Jeopardy

Jeopardy Policy

(updated 3/31/21)

Jeopardy Rules/Shifts we jeopardize for:

  • Any night or 28hr shift anywhere (ward, PICU, PHO, NICU, RCH)

  • Seniors missing wards (Hood, coast, SSA, RCH)

  • Any weekend absence anywhere

  • Daytime intern absence in the MBU

Shifts we consider jeopardy:

  • Daytime pediatric resident absence on NICU if census >10 per rounder

  • Daytime intern absence on hood, coast, RCH, SSA if census >10 per rounder

  • Any PICU day if high census (including ED resident)

  • PHO weekday if high census

Things we do not jeopardize for:

  • ED shifts (split shifts 12-8 and 4-midnight)

  • FM interns (they “cover their own”)

  • Weekday coverage for SSB (renal covers), pulm, clinic (unless both seniors are gone), ID, elective, development, adolescent, cardiology, Kaiser, GI, neuro, renal

Jeopardy Schedule:


PGY-1 J1/pop-off

  • Split between CACH, SCAN, and Pal

    • 1 weekend each

  • J1 and pop-off are covered by the same intern, if J1/pop-off is used then move onto J2 if needed

PGY-2 J1

  • MWF = Pulm

  • TR = NT-CACH

  • Fri PM - Mon AM = split bw Endo and Pulm

PGY-3 J1

  • M-F = SPREE

  • Fri PM - Mon AM = split bw Adol and Dev

J2

  • MWF = Neuro (if no neuro, then GI)

  • TR = Cards

  • Fri PM - Mon AM = split bw Neuro and Cards (if no neuro, then GI)


High Patient Volume Weekend Plan (2020)

“Pop Off”

Situation/Background: On weekends we often operate with a smaller team of residents. There is some degree of continuity, but also lots of cross coverage. In the past, there has been concerns around patient safety and resident workload when census numbers were very high. To help prevent residents from carrying >10 patients a weekend pop-off system was created.

Overnight Senior Responsibilities: The overnight senior will page and call in the PGY1 J1 who covers pop-off. This responsible party should be listed in Amion under “Pop off coverage” as well as “PGY1 J1”. This should be done before 0630 in the morning but ideally a heads up is given before midnight the night prior. It is also the responsibility of the overnight senior to notify the chiefs that the Pop-Off was utilized via email. IF you really don’t want to page pop-off resident please let the chiefs know and we are happy to do it for you.

When to call pop-off: If there are more than 10 patients per rounder, call the pop-off resident

· Example 1: There are 4 rounders for the morning (1 hood, 1 coast, 1 SSA, and 1 SSB) and 41 total patients, which is more than 10 per person, time to call!

· Example 2: There are 5 rounders for the morning (2 hood, 1 coast, 1 SSA, and 1 SSB) and 51 total patients, which is more than 10 per person, time to call!

Of Note: If the above criteria is not met but there are >9 patients per rounder and you have questions about acuity or complexity, you can reach out to chief on call to discuss further.

Daytime Senior Responsibilities: Work with Pop Off resident to get them rounded out and home as soon as possible.

PGY1 J1 Pop Off Responsibilities: Review AMiOn so you know which weekend days you will be covering PGYI J1 and thus pop-off coverage. On days you’re assigned, you should carry your pager with you or make the overnight senior aware that you are pop-off and exchange cell phone numbers. If you’re notified the night before, head in for sign-out at 0700. If you’re notified that morning, get there as soon as you can.

Contingency Plans

The jeopardy resident may not be available for one of several reasons:

1. He/she was on call the previous day.

2. He/she is ill or has a family emergency (or any of the examples noted above).

In the event that the jeopardy resident is not able to take call the J2 resident will be next in line for jeopardy call. The Chief Resident will only be back up if all other levels have been utilized.

Jeopardy Call “Abuse”

There is a system in place to help resolve the potential abuse of jeopardy. If a resident invokes jeopardy more frequently than 3 times in a year, a meeting between the chief and that resident takes place to discuss ways to help avoid these problems and to identify and underlying issues that the rest of the residents may not be aware of. Additionally, ways to “payback” the call will be discussed. This does NOT mean that everyone has “3 free ones a year”. Please take care not to abuse this system, but remember to not feel guilty if you truly need to call for jeopardy coverage.


Jeopardy Policy for EM residents in the PICU and Peds residents in the Peds ED

Updated 2021 (per discussion with EM and Peds Program Directors)

Ill call - for EM residents on the PICU rotation

  • Any EM resident who is acutely ill and can't be present for an assigned shift will call the EM chief and either the EM chief or the resident themselves will call the Peds chief

  • Peds jeopardy will cover call unless call switch can be arranged on short notice

Ill call - for Peds residents in the Peds ED rotation

  • Any Pediatrics resident who is acutely ill and can’t be present for an assigned shift will call the Peds chief and either the Peds chief or the resident themselves will call the EM chief on duty. If the call is short notice, it is helpful to also call the PED attending at 418-5521.

  • For ill calls in the Peds ED, if onset of illness allows for a swap, this is preferable. If onset of illness does not allow for a swap, we will move from a 3-resident to 2-resident schedule (shifts are typically 12-8p and 4-12a). The two other residents who are scheduled that day may be asked to adjust their shift times. Shift times may not be adjusted if they will result in a duty hours violation or conflict with a scheduled continuity clinic. We acknowledge that residents may be unable to adjust shift times based on previously scheduled conflicts (i.e. childcare plans, preexisting appointments).