cases may postpone the designated first ACS case of the day (a relatively common event) but the designated first ACS case should not be swapped out for a different case except in rare circumstances of unanticipated changes in patient condition. The senior-in-house resident should not alter the designated first ACS case of the day except with direct communication with the ACS day team.