Clinicals
Epic Setup and Shortcuts
Apr 11, 20269 min read
By Mike
By MikeDisclaimer: Epic is a registered trademark of © 2026 Epic Systems Corporation. This article is not affiliated with, endorsed by, or sponsored by Epic Systems Corporation. StrudelMed / Strudel Academy LLC is an independent medical education resource. The content below is not medical or clinical advice and is intended for educational purposes and general guidance only. Epic builds vary by institution; some features, shortcuts, or menu names may differ at your hospital.
It's time to talk about everybody's favorite electronic medical software, EPIC Hyperspace (very epic, I know). Let's start by discussing inpatient pre-rounding. Pre-rounding should be completed in a systematic manner. Develop a consistent sequence so you never miss anything and avoid jumping between tabs.
1. Start in your patient list. Open your list and sort by room number or team. Glance at the flag column for overnight alerts, new consult notes, or nursing flags.
2. Review overnight vitals and I/Os. Open the Flowsheets tab or nursing summary. Look at vitals trends, ins and outs, and any medications given overnight.
3. Check new results. Go to Results Review. Focus on labs drawn overnight or early morning. Look at trends, not just individual values.
4. Read overnight notes. Check for new notes from cross-cover, nursing, consultants, or the ED. Filter the Notes tab to the last 12 to 24 hours.
5. Review the MAR. The Medication Administration Record shows what was actually given versus what was ordered. Check if scheduled medications were held or refused and whether PRN medications were used frequently.
6. Check active orders. Scan for anything that needs to be renewed, discontinued, or modified. Look for expiring antibiotics, diet orders that should be advanced, and telemetry or restraint orders that need daily renewal.
7. Imaging and micro. Check for pending imaging reads or preliminary micro results (blood cultures, urine cultures). These are easy to miss if you only look at the lab tab.
Use the Synopsis or Patient Summary tab. Most Epic builds have a synopsis or snapshot view that consolidates vitals, labs, active meds, and active problems onto one screen. This can replace several of the steps above in a single glance (minimizing how many tabs you have to toggle between).
Customize your patient list columns. Add columns for latest vital signs, recent lab values (BMP, CBC), diet, code status, and attending. This gives you a quick overview of your entire list without opening each chart. You can also set an alert in the list for new labs and new notes (this is super helpful).
Set your default tabs. You can configure which tab opens first when you open a patient chart. Setting it to Synopsis or Results Review saves a click on every patient, every day.
Filter by date range. In the Notes tab, filter to the last 24 hours to see only what is new. Expand to 48 to 72 hours if picking up a new patient or returning from a day off.
Read the assessment and plan first. Skip to the A/P to understand the clinical reasoning and plan, then read the HPI and relevant sections for more detail. This is especially useful for long consultant notes (I'm looking at you, infectious disease).
Use the "Notes I Haven't Read" filter if your institution has it enabled. This highlights notes filed since you last opened the chart.
Look for cosigned notes. Attendings sometimes add important addendums or edits when they cosign resident notes. These changes do not generate a separate notification.
**Note History. You can see which parts of a note were manually typed versus auto-populated from templates or copy-forward. Right-click within a note or select the toggle for "View Audit Trail" or "Note History" (naming varies by institution). This is useful for identifying what a provider actually authored versus what was pulled in from a SmartPhrase or copied forward. Some builds color-code the text to distinguish templated content from original input.
Use Chart Search. There is a search bar at the top of the chart (magnifying glass icon) that searches across the entire patient record, including notes, results, orders, and documents. This is different from Ctrl + F, which only searches within whatever is currently displayed on your screen. Chart Search is invaluable for finding a specific consultant recommendation or prior workup result buried in the chart.
Dot phrases are the single biggest time-saver in Epic documentation. A dot phrase is a text shortcut: type a short code starting with a period, and it expands into a block of pre-written text with auto-populated fields.
How they work: Type .yourdotphrase in any text field and press Enter or Tab. The dot phrase expands into your template. Fields marked with *** are blank fill-in spots. Press F2 to jump from one *** placeholder to the next without touching the mouse. You can also go to the Smartphase manager and borrow dot phrases from attendings or other residents!
