Call Guidelines

ADULT ON-CALL SERVICE

The on-call experience during Infectious Diseases training enhances the development of skills and responsibility in trainees. This responsibility requires maturity, knowledge, communication and clinical judgment. On-call also provides graded responsibility for the trainee. During the first six months to a year of clinical training, the trainee usually discusses all consults with the attending physician. Thereafter, they accept more responsibility and usually make decisions without necessarily prior consultation with the attending physician although the attending physician will need to be made aware of every consultation conducted whether it be a phone or in person consultation. The call responsibility provides the resident with a wider range of clinical cases than if their experience were limited solely to day consultations, five days a week.

The on-call schedule for trainees is 1:3 weekends throughout their training and 1:3 weeknights during the period they are on the consultation service. This experience also provides residents with feedback on consultations seen earlier as many of the calls are a direct result of advice given during the working day. When the resident is on call, the resident will be available by pager but will not be required to stay overnight in the hospital.

The objectives for the on-call experience are similar for those of the consult service with a few additional expectations.

MEDICAL EXPERT / CLINICAL DECISION MAKER:

1. Subspecialty Residents must also be knowledgeable about after hour’s laboratory procedures, hospital procedures, including what services are available, appropriate specimen collection and specimen transport.

2. Subspecialty Residents must also be knowledgeable about infection control and occupational health issues as the consult service may be called about such issues after hours.

3. Residents need to be able to decide which issues and patient problems can be handled over the phone and which ones require in hospital review.

4. The Subspecialty Residents will develop judgment regarding when further or immediate consultation with the attending physician should be made.

COMMUNICATOR:

1. Subspecialty Residents will learn to effectively communicate over the phone in addition to personally.

2. The Subspecialty Residents will acquire confidence in answering questions and in triaging consultations from the UAH site over the phone after discussing them with the requesting service or the Infectious Diseases rotating resident who has reviewed the patient.

3. In the last 6 months of training, the resident will develop confidence in answering calls from physicians outside of the UAH site including calls from anywhere in Northern Alberta.

COLLABORATOR:

1. The Subspecialty Residents will learn when they need to call in other health professionals when this can wait until regular working hours.

2. The Subspecialty Residents will learn when they need to ask for lab tests to be performed urgently and which are not normally available after regular hours.

LEADER:

1. The Subspecialty Residents will learn how to cope with limitations of lab services or support staff that are not available after hours.

2. The resident will learn how to manage personal commitments while fulfilling on call responsibilities.

SCHOLAR:

1. The resident will learn the availability of educational resources after hours and be able to look up information or conduct literature searches on line from home or elsewhere outside the hospital.

PROFESSIONAL:

1. While on-call, Subspecialty Residents will provide timely assistance to all health care professional seeking advice in an appropriate professional manner regardless of time of day or day of the week.

2. The Subspecialty Residents will realize that on-call is an important part of the service provided by an Infectious Diseases consultant.