Call Schedule

Jeopardy Call

A backup jeopardy call schedule will be created on a yearly basis to provide coverage of inpatient services in case of emergencies at UMMC, HCMC, and VAMC. Residents are assigned to the jeopardy call schedule when scheduled for an outpatient or elective month. Vacations are not allowed during the time that you are scheduled for jeopardy call. Residents may swap jeopardy call with another resident. Notify the chief resident(s) and program coordinator when a switch is made.

Primary and secondary jeopardy schedules are created. Residents scheduled for backup may be called in to cover G2 - G4 inpatient responsibilities. Backup does not cover continuity clinic. Residents will be provided with emergency back up coverage when they are ill, have emergent court assignment or have a death/serious illness in their immediate family requiring emergent absence from inpatient duties . If an emergent situation arises and you need backup coverage, you must alert the administrative chief (via phone or pager) immediately, so that arrangements for coverage can be made. You must also notify the program coordinator of your absence.

The backup resident (whether primary jeopardy or secondary backup) must be available to respond to their pager or cell phone within 15 minutes of receiving a call. This is true 24/7 for the entire period the resident is on backup. Residents should be prepared to report for duty within 2 hours (ideally less) of notification during their backup call period, 24 hours a day. Jeopardy shifts start/end on Sundays at 7pm. Please pay careful attention to these responsibilities. In the event that a resident cannot be contacted within 30 minutes during a scheduled backup period, an additional two week block will be assigned, and secondary backup is contacted.

Primary backup will be used first for coverage. Primary can cover up to 24 consecutive hours in the event of a night shift following a day-shift. Duty hour regulations still apply, including 12 hrs off after a 24-hr shift. Secondary backup will be used if: 1) primary backup is already in use, 2) it would violate duty hours for primary to cover, 3) primary jeopardy has an emergency or is unavailable, or 4) rare situations up to the discretion of the administrative chief.

The backup resident should still attend their continuity clinic even when filling in for an inpatient service. If continuity clinic would cause a critically low number of residents on the inpatient service, the administrative chief should be contacted.

On-call schedules for teaching staff are structured to ensure that supervision is readily available to residents on duty. Residents are supervised by teaching staff in a way that will allow progressively increasing responsibility for patient care according to their level of training, ability, and experience. The teaching staff determines the level of responsibility accorded to each resident/fellow.

The following levels of supervision are available:

Direct : the supervising physician is physically present with the trainee and patient

Indirect: the supervising physician is physically within the hospital or other site of patient care and is immediately available to provide direct supervision, or, the supervising physician is not physically present within the hospital or other site of patient care, but is immediately available by phone and/or other electronic modalities and is available to provide direct supervision.

Oversight : the supervising physician is available to provide review of procedures/encounters with feedback provided after the care is delivered

Residents concerned they are “out of their depth” must contact a more experienced backup. Senior residents, fellows, and attendings are always available. If you find that you cannot contact senior support, page the assigned attending. If you are not able to reach the attending, please contact the program director. Patient safety is the program’s priority, and residents are encouraged to ask for help when they need it.

Any resident experiencing fatigue sufficient to jeopardize patient care, at any time, must page the assigned attending. The attending is then responsible for arranging or providing patient care.

Below are specific situations which mandate that a trainee contact the supervising physician immediately:

• • • When patients are behaviorally disordered or threatening

    • When there is a need for a CODE team activation

    • Unexpected transfer to ICU or higher level of care

    • Unanticipated intubation or ventilator support

    • Change in CODE status

    • Major neurologic change

    • Major medical problem (e.g. cardiac arrest, a CODE, new or rapidly worsening respiratory distress, PE)

    • Clinical intervention due to medication or treatment errors

    • Development of any new clinical problem requiring an invasive procedure or operation for treatment

    • Patient, family, or clinical staff request for attending notification

    • Death

There are call rooms available at both UMMC and HCMC for trainees to use if they are too tired to drive home.

UMMC – on 4th floor of Mayo building, next to C-496 exercise room

Call 626-6330 for reservations; check-in time 2:00pm to 7:00 am

HCMC – walk-in available at R5.302, door code 2354.

Reserve through Cheryl Neel, 873-2595 x4 when need is known in advance

UMMC also has a general resident lounge on the 6th floor, which offers a TV, computer, telephone, and light refreshments (restocked twice a day).