5-Minute Orientation Rotation Name: SCVMC Wards / PICU Rotation Director and Contact People Rotation Directors: Suzanne Mendez - suzanne.mendez@hhs.sccgov.org Alan Schroder - alan.schroeder@hhs.sccgov.org Resident Liaison: Adriana Anavitarte – adrianaa@stanford.edu Team Structure DAYTIME TEAM Attending o 1 ward attending o 1 PICU attending 1 senior resident 1 junior resident 2 interns o 1 pediatric intern o 1 transitional intern 3 medical students o 4 medical students per month at the Valley, but each spends one week in the NICU NIGHTIME TEAM Attending o PICU attending - home call o Hospitalist on the ward q2 nights o NICU hospitalist q2 nights 1 senior resident 1 junior resident 1 intern Medical student (sometimes) o Med students alternate taking call until 10pm What to Expect On Your First Day Address: 751 S Bascom Ave, San Jose, CA 95128 Park in the staff-only parking structure (ensure you have the "C" permit displayed) The pediatrics ward / PICU is in the "new" section of main hospital, 5th floor INTERN / MED STUDENT sign out: 6 am at the PICU front desk JUNIOR / SENIOR sign out: 6:30 am at the PICU front desk Each resident receives meal card for month OR bring your own lunch Orientation ● Obtain sign out from previous team ● Interns / med students will receive an orientation to Healthlinks, the floor, and the rotation during morning report on the first day Schedule Monday Tuesday Wednesday Thursday Friday Sat - Sun 0600 0800 0800 0830 Time Sign out + pre-round Morning Report Sign out + pre-round Morning Report Sign out + pre-round Morning Report Sign out + pre-round Morning Report Sign out + pre-round 0830 - ICU Rounds ICU Rounds ICU Rounds ICU Rounds ICU Rounds - 1130 1200 1300 Ward Rounds Noon Conference Ward Rounds Noon Conference (journal club) Ward Rounds Noon Conference Ward Rounds 1300 1730 1730 Patient Care Ward Rounds Noon Conference (med student case) Patient Care Sign out + pre-round Grand Rounds (8:15 - 9:15) ICU Rounds (9:30am start) Ward Rounds Noon Conference Patient Care Patient Care Patient Care Patient Care Sign-out Sign-out Sign-out Sign-out Sign-out Sign-out *** Please be EARLY / ON TIME for noon conferences and grand rounds. Attendings notice! *** Rounding ● PICU rounds begin at 8:30am, Ward rounds follow immediately ● Family-centered walk rounds in both the PICU and wards ● Interns and medical students expected to present all patients, including PICU patients ● Junior resident leads rounds and will set expectations re: presentations, team set up, computer use, etc ● Senior resident acts as a back-up team supervisor and provides teaching points RESIDENT ROLES Senior Role EDUCATION! Leads morning report, provides feedback, etc Oversees all patient care Initial consult on surgical co-follows Provides back-up to the junior Junior Role TEAM LEADER! o For team, rounds, expectations, and workflow Sees all ED consults Accept direct admissions from Valley Clinics – if you have concerns about the appropriateness of an admission, politely ask for explanation for the admission. If you still have concerns, do not give push back but engage your ward. Consults on burn unit patients Intern Role BE THE DOCTOR! Examine, present, and write notes on all patients on floor and PICU “Cap” at 10 patients per intern (except weekends – cap at pre-rounding on 10 and presenting 15) Weekends: o Nighttime intern pre-rounds / examines new admits + half team o Daytime intern pre-rounds / examines other half + presents all patients STAFFING PATIENTS Overnight Admissions o PICU patients Notify PICU attending, staff, and 5th floor Hospitalist (if admission comes before midnight) o Ward patients Hospitalist on the 5th floor q2 nights – sees all admissions When no hospitalist on the 5th floor: NICU hospitalist sees patients admitted before midnight Daytime attending sees patients admitted after midnight in the morning ED Consults o If patient admitted, follow above rules o If patient discharged from ED: If 5th floor Hospitalist – needs to see patient in the ED If NICU hospitalist – can discuss case and send note to her, but NICU hospitalist will not see the patient in ED Surgical Consults o ALL surgical patients on 5th floor require pediatric team consult by Senior resident (can be delegated to intern if census is low) o Attending / senior to decide if patient should continue to be followed The Pediatric team serves as the Primary team for all Rehab patients, Pediatric Surgery patients and Neurosurgery patients on the ward.