UCSD   Hospitalist Rotation

PGY-3

WHO:             GME ADMINISTRATOR: Denise Killian : dkillian@health.ucsd.edu, c. 619-471-9009

UCSD Faculty: Yuri Shindo, MD:  y1shindo@health.ucsd.edu  858-345-0639 (cell).

Meghan Sebasky, MD:  mmsebasky@health.ucsd.edu  612-239-0757 (cell).

FM GME Administrator: Janell Bean:  janell.bean.civ@health.mil

FM GME Administrator: Michelle Paton: michelle.n.patton.civ@health.mil 

FM Faculty Liaison:  Dr. Noa Hammer: noa.c.hammer.mil@health.mil

WHERE:  La Jolla, Jacobs Medical Center (UCSD ID Badge), Lower level 410, 9300 Campus Point Drive, SD 92037

WHEN:  Per communications between Ann Zultner and resident. 

HOSPITAL ID BADGE:

There are 2 locations to pick up the hospital ID Badge, at the Jacobs Medical Center and at their Hillcrest location.  Badges can be picked up as early as 2 weeks prior to rotation, but rotator MUST have badge for day 1.   One more thing as stated in the rotation email, we ask that rotators call the security office before going there due to their unique hours of operation.

1-COMPLETE APPLICATION & SUBMIT SUPPORTING DOCUMENTS:  Resident must complete an online registration as early as possible. https://medschool.ucsd.edu/education/gme/visiting-residents/Pages/default.aspx 

Application and supporting documents are due NLT than 3 weeks prior to rotation. 

You will need—

-a copy of your diploma. 

-to fill out dates for TDAP and Flu, and dates & manufacturer for Covid vaccinations & booster.

-to submit proof of TB test.   TB test must be done within 3 months of rotation. 

- to submit copy of your Travel Orders. (these may be submitted later/after arrival). 

2- CONTACT GME COORDINATOR:  Resident must call or email Ann Zultner, GME Administrator, no less than 4 weeks prior to your rotation to discuss your registration and scheduling.  Ann Zultner:  619-543-8254.  azultner@health.ucsd.edu

3-COMPLETE DOCUMENTS AND TRAINING listed on their website, must be done NLT than 48 hours prior to start.  See online registration page for full list of documents and deadlines.

After completion of application and submitting all documents, Ms. Zultner will confirm with resident via email and provide specific check-in instructions.   Parking and badging instructions are on registration website. 

Camp Pendleton Navy Resident Team (LJ Team 3)

Adult Medicine- Jacobs Medical Center 2021-2022

Rotation Description: Residents are assigned to work on a hospitalist service for a four-week rotation. Responsibilities include admitting, managing and coordinating all essential patient care activities and discharging patients on that service. As hospital medicine faculty rotate on a weekly basis on Tuesdays, residents will have the opportunity to work with four hospitalists over the course of the rotation.

Approved Absences from Rotation:

- Retreat March 24th-25th,2023

- Holiday events TBD

- Graduation June 30th,2023

Patient Encounters

Please submit your total number of patient encounters (represented by completed notes) to your program by accessing the following report in EPIC on the last day of your rotation. See instructions below:

·         Click on EPIC (top left of screen)--> Reports--> My Reports--> My IP Notes ALL TIME-NAVY--> run report---> summary #1 tab shows how many notes were signed. Take a picture of the screen and send to Dr. Hammer and your program coordinator.

Goals and Objectives

Medical Knowledge

In the appropriate setting, the resident should demonstrate the ability to apply knowledge of/ to:

1.       Deep‐seated soft tissue infections versus superficial infections

2.       Impending respiratory failure

3.   Management of benzodiazepines in a patient with alcohol withdrawal

4.   Appropriate use of blood products

Patient Care

In the appropriate setting, the resident should demonstrate the ability to independently perform or appropriately refer the following skills:

1.   Manage diabetic ketoacidosis

2.   Manage extremes of blood pressure

3.   Demonstrate a cost-effective workup of loss of consciousness

4.   Adjust type, dose, and duration of therapy for pneumonia based on clinical course

5.   Manage and escalate care in a patient with sepsis

6.   Manage anticoagulation in a patient with suspected or known venous thromboembolism.

 Rotation Specific Guidelines:

Medical Knowledge

In the appropriate setting, the resident should demonstrate the ability to apply knowledge of/ to:

1. Deep‐seated soft tissue infections versus superficial infections

2. Impending respiratory failure

3. Management of benzodiazepines in a patient with alcohol withdrawal

4. Appropriate use of blood products

Patient Care

In the appropriate setting, the resident should demonstrate the ability to independently perform or appropriately refer the following skills:

