Training physicians providing overnight coverage on a busy pediatric acute care unit face many challenges especially when caring for complex patients on the Cardiology service. Notably, admission orders for pediatric patients with complex congenital heart disease such as those with single ventricle physiology must align with the standard of care for these conditions.  As novice providers, resident physicians may experience some uncertainty when writing admission orders for these complex patients increasing the risk of medical error and a delay in patient care. Additionally, when orders are initiated during an overnight shift they often fall outside of the standard of care for treatment. The purpose of this quality improvement project is to establish a standard admission order set for congenital cardiology patients with single ventricle physiology. The ultimate goal is to improve patient care by preventing medical errors and delay in care. We also hope this will improve nursing and physician communication and to minimize the number of calls to cross covering training physicians overnight. A collaborative interdisciplinary approach has been utilized to create a standard admission order set for pediatric patients with single ventricle physiology that are admitted to our inpatient pediatric unit. This includes the insights from attending pediatric cardiologists, training resident and fellow physicians, pediatric nursing staff and information technology (IT) specialists. The order set includes standard labs, imaging, monitoring, medications, diet, vital sign parameters based on surgical stage, and consults (case management, nutrition, PT, OT, SLP, Child Life, and surgical). It will be easily accessible on search of our electronic medical record (EMR) system. 
By creating this single ventricle specific cardiology order set, our goals are to improve overall patient care, efficiency for the medial team and improved communication between nursing staff and medical providers. This order set will help to maintain the standard of care for this highly complex and often fragile patient population. In the future, our goal is to create a variety of order sets tailored specifically for other cardiac pathologies such as arrhythmias and cardiomyopathies.  Anatomical diagrams that are placed at the head of each patient’s bed are also being utilized to assist in reminding staff of their underlying cardiac anatomy and where they are in the  staged surgical palliative process.