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July 2011 inpatient changes

Page history last edited by Dan Waldman 9 years, 1 month ago

1. Who's the day call/"late" intern?
It's now an intern from the same team as the upper level.  For example, if it's an "B" day (found in amion.com), then the resident and an intern from that team are the late people.  Which one specifically?

Here's the block schedule:
http://unmfm.pbworks.com/w/page/39072085/inpatient+resident+template+2011-2012

the schedule for months with an anesthesiology intern (who is on team A):
http://unmfm.pbworks.com/w/page/39072749/inpatient+resident+template+2011-2012+blocks+with+anesthesiology+intern


2. How do we do signout then?
the non late team resident needs to call in to the resident NF to sign out the team overnight.  This avoids a "double" signout.  When the non-day call resident leaves at 5, he/she briefly signs out to the late resident, who will cover the team for about 1.5hrs.  So that signout should be brief.  I recommend being brief (5 mins) highlighting sick people and being available via phone/pager if needed before you sign out to the resident NF.

Want more details?
http://unmfm.pbworks.com/w/page/34006254/Inpatient+Sign-Out+Procedures

3. Shift hour changes:
Day call intern and resident now both sign out at 6:45pm (the intern used to stay 1/2 hr later)
http://unmfm.pbworks.com/w/page/34005100/Inpatient-Shift-Hours


4. Weekends
the off-service resident coming in rounds for the resident on the day call team.  So your weekend day off as chief is the day your team is listed as day call.

Saturday: now a 24 hr shift for continuity reasons (actually 26 hrs)
Sunday: the late resident is now the off-service resident.  It has to do with not needing the continuity of the chief since the intern stays late that day.


5. Holidays
interns aren't too affected by holidays- we just go with the schedule.  If you're on B and you want to give one of the interns a day off because the service is light you can, don't give the day call intern the day off, otherwise it's up to you how you'd like to handle it.  I can't figure out a way to make a rule for that without it seeming arbitrary.

residents:
I'm sorry about this, but I can't figure out a way to handle the holidays where people get extra days off without the risk of having days where no one from the team was there the day before.  So, for now, on a holiday, both chiefs come in to round, and they leave when work is done to the holiday person who can relax in the morning assuming there are no admissions/consults to be done.  Sign things out to be finished, and try your best to leave by noon.

I'll bring this up with the chief residents at our meeting next week and we can brainstorm, but the only way I could figure it out is if we had a schedule where we figured out how to handle the holiday depending on the day of the week and A/B day.  It's confusing and makes my head spin.  I'm open to ideas- start with thinking about how we'd handle a holiday on an A day on Monday, and who was there the day before.  Maybe it will come down to some elaborate flowsheet about by day of the week and call-day, but I haven't figured that out yet. This is the downside of having days off that fall on weekends.

6. Other misc things
-PA late day moved to a Wednesday (once every 2 weeks)
-PA extra day off for hours moved to Friday (team B)
-interns don't do 7 nights in a row of NF
-don't need to have the intern coming off night float come in late- they already have 4 full 24 hr periods off

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