Pediatric Hospitalist Job Description: Difference between revisions

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'''Peds Day Hospitalist (Labeled P on the 'Peds Scheduling' Spreadsheet): 8 a.m.–6 p.m.'''  
==Peds Hospitalists==
'''Labeled P for 8am-6pm shift and  P+ for  6pm-8am shift on the ‘Peds Scheduling Spreadsheet '''


*Assumes the pediatric service and opts into tiger text roll for ‘Peds Wards On Call’, in person, at or before 8am
*Assumes the pediatric service and opts into [[Tiger Connect]] role for ‘Peds Wards On Duty’ at or before 8am/6pm.
*Gets peds sign out and summary of all the patients on the peds service plus information about any other concerning pediatric patients on NW, OB, ER, in the villages and patients coming in on medevacs etc.
*Gets peds sign out and summary of all the patients on the peds service plus information about any other concerning pediatric patients on NW, OB, ER, in the villages, coming in on medevacs, etc.  
*Rounds with Family Medicine DW/NF docs and peds nurses about concerning peds patients.
**'''Day to Night hospitalist sign out may include a list of tasks that the day hospitalist could not complete. This may include chart reviews, case manager requests, further conversations with families of admitted patients, etc. The transition should be seamless. Day and night hospitalist should take equal responsibility for patient care tasks even if the tasks were initially sent to the day hospitalist.'''
*Manages the pediatric service, which includes all CPP patients as well as occasional non CPP patients. Non CPP patients may be admitted to the peds service if requested and the peds service is able to accept. Family medicine generally admits all non CPP patients unless they request that the peds service takes the admission. Pediatricians must ensure that the FM Hospitalist has had right of first refusal prior to peds service accepting a patient.  
*Checks in with Family Medicine hospitalist and peds nurses about concerning peds patients.  
*'''''(If there is a question about whether a patient should be admitted or not…inpatient provider will discuss with admitting provider and evaluate patient in person. If admission is determined NOT to be necessary or appropriate, inpatient provider will write a note documenting why admission was not accepted ie needs higher level of care, can be managed outpatient, etc)'''''
*Rounds on peds service patients as early in the morning or evening as possible to arrange for any discharges by noon and to provide time for needed patient assessment, counseling of parents, and education/support of staff. Examines patients, reviews meds and care plans, and makes changes as needed.
*Rounds on patients in the morning early enough to arrange any discharges by noon if possible
*Documents all significant changes to care plan or patient status in a progress, an event note, or an addendum to the daily progress note.
*Provides consultation and/or help stabilizing pediatric patients in the ER, Labor & Delivery, Newborn Nursery, Outpatient Clinics (as able)/ SRCs/villages and on the inpatient unit. Must document, in a note or an addendum, any advice given with consultation.
*Is responsible for all [[Chronic Pediatric RMT|chronic pediatric Radio Medical Traffic (RMT)]] and helps with any [[Urgent RMT|urgent]]/[[ Emergency RMT Scenarios and Responses|emergency]] pediatric RMT as requested.
*Responsible for all chronic pediatric Radio Medical Traffic (RMT) and helps with any urgent/emergency pediatric RMT as required.  
*Checks in with ER (or ER pediatrician, if present) about possible pediatric [[INTRA and INTERhospital Transfers|admissions]] and/or [[:Category:Medevacs and Transport|medevacs]] to Anchorage or from the village.
*Goes on medevacs for possible preterm (less than 36 weeks) or anticipated high risk delivery in villages. (1.)
*Admits [[Chronic Pediatric Patient Definition|CPP patients]]. May also admit Non-CPP patients to peds service if requested and the peds service is able to accept the patient. Family Medicine generally admits all non-CPP patients unless they request the peds service take the admission. Pediatricians must ensure that the FM Hospitalist has had the right of first refusal prior to the peds service accepting a patient.  
**''NOTE: If there is a question about whether any patient should be admitted or not, the inpatient provider will discuss patient with provider requesting admission and evaluate the patient in person. If admission is determined NOT to be necessary or appropriate, the inpatient provider will write a note documenting why admission was not accepted (ie needs higher level of care, can be managed outpatient, etc.).''
*Performs detailed chart reviews and helps get as much primary and chronic care arranged for admitted CPP patients or other peds service patients, who do not get to clinic much. This will be done by both day and night hospitalist as a joint effort, but the night peds hospitalists generally have more time to do this.
*Provides consultation and/or help stabilizing pediatric patients in the ER, Labor & Delivery, Newborn Nursery, Outpatient Clinics/SRCs/villages, and on the inpatient unit. Must document, in a note or an addendum, any advice given with all consultations.
*Goes on [[Pediatric Village Delivery Orientation|medevacs for possible preterm]] (less than 36 weeks) or anticipated high-risk deliveries in villages.  
**''The Peds day physician is responsible for going on any medevac which requires a pediatrician during their 8am to 6pm shift.''
**''The Peds day physician is also responsible for going on any morning “shift-change” medevacs occurring between 7am to 8am. This is to spare the night shift person from having to work more than 14 hours at a time.  If you end up on a medevac outside your regularly scheduled shift hours, notify the peds scheduler of the extra hours worked.''
**''If the Peds hospitalist has to go on a medevac the Tiger Connect role for ‘Peds Wards On Duty’ is assumed by a FM hospitalist until the pediatrician returns.''
*Keeps the ER physician updated on any pending medevacs from villages or to Anchorage.
*Keeps the ER physician updated on any pending medevacs from villages or to Anchorage.
*Responds to all Code Blue and Rapid Responses, regardless of age of patient. Pediatricians can be helpful at adult codes by placing orders, taking notes, making calls, completing paperwork, and talking with family etc.
*Follows-up on patients listed on Peds Alert List. These are generally patients who live in villages who need regular follow-up and have a history of falling through the cracks. All patients on the Peds Alert List should have a “sticky note” with a brief description of what needs to happen.
*Signs out, in house, to Pediatric Night Float at 6pm and reviews peds service changes plus any potential patients or clinical issues the daytime pediatrician may have to address. Sign out should include a list of
*Responds to all Code Blue and Rapid Responses, regardless of age of patient.  
**Pediatricians can be helpful at adult codes by placing orders, taking notes, making calls, completing paperwork, talking with family, etc.
*When requested, and if acute priorities have been fulfilled, sees pediatric patients in the ER; does routine newborn admit exams and note for FM hospitalist; and helps in whatever capacity that is needed, as a team member, for any emergencies.
*Additional duties of the night hospitalist:
**Checks proxy boxes for absent providers.
**Reviews dictations and specialty notes, [[Updating Problem Lists|updating problem list]]/med lists and making [[Specialty Referrals#Pediatric Referrals|referrals]], etc.
**For admitted patients with complex PMH, the night hospitalist should do a full chart review to ensure that all medical needs are being met, as able. This is often the only time that these complex patients encounter the medical system, so this opportunity must not be missed.
**Helps with pharmacy medication orders or case manager requests as needed.
**[[OR for Peds#Procedure for Dental Pre-ops in OR suite|Dental Pre-ops]] as requested and able
**See detailed Night Float Priority Consensus 9.29.20 in the Pediatric Job Duties and Priorities folder \\vault1\DEPTS\Pediatrics\Job Duties and Priorities


