Randall Children's Hospital

Rotation director:

Name: Megan Durham, M.D.

** Email: MRDURHAM@LHS.ORG

pager: 503-938-1828

phone: cell 818-209-0333

office location: Legacy Emanuel Medical Center

**If it’s important, call or text me on my cell phone. It’s the most reliable way to reach me because I’m not in the office/hospital every day

Overview:

The inpatient pediatric rotation Randall Children’s Hospital at Legacy Emanuel provides an opportunity for interns to gain experience in the care of acutely ill pediatric patients. The structure of the rotation varies by program, but all pediatric residents will spend 3 weeks working a variety of day and night shifts on the inpatient pediatric ward with a pediatric hospitalist on the Blue Service.

This Randall team includes a PGY2 Pediatric resident, PGY1 Pediatric intern, as well as a PGY1 Family Medicine intern. The service covers the following patients:

• • Patients with general pediatric issues to Randall Children’s

  • Patients admitted to the pediatric gastroenterology service

Rotation goals and objectives:

• 1. Provide family-centered patient care for patients with common pediatric signs, symptoms, and diagnoses requiring hospitalization

  2. Understand the scope of medical knowledge needed to manage common inpatient diagnoses and demonstrate the ability to acquire, interpret, and apply new knowledge to patient care

  3. Demonstrate effective communication skills with patients, families, and colleagues

  4. Demonstrate an understanding to standard clinical approach to many common disease processes in pediatric gastroenterology, such as Crohn’s, ulcerative colitis, celiac disease, acute hepatitis, and pancreatitis

Prior to the start of the rotation:

• 1. Read and respond to email from Randall administrator. This includes a powerpoint you need to review.

  2. Complete any pertinent online training AT LEAST 2 BUSINESS DAYS PRIOR to start date

  3. Obtain sign-out of patients and the service from preceding resident

First day of the rotation:

• • Arrive at 6:15 am and go to the 6th Floor Physician Workroom where you will find the folder with your name on it. Inside is information, call numbers, and meal cards

    • If you need help getting there, you can reach your senior resident at 503-276-6849 OR simply 6-6849 from a hospital phone

  • Receive signout on overnight patients and sign in to intern phone

  • Pre Round and see all patient prior to rounds. Triage sick/ill or discharging patients

  • Complete rounds and urgent tasks prior to noon conference

  • All admissions need an H&P documented by a resident. All daily notes must have a physical exam and plan of care for the day documented by a resident

  • Update signout prior to handoff

ALSO ON THE FIRST DAY: Obtain ID Badge from Security Office and DEA#

Intern Expectations:

• • All patients must be examined prior to rounds and have a preliminary care plan in place at rounds. Discussion with the senior prior to rounds is encouraged.

  • Give clear SOAP format presentations on rounds w/ pertinent information that includes a daily review of the MAR specifics as well as a thoughtful assessment and plan

  • Morning discharges should be examined, discussed with senior/attending and have signed discharge order in computer prior to rounds, when applicable

  • Finish all notes prior to leaving hospital if at all possible

Senior Expectations:

• • Organize day to prioritize attending conferences, getting post-call and clinic residents out in time, etc.

  • Bedside rounding on sick kids as well as new admits, if possible, prior to team rounding

  • Take charge of running efficient family-centered bedside rounds. This includes ensuring orders are written in patient room, coaching/facilitating intern and medical student presentations, and finding teaching points and giving feedback

  • Lead daily 5 min informal teaching sessions if possible

  • Take active bedside involvement in patient care in the afternoon – i.e. participating in new admissions, assisting interns in creating care plans for children with active developing issues, etc.

  • Run the list w/ the attending in AM after sign-out and PM prior to sign-out to triage rounding for the day and review and solidify patient plans as needed

  • Run a noon conference during the rotation. This can be as formal or informal as you would like- it is PowerPoint optional! If you do not have another opportunity to do so, you are also welcome to use this time to lead a practice LP session with the teaching mannequin

General Schedule:

• • Rounds start with Gastroenterology between 8:45 and 9am. Rounds start with the hospitalist team start at 9:30am

  • Residents are expected to participate in noon conference at 1215 Monday-Wednesday and on Friday in the 6th floor report room.

  • Thursday they will attend grand rounds at 1200 in the Lorenzo Center.

  • Weekly case conference Friday morning at 7:30am. Expect you will present a case during your rotation

  • There is an orientation packet to refer to with more information and resident expectations

If you are going to be absent for all or part of a day:

• • Please call/page attending on service (503-276-6855), chief on call, and Michael Grubbs if you are unable to make it to work. A verbal exchange must happen with the chief on call.

  • Any resident missing more than 2 days (or 4 half days) may be required to make up the difference at a future date at the discretion of the rotation director and chiefs.

Resident Resources, Helpful Tips, and Further Readings:

Formal Curriculum