1. Manage diabetic ketoacidosis

2. Manage extremes of blood pressure

3. Demonstrate a cost-effective workup of loss of consciousness

4. Adjust type, dose, and duration of therapy for pneumonia based on clinical course

5. Manage and escalate care in a patient with sepsis

6. Manage anticoagulation in a patient with suspected or known venous thromboembolism.

 Rotation Specific Guidelines:

Inpatient Hospitalist Responsibilities:

You will be assigned to work on a hospitalist service for your four‐week rotation. You will be responsible for admitting, managing and coordinating all essential patient care activities and discharging patients on that service. You will follow up to, but no more than, 8 patients your first week, and up to 10 patients the remainder of the rotation, with the exact number to be determined at the hospitalist’s discretion. As hospital medicine faculty rotate on a weekly basis on Tuesdays, you will have the opportunity to work with four hospitalists over the course of the rotation. There is no overnight call requirement. There is one admitting day per week on Fridays. Patients that you admit will remain on your team if they are cohorted to your geographic unit. You will also participate in FIT rounds (Focused Interdisciplinary Team rounds). These occur from 10:30-11:15 AM daily during weekdays (holidays excluded). Your attending will provide you with more details regarding this.

Schedule:

You are off on Sundays during the rotation. Should you need to modify your day off, please work with your assigned hospitalist to identify an alternative date that will be safest for patient care. General hours for the rotation are 7 AM to 7 PM. You will sign out your patients nightly to the nocturnist via the EPIC handoff tab (log in under Hospital Medicine to access this tab). Your pager can be forwarded to Medicine LJ Crosscover [pager 619-290-4401 from 7 PM to 7 AM] by updating 1st to call field in EPIC. Refer to the end of this document for further instruction on hand offs. Ensure you adhere to UCSD and ACGME work hour restrictions. You are responsible for keeping track of duty hours by logging them on the New Innovations website.

Team Logistics:

You will be assigned to Team 3 which is cohorted to Thornton 3E. Contact the hospitalist on Team 3 by email or pager on the Sunday before the rotation to arrange a time to meet on your first day. Please arrive no later than 7:00 AM.

Clinic Responsibilities:

None during this rotation.

Conferences:

Attendance at Medicine Grand Rounds (Wednesdays 12-1 pm via telecast) is considered optional.

Attendance at Afternoon Report with the Chief Medical Resident on Wednesdays and Thursdays from 1:15 – 2 PM is encouraged. This conference is held specifically for residents. It takes place at various conference rooms in the Jacobs tower. If you do not receive email communication from the chief resident at the beginning of the week, you can also ask the UCSD residents on service where the conference will be held.

COVID Information

Team 3 is not a primary COVID team, but it is possible that you may have COVID patients on your service.

Goggles/face shield and face mask are required for all patient contact and are provided at the hospital. You are also required to wear a face mask at all times on hospital property. Please also complete the daily symptom checker and be prepared to show your ID badge when entering the hospital each day.

Symptom checker: https://blink.ucsd.edu/HR/services/covid-19/symptom-screening/index.html

If you’re sick:

Should you exhibit symptoms associated with COVID-19, contact the testing support line for employees at 619-543-8260.

o COVID rules and regulations are subject to change. Please visit pulse.ucsd.edu for information on current protocols. Coordinate with your attending to determine when you may return to work.

Program Director:  CDR Noa C. Hammer, MD.  Email:  noa.c.hammer.mil@mail.mil/ 760-719-3133.

Associate PD:  LCDR Richard B. Thompson, MD.  Email:  richard.b.thompson66.mil@mail.mil/ 760-719-3586.

Associate PD:  Emma Par, MD.  Email:  emma.j.par.civ@mail.mil/ 760-719-3180.

GME Coordinator:  Janell Bean.  janell.bean.civ@mail.mil/ 760-719-3364.

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Hospitalist Epic Handoff Instructions

1. Select a patient.

2. Select “Write Handoff” button just above the patient list.

3. Sidebar will open with Handoff input boxes.

4. Make sure the service in upper right-hand corner says “HOSPITAL MEDICINE UCSD”

5. Fill in “One-liner”, e.g. “45-year-old male with a h/o CHF admitted with acute exacerbation.”  Include illness severity.

6. Fill in “Active issues”, e.g. “CHF-started on IV Lasix BID. Goal net negative 1.5L. Currently on 4L NC.”

7. Fill in “To Do Overnight”. Leave blank if there is nothing to do. Use “ [ ]” before all To-Dos

8. Select “Close” button when you are done. This will save it (there is no separate “Save” button).

a.  Alternatively, you can select “Next” to go to the next patient on your list. This will save your current work and bring up the handoff for the next patient

9. When admitting a patient that will be handed off the next day, put any items the day person may need to prioritize the next day. For example, “Consult ID in AM to get approval for meropenem.