Night 2

Night 2 Cross Coverage Provider

The Night 2 Provider provides coverage for patients admitted to the Hospitalist service overnight. Night 1 provides overnight admissions to our MDH direct care services and serves as primary support for our Night 2 cross covering provider. Expectations and Responsibilities: - Shift hours are 7 pm – 7 am. - The primary responsibility of Night 2 is to provide coverage for all MDH direct care patients overnight. - Covering providers should attend all Code Blues, Rapid Responses and Behavioral Response calls for patients on the MDH teams. Covering processes: - Day teams have usually given sign out to the Long Call provider earlier in the afternoon. Page this provider if they are not in the office for sign out. They should report any significant cross cover issues that have occurred and any other remaining items for follow up overnight - Please sign into all MDH pagers on arrival, including the H New Admit pager. - "Sign In" to the teams and patients on your list as “Covering Provider” with a 0700 sign out time including MedH NEW ADMIT, this should set you as “First Contact” in Epic (click “Take over overlapping assignments”). It is helpful to set an end time to prevent receiving messages inappropriately after your shift. - If this step does not work for certain patients (because others are assigned as attending), you can right-click and pick “Assign Me as 1st Contact” to take over - Some patients will have issues that require follow up overnight such as labs or imaging and these will be written in the Plan Notes (and should be verbally signed out as well). Please review Plan Notes for Night Float To Do items for all patients at beginning of shift. - Consistency in patient care from our service is an important principle that we try to maintain despite having multiple providers involved in patient care. Please try to adhere to the attending provider guidance which should be updated daily in the Plan Notes window. For difficult issues (i.e. pain medication escalation), you can use your clinical judgment when needed to make exceptions. - If cross cover becomes too busy or a complex situation arises, the Swing Shift or Night 1 provider are available for assistance. Sign Out: - Cross cover issues from overnight should be written at the bottom of the patient’s Plan Note sticky note by the cross cover prompt “XC.” These should be reviewed by team providers daily. - For major cross cover events, such as codes and rapid responses or any other events which may require significant adjustments in the patient’s plan of care, please leave a “Significant Event” note in the patient’s chart to document the situation. - Daytime providers are expected to arrive by 7 am or call in by phone if they desire verbal sign out. Any significant items from overnight can be communicated directly at that time. You are not obligated to remain if providers are unavailable by 7 am. Other resources: - The Night 2 call room is E3003 and located on 3 Anderson immediately after leaving the double doors from 3 West. The room has an attached bathroom, shower and lockers. There is a computer, mini-fridge, phone, and cot. The code is 4, then 1, then 1.