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Published byAnnabelle Wilkinson Modified over 9 years ago
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A new era of comprehensive review Written by: the ACGME
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Our Patients Nurses Colleagues (Peer) Faculty
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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;
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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
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V.A.1.b).(2) use multiple evaluators (e.g., faculty, peers, patients, self, and other professional staff); Common Program Requirements 9 by ACGME
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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
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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
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A minimum of 10 per year Evalue Your colleagues will be assigned to you Encouraged to submit “on the fly” evals ACGME core competencies
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Respects staff and peers Works as a team player Is prompt and present for rounds and sign out Promptly return pages and emails 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
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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
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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
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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
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Each Tuesday at 1:15 in 8 BT Conference Room Residents, Interns, Students expected to attend
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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
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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
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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.
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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
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R4: Andrew Smitherman R3: Lindsay Kruska, Nicole Tintera R2: Ed Barnes, John Rommel Interns: soon-ish
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