'''NOTES:'''
==ER Pediatrician==
#''The Peds day physician is responsible for going on any medevac which requires a pediatrician and occurs during their 8am-6pm shift. If the Peds day physician has to go on a medevac with a FM day physician, the second FM day physician (or Peds ER provider if appropriate/available), opts into tiger text roll for ‘Peds Wards On Call’ and covers peds pages until the peds day physician returns and is able to resume tiger text coverage again.''
'''Labeled ER on the ‘Peds Scheduling Spreadsheet)-When Staffing allows'''
#''The Peds day physician is also responsible for going on any morning “shift-change” medevacs that are activated 7:00-8:00 a.m. This is to spare the night shift person from having to work more than 14 hours at a time. '''If you end up on a medevac outside your regularly scheduled shift hours notify peds scheduler.'''''
*Based in ER. Sees pediatric patients in the ER and in Urgent Care/Fast Track as needed.
 
*Checks in with day pediatrician at beginning of shift and gets sign out about medevacs, pending ER admissions, recent ER peds consults, etc.  
'''Peds Night Hospitalist (Labeled P+ on the 'Peds Scheduling' Spreadsheet): 6 p.m.–8 a.m.'''
*Helps peds hospitalist with [[Emergency RMT Scenarios and Responses|emergency pediatric RMT]] if needed and regular CPP RMT for peds hospitalist as able.
 
