Medicine Consult Resident Expectations

Medicine Consult Service Expectations - “Kindness begets kindness” – Treat others as you would have them treat you - Treat patients you consult on as your own patients - Communicate - Answer pages in as timely a fashion as you can - Communicate assessments/recommendations back to primary teams - Offer to enter orders if that will provide more efficient and timely care (except for Psychiatry patients – can pend orders for them) - If one of your recommendations is to consult a medicine subspecialty, consider calling that consult yourself if the primary team permits - If planning to sign off, communicate that to the primary team - Document all services: phone consults, curbsides, quick follow-ups, lab reviews, etc can be "treatment plan” notes - Go to Morning Report, Noon Conference, and Grand Rounds - Make sure you eat breakfast and/or lunch

  • Nuts/Bolts:

  • Helpful dot phrases (can get from chiefs, senior resident, or attending’s SmartPhrases):

  • .medresconsulthp

  • .medresconsultfu
  • .medrespreopeval

  • .medreshbhtransfer

  • Use “Summary” tab > “Signout Notes” tab (may need to wrench in) > “Hospitalist Signout Notes” to communicate signout to each other; can also add “Hospitalist Signout Notes” to your columns in your Medicine Consults patient list properties in Epic

  • Typical daily flow (this is flexible based on the day’s outlook):
  • 9 AM – 10:30 AM: Residents + attending round on old consults and overnight news
  • 10:30 – 3 PM: Residents see new consults through the day. Attdg may seem some on their own
  • 3 PM: Touch base with attending to staff new daytime consults
  • 4 PM: Cut off time for new consults (depends on urgency)
  • 3 – 5:30 PM: Work on orders, communicate with primary teams, notes
  • Urgent consult requests are rare, but every effort should be made to staff urgent requests ASAP. Overnight, urgent consults are done by the covering night float resident and staffed with on-site hospitalist, including pre-op evals
  • We do not consult on ICU patients unless it is the Burn ICU, as there are many floor- and stepdown-level patients housed there. The appropriate medicine subspecialty service should be consulted for ICU patients
  • Requests to transfer to medicine should be paged directly to the Consults attending (it is very clearly stated in the paging directory)
  • On weekends when we do not have the full consult team, the attending will help see patients and write notes.