1. IF AN ADMITTED PATIENT IS UNDER THE CARE OF A CARDIOLOGY ATTENDING OR NP, NOTIFY THE
FELLOW. IT IS THE FELLOW’S RESPONSIBILITY TO NOTIFY THE ATTENDING OR NP. ALL ATTENDINGS AND
NPS MUST BE NOTIFIED.
2. ALL HEART FAILURE IS ADMITTED TO CARDIOLOGY EXCEPT:
A) HEM ONC PATIENTS ACTIVELY RECEIVING TREATMENT
B) MULTIPLE ADMISSION DIAGNOSIS, ONLY ONE OF WHICH IS HF
C) IF THERE IS ANY QUESTION OF APPROPRIATE ADMITTING TEAM, ADMIT TO CARDIOLOGY
AND THE ATTENDING WILL DECIDE THE NEXT AM.
3. IT IS THE RESIDENT’S RESPONSIBILITY TO ADHERE TO DUTY HOURS. THERE IS NEVER AN EXCUSE FOR
DUTY HOUR VIOLATION SET FORTH BY THE DEPARTMENT OF INTERNAL MEDICINE. THE FELLOW IS TO
BE NOTIFIED OF DUTY HOUR DIFFICULTIES BEFORE A VIOLATION OCCURS. THE FELLOW IS TO BE
NOTIFIED OF UNFINISHED WORK. IT IS THE FELLOW’S RESPONSIBILITY TO SEE THAT THE UNFINISHED
WORK IS ASSIGNED.
4. THE 7s PHARMACIST HAS A SPECIFIC PLAN FOR DISCHARGE MEDICATION/RECONCILLIATION. THIS
PLAN IS TO BE FOLLOWED TO THE LETTER FOR ALL DISCHARGES. FAILURE TO ADHERE TO THIS PLAN
WILL RESULT IN FAILURE OF THE ROTATION. THE PHARMACIST WILL NOTIFY THE COURSE DIRECTOR OF
THOSE RESIDENTS FAILING 14 DAYS INTO THE ROTATION. THE RESIDENT WILL BE NOTIFIED OF HIS/HER
FAILING GRADE AND GIVEN AN OPPORTUNITY TO PASS BY CORRECTION OF ALL DEFICITS. FAILURE TO
SATISFY THE PHARMACIST IN THE DISCHARGE PROCESS WILL RESULT IN FAILURE OF THE ROTATION.
5. THERE WILL BE NO TRANSFER OF CARDIOLOGY PATIENTS TO THE INTERNAL MEDICINE SERVICE BY
RESIDENTS OR FELLOWS. ALL TRANSFERS ARE HANDLED ATTENDING-TO- ATTENDING. THE TRANSFER
OCCURS ONLY WHEN THE CARDIOLGY ATTENDING HAS DISCUSSED THE TRANSFER WITH THE INTERNAL
MEDICINE ATTENDING.
6. ALL ADMISSIONS OCCURING FROM 7AM-8:30 PM ARE DISCUSSED WITH THE CARDIOLOGY FELLOW.
7. ALL DISCHARGE SUMMARIES ARE COMPLETED BEFORE LEAVING THE ROTATION.
8. ATTENDING ROUNDS ARE TO BEGIN AT 8:30 AM. THE COURSE DIRECTOR IS TO BE NOTIFIED OF AN
ATTENDING’S PERSISTENT FAILURE TO ADHERE TO THIS RULE.
9. DISCHARGE ROUNDS TAKE PLACE MONDAY-FRIDAY AT 8 AM.
10. THE DAYTIME RESIDENTS WILL GIVE APPROPRIATE AND THOROUGH HAND-OFF TO THE NIGHT
CARDIOLOGY RESIDENT.

11. THE CARDILOGY FELLOW WILL PRE-ROUND AT 7 AM. ON WEDNESDAYS, HE/SHE WILL PREROUND BY
TELEPHONE IF NOT ABLE TO BE ON 7S PHYSICALLY.
12. THE RESULTS OF THE PHQ9 (ALL CAD, PCI, ACS, AND HF PATIENTS) AND MINNESOTA LIVING WITH
HEART FAILURE QUESTIONAIRE (ALL HF PATIENTS) WILL BE DICTATED IN THE DISCHARGE SUMMARY.