*Provides [[:Category:Consults#Internal (Bethel) Consult Services|pediatric consultation]] for ER and Fast Track providers.
*Assumes the pediatric service and opts into tiger text roll for ‘Peds Wards On Call’, in person, at or before 6 p.m.
*May assume medical control of sick pediatric patients from ER doc or inpatient pediatrician if needed.
*Gets peds sign out and summary of all the patients on the peds service plus information about any other concerning pediatric patients on NW, OB, ER, in the villages and patients coming in on medevacs etc.
*Responds to all Code Blue and Rapid Responses, regardless of age of patient.  
*Rounds with Family Medicine NF docs and peds nurse about all concerning pediatric patients
**(Pediatricians can be helpful at adult codes by placing orders, taking notes, making calls, completing paperwork, talking with family, etc.)
*Manages the pediatric service, which includes all CPP patients as well as occasional non CPP patients. Non CPP patients may be admitted to the peds service if requested and the peds service is able to accept. Family medicine generally admits all non CPP patients unless they request that the peds service takes the admission. Pediatricians must ensure that the FM Hospitalist has had right of first refusal prior to peds service accepting a patient. 
*May assume "Peds Wards on Duty" role if pediatric hospitalist goes out on a medevac, if appropriate and able.
*'''''(If there is a question about whether a patient should be admitted or not…inpatient provider will discuss with admitting provider and evaluate patient in person. If admission is determined NOT to be necessary or appropriate, inpatient provider will write a note documenting why admission was not accepted ie needs higher level of care, can be managed outpatient, etc)'''''
*May do clinic consults if required and able
*Rounds on PEDS service patients as early in the evening as possible and as needed for patient assessment, counseling of parents and education/support of staff.  Examine patients and review meds and care plans; make small or acute care changes as needed; allow day physician to make major changes to care if possible.
*This position can be flexible to meet the needs of the ER or Urgent Care depending on volume, acuity, resource, etc.
*Covers both CPP, emergency and regular pediatric RMT as requested
*Checks out with night pediatrician with updates on patients that may require follow up or assumption of care, medevac or admission, etc.
*Provides consultation and/or help stabilizing pediatric patients in the ER, Labor & Delivery, Newborn Nursery, Outpatient Clinics (as able)/ SRCs/villages and on the inpatient unit. Must document, in a note or an addendum, any advice given with consultation.
*Goes on medevacs for possible preterm (less than 36 weeks) anticipated high-risk delivery in villages. (see NOTE)
*Keeps the ER physician updated on any pending medevacs from villages or to Anchorage.
*Performs detailed chart reviews and helps get as much primary/chronic care arranged for complicated CPP patient, who do not get to clinic much, and are admitted. This will be done by both day and night hospitalist as a joint effort, as able but the night peds hospitalists generally have more time to do this.
*When requested and if all other priorities have been fulfilled, sees pediatric patients in the ER/Urgent Care, does routine newborn admit exam and note for NF and helps in whatever capacity that is needed, as a team member, for any emergencies
*Checks proxy boxes for absent providers; reviews dictations and specialty notes and updates problem list/med lists and makes referrals etc; '''''helps with pharmacy medication order or case manager requests as needed. '''''
*Responds to all Code Blue and Rapid Responses, regardless of age of patient. Pediatricians can be helpful at adult codes by placing orders, taking notes, making calls, completing paperwork, and talking with family etc.
*Signs out, in house, to inpatient pediatric provider at 8am and reviews peds service changes plus any potential patients or clinical issues the daytime pediatrician may have to address.
 
'''NOTE''':
''If Peds night physician has to go on a medevac with the FM Night Float physician, the on call FM physician who is called in (or Peds ER provider if appropriate/available), opts into tiger text roll for ‘Peds Wards On Call’ and covers peds pages until the peds night physician returns and is able to resume tiger text coverage again.


'''Hospitalist Admin (Labeled AD on the 'Peds Scheduling' Spreadsheet): 8 hours'''  
==Hospitalist Admin==
'''Labeled AD on the ‘Peds Scheduling Spreadsheet): 8 hours'''


*Flexible time to do clinical administration, quality improvement projects and committee work.
*Flexible time assigned to do clinical administration, quality improvement projects and committee work.


'''ER/Urgent Care Pediatrician (Labeled ER on the 'Peds Scheduling' Spreadsheet): Mon–Sun 12 p.m.–10 p.m.'''
==Hospitalist Resident Precepting Responsibilities==
*see [[Pediatric Resident Supervision Guide#INPATIENT PRECEPTOR LOGISTICS|Inpatient Preceptor Pediatric Resident Supervision Responsibilities]] for more details
*Support resident learning goals during their inpatient time and help them with supplemental educational opportunities (medevacs, procedures in the ER etc)
*For [[Second Year Expectations|2nd]] and [[Third Year Expectations|3rd]] year residents, allow them take over the TigerText Peds Wards On Duty role based on preceptor assessment of resident competency
*All inpatient notes must be addended and cosigned by the end of the day
*For RMTs, residents must include documentation in their RMT response stating that the case and plan was discussed with the preceptor. Preceptors do not have to sign or addend the RMT if this is done
*Review Pediatric residency precepting guide expectations in the peds residency folder \\vault1\Qemagvvik\Ykhosp\DEPTS\Pediatrics\Residency or in the [[:Category:Residents|WIKI Residents section]]. Clarify any precepting or specific resident questions with residency site director


