A new era of comprehensive review Written by: the ACGME

 Our Patients  Nurses  Colleagues (Peer)  Faculty

Formative Evaluation The program must: V.A.1.b). (1) provide objective assessments of competence in patient care, medical knowledge, practice-based learning, interpersonal and communication skills, professionalism, and systems-based practice;

 Patient Care is the compassionate, appropriate, and effective treatment of health problems  Medical Knowledge about established and evolving biomedical, clinical, and cognate sciences  Practice-Based Learning and improvement that involves investigation and evaluation of their own patient care and assimilation of scientific evidence in patient care.  Interpersonal and Communication Skills that result in effective information exchange  Professionalism as manifested through a commitment to carrying out professional responsibilities  Systems-Based Practice as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care

 V.A.1.b).(2) use multiple evaluators (e.g., faculty, peers, patients, self, and other professional staff); Common Program Requirements 9 by ACGME

 A minimum of 10 evaluations per year  Self-distribution to clinic patients at the end of the clinic visit  “Anonymous”  The patient returns the survey to the front desk along with check out sheet  Paper

 A minimum of 10 per year  “Anonymous”  Electronic ISD survey  Distributed monthly by Nurse Managers  Evaluating night float, ward residents and interns in close proximity to nurses station  Wake Med nurses possibly included

 A minimum of 10 per year  Evalue  Your colleagues will be assigned to you  Encouraged to submit “on the fly” evals  ACGME core competencies

 Respects staff and peers  Works as a team player  Is prompt and present for rounds and sign out  Promptly return pages and s  Shows respect and empathy to patients and families  Keep current and effective communication to main aspects of patient care  Maintains a positive and supportive attitude

 RRC Rules  80h work week over 4 week average  1 day off in 4 over 4 week average  10h between shifts  24+6 call cycle

 If you worked >30h, we want to know about it  If you had <10h off between shifts, we want to know about it  At same time  You should structure your call to prioritize these mandates  You should sign-out procedures, labs, and other outstanding issues  This fits into the ‘team approach’ to inpatient care

 Always tell us your shift  Lunches are part of your work hours  Pay attention to AM/PM, start/end dates for overnight inpatient duties  In ED, chart your patients as your shift is coming to a close, staying after can break the <10h rule

 Each Tuesday at 1:15 in 8 BT Conference Room  Residents, Interns, Students expected to attend

1. The Patient takes all priority 2. On-call interns meet their admissions cap 3. Patient are admitted to appropriate services  All services are ‘general medicie’ first, specialty second  This usually is not an issue 4. Team equity and fairness amongst teams

 Hard intern on-call cap at 11pm  If 5 day admissions are not reached by 11pm, that team will not cap for the day  Non specialty patients might be assigned to a specialty service  Pre-Call Floats begin once on-call cap has completed  We want our interns to have more opportunities to go independently complete the admissions process

 No hard 11pm cap  Admissions and patient placement returns to our priorities  If all on-call teams will cap, patients admitted early in the night [e.g. 8pm] can be floated to the next team; patients admitted in the middle of the night [e.g. 2am] can go to the on-call team  Night Floats should not modify/reassign the now post-call assignments after any team member could have woken and reviewed WebCIS from home.

 Fact: some teams cap earlier than others  Fact: most residents also function as a mini-MAO for their team or beyond  Fact: no one likes doing this; particularly if you are trying to find a spot for our patient  On-call residents together work as a team of MAOs  If patients are called for admission from ED or arrive to floor to direct admit, they take priority over any other ‘potential’ patient.  Do not ‘save spots’  Please let us help you if resident/attending tension arises

 R4: Andrew Smitherman  R3: Lindsay Kruska, Nicole Tintera  R2: Ed Barnes, John Rommel  Interns: soon-ish