Rotation Director:
Name: Sarah Green
Email: greensh@ohsu.edu
Office: CDRC 1240
Phone: 503-494-1170
Pager: 14161
Overview:
This is an inpatient rotation where residents will provide direct clinical care for hospitalized pediatric patients on both general and subspecialty services.
Rotation goals and objectives:
Residents will actively care for patients on the wards, including admitting new patients, moving forward care plans, addressing new clinical issues and concerns, and anticipating and preparing discharges
Residents will be able to have effective team communication and interprofessional collaboration. This includes communicating with one another (ie senior aware of intern activities, intern knows senior expectations and triage, interns communicate to share admit workload), with nursing, and with attendings as indicated (ex with questions, alerting when there are big clinical changes)
Prior to the start of the rotation:
Residents should come prepared with their pager, PALS card, and emergency card
First night of the rotation:
During the weekdays, sign-out starts at 5:30pm in the resident lounge. Both interns are expected to arrive for sign-out each day at 5:30pm, regardless of which team signs out first that day. (Please see below for full sign-out schedule)
During the weekends, sign-out starts at 5:30pm in the Hood workroom
Each intern will take two of the four inpatient teams. Either Hood/SSB or Coast/SSA
Helpful things the 2nd intern can do (while the other is getting sign-out):
Change first call
Listen to sign-out and help change any orders that come up. Be sure to close the loop with the day and night team regarding any changes made
Help answer any pages that come up during sign-out
Begin seeing sick patients or new admissions as needed
Resident Expectations:
Intern Expectations:
Provide family-centered patient care for patients with common pediatric signs, symptoms, and diagnoses requiring hospitalization:
See and examine new admissions, “watchers”, and patients with clinical status changes as needed throughout the night
Complete I-PASS action items and address new questions and concerns raised by all care team members and families overnight
Develop plan of care for new admissions
As time permits, anticipate discharges and help initiate discharge instructions and summary for patients likely to be discharged the next day
For new admissions:
Prepare patients and families for family centered rounds. Keep the family informed of changes in clinical status or in plan of care
Write H&P including problem based plan
Conduct an admission huddle with admitting RN to review care plan, address any concerns, answer questions
For known patients, residents should write a concise progress note for any significant overnight events or changes, emphasizing your medical decision making and plan of care
During sign-out in the morning, communicate key medical information including overnight events, clinical status changes, any immediate follow-up action items
Senior Expectations:
Provide leadership and organization to the inpatient teams:
Assigning admissions to interns, leading multidisciplinary midnight rounds (residents touch base with nurses on each floor for every patient), help coordinate communication between subspecialty attendings and team, maintaining I-PASS sign-out list, and assistant with discharge prep
When busy, helping maintain night flow including doing admissions independently if needed
Serve as the principal educator for the team:
Scheduling teaching time as able
Demonstrating physical exam findings and clinical pearls
Providing student and interns with direct, constructive feedback
Supervise the clinical care provided by interns and students:
Directly oversee all clinical care (including co-signing notes and orders for sub-interns – please note that sub-interns H&P notes and discharge summaries CANNOT be billed off of and thus new admissions or discharges will need a separate H&P or discharge summary)
Providing oversight, leadership, and support to interns including reviewing care plan and orders on all new admissions, supervising admission huddles, and helping interns develop time efficient strategies for completing clinical work
All residents are expected to respond to Pediatric Code Blues, including at Shriners and Casey Eye Institute
General Schedule:
Interns: Work Monday-Friday nights. Please note that your Senior resident will be different on Friday night. This will be a daytime ward senior on a 24 hour shift
Seniors: Work Sunday-Thursday nights
Evening Sign-out schedule:
General night schedule:
If you are going to be absent for all or part of a day:
Please contact (page or text) chief on call as soon as possible to arrange coverage. A verbal exchange must happen with the chief on call because you may need to contact other individuals.
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, chiefs, and program leadership.
Resident Resources, Helpful Tips, and Further Readings:
Box Folder (algorithms, policies, dot phrases, etc.)