13. ALL CAD AND HF PATIENTS WILL BE REFERRRED TO CARDIAC REHAB.
14. THE FELLOW (AND, IF POSSIBLE, THE RESIDENT ON DAY CALL) WILL CHECK OUT WITH THE
ATTENDING AT 4 PM MONDAY –FRIDAY.
15. ALL HEART FAILURE ADMISSIONS ARE OBSERVATION STATUS - CONVERSION FROM OBSERVATION
TO ADMISSION WILL OCCUR AT THE APPROPRIATE TIME.
16. THE HEART FAILURE POWER PLAN WILL BE USED FOR ALL HF PATIENTS
17. THE ON-CALL RESIDENT ASSUMES CONSULT RESPONSIBILITIES MONDAY-FRIDAY FROM 5PM-7AM
AND SATURDAY AND SUNDAY AFTER 3PM. IT IS THE FELLOW’S RESPONSIBILITY TO NOTIFY THE ON-
CALL RESIDENT OF THAT TIME.
18. WHEN THE HEART FAILURE RESIDENT IS ON THE 7SOUTH SERVICE FOR ONE WEEK, THE HEART
FAILURE RESIDENT WILL BE ASSIGNED HEART FAILURE PATIENTS ONLY.
19. THE RESIDENT IS NOT RESPONSIBLE FOR ARRANGING FOLLOW UP APPOINTMENTS WITH A PCP.
UNIVERSITY CARDIOLOGY ROTATION EXPECTATIONS
1.
The educational goals for the rotation are for you to become comfortable with the diagnosis, management, and appropriate discharge of patients with acute coronary syndromes, heart failure, arrhythmias and valvular disease.
2.
Residents are expected to “know” all patients on the service, not just the patients they have admitted. This is to ensure appropriate handoff and night time coverage.
3.
Residents are expected to work as a team. If a resident is not post call or in clinic or conference, they are expected to assist their on call colleague, and not leave before checkout is done with the attending and fellow.
4.
If an admission is to be refused or passed off to another service, the case must be discussed with the cardiology fellow and document which fellow is in agreement with the decision to refuse admission.
5.
On refusals for admission to the cardiology service, a consult note will be submitted with explanation of why admission to the cardiology service was inappropriate.
6.
Call begins at 8am and ends 8am the next day, residents must be out by 12pm and cannot work
>28hrs. Wing person should assist in admissions during the overlap period, so the on call resident can be present for the admissions overnight.
7.
Morning rounds start at about 8:30 am and in order to be compliant with work hour rules, the on call resident must leave by 12pm. Please let your attending and fellow know if you need to break from rounds to complete necessary work (ie. documentation, follow up patient care), in order to assist your ability to leave on time.

8.
Progress Notes: a.
All history and physicals should be dictated prior to beginning rounds. They should include past cardiovascular history and procedures. b.
All discharge summaries should be dictated within 24 hours of discharge.
9.
Prior to rounds make sure to check 24 hour telemetry and document findings in your progress notes.
10.
For new patients, have ECG ‘s (old and new) available for review.
11.
Keep the patient list up to date, as this is important for appropriate and safe hand offs.
12.
Monday through Friday Consults: will be done by the resident after 5 pm. These consults will then be handed to the consult fellow/team the following morning. Unless it is an emergent consult requiring the on call cardiology attending to come to the hospital, dictate these notes to the consult attending (found in amion)
13.
Weekends Consults (Saturday and Sunday): will be done by the residents after 3pm a.
There is a consult attending that rounds on Saturday. So, for Friday evening consults, again dictate to the consult attending. The cardiology fellow will check out to you on Saturday at 3pm, and at that time the resident is responsible for consults. b.
On Sunday there is one attending for consults and inpatient service rounding. So for Saturday consults that the resident evaluates, dictate these patients to the inpatient attending.
14.
The resident is not responsible for the ER observation patients. If there is a question from the ED about these patients, please refer them to the consult team, or the on call fellow. a.
On Sundays, if the clinical service is not overburdened, we do ask the residents to evaluate the
Observation patients. This is not a mandate, only if the resident did not have a heavy night of admissions. This allows everyone, attending, fellow and resident to round more efficiently on
Sundays.
15.
Please utilize other members of the Healthcare team to improve patient care: Nurses, Pharmacists,
Case managers, and Educators.
Questions? Contact the inpatient medical director:
Dr. Cox at BartCox@salud.unm.edu
, pager 951-0049