EXPECTATIONS

• • Please arrive on time and be available for patient work ups/H&P

  • Please be proactive for prep/drape of procedure that you wish to participate in

  • If possible, aside from mandatory IR conferences, please reschedule other conferences/meetings that could limit ability to participate in patient care (DO NOT attend megaconference or other meetings).

    • Patient care always comes first.  If patient arrives, do patient care duties (i.e. interview / prep patient) before (or instead of) attending conference.

  • If possible, please identify lead apron and radiation safety goggles to be utilized for that day ahead of time.

  • Dictate cases you participated in - include radiation dose and contrast (even if "none") in each dictation.

  • For clinic office hours, please perform a preliminary review of the charts of the patients to be seen such that the trainee can elaborate the patient presentation on the H&P and EPIC notes.

RESPONSIBILITIES

• Pre-procedure evaluation 

  • Informed consent form

  • Pre-procedure note in patient’s chart

    • Check relevant lab results (especially PT/INR, platelets, Cr, K)

    • Check for anticoagulation medications

    • Check NPO status pre-procedurally 

    • Mallampati, BMI should be in preop H&P for patients getting monitored sedation 

• During procedure

  • The degree of involvement in procedures will be determined based on demonstrated ability and interest

  • Familiarity with the clinical presentation, including history, physical examination, laboratory and other tests, pathophysiology of the disease process, and an appropriate assessment should precede resident involvement in any case

  • Residents who acquire competent clinical skills and adequacy in the roles of first and second assistant will graduate to primary operator on appropriate cases

• Post-procedure 

  • surgical style notes and orders will be written on the patients that the resident has performed procedures on

  • Cases may be dictated during the work day only if there are no ongoing procedures without physician first and second assistants

  • Otherwise, dictations should be done after completion of all procedures and readout

  • All procedure dictations and sign offs should be completed before the end of the work day

• Inpatient SIGN OUT

  • To communicate between the daytime staff and night and weekend coverage

  • W: This sign out is the responsibility of the residents and fellows and can be found on the HDrive under our Radiology Dept, SLW Residency, sub-folder VIR sign-out

  • BI: The sign out can be found on the desktop of the Room 4 computer and is often managed by the PAs during the day.

  • In addition to the sign out, you should email or call the call resident to transfer care for any patients they need to trend labs, write notes, and/or round on over the weekend

  •  The night and weekend coverage should inform the daytime team of any procedures they did as the daytime team will have to follow the patient

• Consults

  • Place a consult note after seeing the patient and discussing the case with the attending 

    • Keep track of inpatients on the schedule board.

  • At BI - check in with PA Jenna Strauss, and co-residents/fellows to manage the consult list.

• Rounding

  • This may be accomplished prior to start of the work day or after completion of all procedures and readout in the department

  • More active patients may be seen both prior to and after the work day

  • Less active patients may be seen less frequently or dropped from the inpatient list (this will be determined on a case-by-case basis by the attending Interventional Radiologist)

DOCUMENTATION

• All procedures require a consent, pre-procedural and post-procedural note 

• Outpatient notes are handwritten/charted per attending

• Inpatient notes are placed in the EMR

• Informed consent on Neuroradiology Primer or on paper at nursing bay