This document summarizes policies and procedures regarding trainee supervision. These policies are designed to be 100% compliant with the 2014 ACGME Program Requirements. It is mandatory that all trainees and faculty understand and uphold these policies at all times.
Supervision Policy, GME The Institution Manual
Levels of Supervision
Direct Supervision: supervising physician is physically present during the procedure/encounter
Indirect Supervision: supervising physician is available by phone, text, or pager to be able to provide Direct Supervision
Oversight: supervising physician reviews the procedure/encounter at a later time and provides feedback after care is delivered
Principles of Supervision of All Trainees
All trainees are supervised by an identifiable, credentialed, and privileged attending surgeon faculty who is ultimately responsible for that patient's care. This information is readily available to trainees, faculty members, and other health care professionals at each hospital. Additionally, every patient is apprised of who this attending is upon admission to the hospital. Typically, this information is available to the patient with complete information about the care team at the facility (resident, fellow, faculty, nurse, etc.) This also clarifies the roles of each member of the care team for the patient. Attending call schedules are available through the hospital operators. Additionally, most sites have attending call schedules available on line. Direct Supervision is provided in the operating room for all trainees when performing cases at our training institutions.
Guidelines for Specific Circumstances and Events
The University of Minnesota Physicians faculty practice has established guidelines for when attending physicians are to be notified about patient care issues. While not all-inclusive, fellows are also expected to contact attending staff for other issues as needed. Fellows are required to notify attending staff specifically for the following indications.
Admission to the hospital
Transfer to ICU or higher level of care
Unanticipated intubation or ventilator support
Development of new significant neurological changes (e.g. CVA, seizure, new onset of paralysis, acute decline in level of consciousness)
Development of new significant cardiac changes (e.g. CODE, serious arrhythmia, PE, hemodynamic instability)
Development of major wound complications (e.g. dehiscence or evisceration) • Medication or treatment errors requiring clinical intervention (e.g. invasive procedures, increased monitoring, new medications except Narcan)
Unanticipated blood transfusion without prior attending knowledge or instruction (before or after operation)
Development of any clinical problem requiring an invasive procedure or operation
Patient, family, or clinical staff request for attending notification
Death
BACK TO: