Vol 26, Issue 5
Andrew Donohoe, MD Associate Chief, Clinical Operations at Chapel Hill
| Operations | 1-2 |
|---|---|
| APP Updates | 2 |
| Upcoming Meetings | 2 |
| MDUUpdates | 3 |
| Announcements |
UNC Division of Hospital Medicine¶
Hospitalist Happenings¶
VIEW FROM THE NINTH FLOOR¶
Good afternoon.
As many of you have heard, we have tried to pilot a new consult process. The intent is to help improve the functionality of the actual consult order and streamline the workflow. As a pilot, we decided to focus efforts only on consults placed by the hospitalist group to either GI or Neurology. A few important points about this process:
- Hillsborough is excluded from this pilot.
- Consult orders populate a treatment team list for the target teams. Routine consults do not require a page (the consult order is sufficient). The consult order should still be placed for stat consults but a page to the consult team is necessary as well.
- Please ensure that the target team is designated within the consult order. Screen shot below- Green Arrow. Notice that GI has included tips at the top of the order to help identify the correct target team.
- Please include your contact information in the Comments of the order- Blue Arrow. If you are a night provider, GI will not be contacting you in the morning. It may be more reasonable to include the name of the primary attending for the rounding team (bonus points if you include the phone number).
Hospitalist Happenings¶
There are certainly pros and cons to how we participate in a pilot. This does give us opportunity to fine tune the process before potentially rolling out to larger groups. On the other hand, we're doing fairly frequent modifications to the process along the way and this does require clear communication and effort to participate from our group. I believe that the ultimate goal is valuable and so I hope this justifies the patience it will take along the way.
Thank you. Andy.
APP Updates¶
I thoroughly enjoyed last week's DHM newsletter and seeing all our kids heading back to school! These photos reminded me how much all of us, even those without young children, are constantly juggling to maintain our work-life balance. Hopefully, this academic year will prove a bit less demanding particularly on the weekend rounding services, now that we have two APPs scheduled on weekends with Stella on Cedar APP and covering the Med H shift (4 PM -7 PM) Friday through Monday.
Two other brief APP updates: At this point most everyone has likely met Cherie Somera, NP, if not in person than via a prior issue of the newsletter. Cherie is wrapping up her last weeks of orientation before starting on her own as our latest daytime APP. Magdalene Tukov-Yual, NP is our most recent hire, starting on 8/18! She is an experienced APP hired to fill Night 2 alongside Vibha and Amy. When you see them please say hello!
Upcoming Meetings¶
Upcoming DHM Faculty Meeting¶
Noon - 1:00 | PECR3 & Webex
Sept. 17th:
Health Equity in Research/QI Projects¶
w/ Carlton Moore, MD
Sept 24th: PCN De-labeling Pathway
w/ Mildred Kwan, MD
DHM Operations Weekly Huddle¶
Mondays, 12:30-1:00 | Zoom
Grand Rounds¶
Sept 18th: Chirag Desai, MD -New Frontiers in Transplantation
Hospital Medicine Grand Rounds¶
Oct. 14th MDU¶
Dana Mabry, NP APP Service Line Leader¶
Christina Kahl, MD, PhD Physician Service Leader,
Quality Improvement¶
We continue to work on reducing length of stay with MDW and 7GMU. Some new initiatives and reminders.
Please encourage residents to send one secure chat message to the Case Manager and Eric Allman in the early morning with potential discharges for the day. The Case Manager will relay that information to other members of their team and the charge nurse for the day. So they can get started on finalizing home health, getting supplies, and completing an y patient teaching in the morning. I have requested that they minimize secure chat during rounds but it is helpful that they know about potential discharges especially if EDD has changed.
Please discuss on rounds the estimated date when the patients will be medically ready and EDD (if delayed due to placement or other issue). It is helpful for the new second year residents and interns and so that the entire team is aware. It is also a great time for brief teaching on the criteria for discharge for patients.
Remember if your patient came from an outside hospital and no longer needs quaternary or specialty care at UNC, please consider back transfer.
Patient Safety¶
Keep submitting Safe reports for any concerns about patient safety. MDU has one of the highest rates of participation among attendings, residents, and APPs. It is great to model and show the interns and resident how to file Safe reports.
Remember to use the sepsis order set for anyone with a new infection and you are starting antibiotics, including on admission.
MDU Update¶
The new workroom on 7GMU opened in late July. I have heard positive comments except the very cold HVAC system, which is hopefully fixed. Please let me know if you need anything for the workroom or have any ideas to improve the space for teaching and patient care. Of course, always reach out to me if you have any concerns about MDU.
Dr. Bellamy used the entire large whiteboard in the new MDU workroom and all the colored markers!!
It took many requests to get a larger whiteboard and glad it got put to good use in the first month.
Announcements¶
Congratulations to Erin Sigler and her husband, Patrick, on the birth of their son, Jack! Erin joined the Hospital Medicine team over the summer and will begin working with us in December.