Build dot phrases for everything you do repeatedly:
.admit — Admission note template
.progress — Daily progress note template
.dc or .discharge — Discharge summary template
.event — Overnight event note for cross-cover
Dot phrase tips:
Use SmartLinks to auto-populate patient data. Type @NAME@ for the patient's name, @AGE@ for age, @MRN@ for MRN, and @TD@ for today's date. These pull directly from the chart and prevent transcription errors.
Create a .lab dot phrase that auto-imports today's lab values using SmartLinks like .LASTCBC or .LASTCHEM. This saves significant time on progress notes and ensures accuracy. Ask a senior resident to share theirs.
Name your dot phrases with a consistent prefix so they are easy to find. For example, use your initials: .mknote, .mkadmit, .mkdischarge. This prevents conflicts with institutional dot phrases.
In the attending field of a note, type = and it will auto-populate with the last attending you used. Saves time when writing multiple notes on the same service (especially in clinic).
Common SmartLinks to embed in your note templates:
@VITALS@ — Most recent vital signs
@MEDS@ — Current medication list
@PROBLEMS@ — Active problem list
@ALLERGIES@ — Allergy list
@LABS@ — Recent lab results (may need to be configured)
@BMI@ — Patient BMI
@DIET@ — Current diet order
@HE@ — Patient pronouns
Using these in your templates means less manual data entry, fewer transcription errors, and faster documentation.
The copy-forward function pulls yesterday's note into today's note as a starting point. Useful for progress notes on stable patients, but always update the subjective, objective data, and plan. Delete anything that is no longer relevant. Outdated information left in a copied note is a patient safety issue.
Search, don't browse. When placing orders, type the first few letters in the search bar rather than navigating through menus. Epic's search is fast and usually predictive after 3 to 4 characters.
Use order sets. Most institutions have pre-built order sets for common admissions (CHF, COPD exacerbation, DKA, sepsis, post-op). These are faster than placing orders individually and help you avoid forgetting routine orders like DVT prophylaxis or diet.
Favorite your frequent orders. Star orders you use regularly so they appear in your favorites list. Do this during your first week for common PRNs (Tylenol, ondansetron, melatonin), labs (BMP, CBC, coags), and imaging (CXR portable).
Batch sign orders. Queue up multiple orders and sign them all at once using the "Sign Orders" button rather than signing each one individually.
These vary by institution, but common ones include:
Ctrl + Space — Jump to Epic search bar
Ctrl + O — Open orders
Ctrl + 2 — Open patient list
Ctrl + 3 — Open Patient Station
Alt + S — Sign/submit
Alt + A — Accept
F2 — Jump to next *** placeholder in a note
Ctrl + Alt + S — Secure your workstation
Ctrl + Alt + L — Log out of Epic
Many commands also have an underlined letter in the interface, which indicates that Alt + that letter will activate the command.
Start the discharge summary early. If a patient is likely going home tomorrow, start the discharge summary early in the hospitalization to ensure accuracy and avoid dumping work on your colleagues taking over the service after you.
Use an AVS dot phrase. Build a dot phrase for the After Visit Summary (patient-facing discharge instructions) that covers common discharge scenarios. Include medication changes in plain language, follow-up appointments, and return precautions.
Reconcile medications as you go. When you discontinue an inpatient-only medication or switch IV to oral, update the discharge med list at the same time. This makes the final reconciliation faster.
Prepare follow-up before discharge day. Place referral orders and schedule follow-up appointments 1 to 2 days before anticipated discharge. Waiting until discharge day to arrange follow-up is a common bottleneck.
Hyperlinks in notes. You can hyperlink to specific results, imaging, or notes within your documentation. Useful in handoff notes or complex assessments where you want the reader to quickly access source data.
Patient report for rounding. The Synopsis or patient report can often be printed as a one-page summary. Many teams use a printed synopsis as a rounding sheet instead of hand-writing one.
Secure Chat. If your institution uses Epic's secure messaging, use it for non-urgent (yes, NON-URGENT) communication with nurses, pharmacists, and consultants.
The best time to set up your Epic environment is during orientation or your first week. Spend 30 to 60 minutes on the following:
The goal is not to master Epic on day one. It is to build habits and templates that compound over time. Every minute saved in the chart is a minute that can be spent at the bedside, learning, or taking care of yourself.
Best of luck
— Mike