*Based in ER.  Sees pediatric patients in Urgent Care and the ER as needed
*Checks in with day pediatrician at beginning of shift. Gets sign out about medevacs, admissions, recent ER peds consults, etc
*Helps peds hospitalist with emergency pediatric RMT if needed and regular CPP RMT for peds hospitalist as able
*Provides pediatric consultation for ER and Fast Track providers
*May assume medical control of sick pediatric patients from ER doc or inpatient pediatrician if needed.
*May assume Hospitalist role if pediatric hospitalist goes out on a medevac
*May do clinic consults if required and able
*This position can be flexible to meet the needs of the ER or Urgent Care depending on volume acuity and resources etc
*Responds to all Code Blue and Rapid Responses, regardless of age of patient. Pediatricians can be helpful at adult codes by placing orders, taking notes, making calls, completing paperwork, and talking with family etc.*Checks out with night pediatrician with updates on patients that may require follow up or assumption of care, medevac or admission etc...


[[:Category:Pediatrics]]
[[:Category:Pediatrics|Pediatrics Main Page]]
<br/>[[Job Duties|Job Duties Main Page]]

Latest revision as of 21:27, 16 December 2020

Peds Hospitalists

Labeled P for 8am-6pm shift and P+ for 6pm-8am shift on the ‘Peds Scheduling Spreadsheet

  • Assumes the pediatric service and opts into Tiger Connect role for ‘Peds Wards On Duty’ at or before 8am/6pm.
  • Gets peds sign out and summary of all the patients on the peds service plus information about any other concerning pediatric patients on NW, OB, ER, in the villages, coming in on medevacs, etc.
    • Day to Night hospitalist sign out may include a list of tasks that the day hospitalist could not complete. This may include chart reviews, case manager requests, further conversations with families of admitted patients, etc. The transition should be seamless. Day and night hospitalist should take equal responsibility for patient care tasks even if the tasks were initially sent to the day hospitalist.
  • Checks in with Family Medicine hospitalist and peds nurses about concerning peds patients.
  • Rounds on peds service patients as early in the morning or evening as possible to arrange for any discharges by noon and to provide time for needed patient assessment, counseling of parents, and education/support of staff. Examines patients, reviews meds and care plans, and makes changes as needed.
  • Documents all significant changes to care plan or patient status in a progress, an event note, or an addendum to the daily progress note.
  • Is responsible for all chronic pediatric Radio Medical Traffic (RMT) and helps with any urgent/emergency pediatric RMT as requested.
  • Checks in with ER (or ER pediatrician, if present) about possible pediatric admissions and/or medevacs to Anchorage or from the village.
  • Admits CPP patients. May also admit Non-CPP patients to peds service if requested and the peds service is able to accept the patient. Family Medicine generally admits all non-CPP patients unless they request the peds service take the admission. Pediatricians must ensure that the FM Hospitalist has had the right of first refusal prior to the peds service accepting a patient.
    • NOTE: If there is a question about whether any patient should be admitted or not, the inpatient provider will discuss patient with provider requesting admission and evaluate the patient in person. If admission is determined NOT to be necessary or appropriate, the inpatient provider will write a note documenting why admission was not accepted (ie needs higher level of care, can be managed outpatient, etc.).
  • Performs detailed chart reviews and helps get as much primary and chronic care arranged for admitted CPP patients or other peds service patients, who do not get to clinic much. This will be done by both day and night hospitalist as a joint effort, but the night peds hospitalists generally have more time to do this.
  • Provides consultation and/or help stabilizing pediatric patients in the ER, Labor & Delivery, Newborn Nursery, Outpatient Clinics/SRCs/villages, and on the inpatient unit. Must document, in a note or an addendum, any advice given with all consultations.
  • Goes on medevacs for possible preterm (less than 36 weeks) or anticipated high-risk deliveries in villages.
    • The Peds day physician is responsible for going on any medevac which requires a pediatrician during their 8am to 6pm shift.
    • The Peds day physician is also responsible for going on any morning “shift-change” medevacs occurring between 7am to 8am. This is to spare the night shift person from having to work more than 14 hours at a time. If you end up on a medevac outside your regularly scheduled shift hours, notify the peds scheduler of the extra hours worked.
    • If the Peds hospitalist has to go on a medevac the Tiger Connect role for ‘Peds Wards On Duty’ is assumed by a FM hospitalist until the pediatrician returns.
  • Keeps the ER physician updated on any pending medevacs from villages or to Anchorage.
  • Follows-up on patients listed on Peds Alert List. These are generally patients who live in villages who need regular follow-up and have a history of falling through the cracks. All patients on the Peds Alert List should have a “sticky note” with a brief description of what needs to happen.
  • Responds to all Code Blue and Rapid Responses, regardless of age of patient.
    • Pediatricians can be helpful at adult codes by placing orders, taking notes, making calls, completing paperwork, talking with family, etc.
  • When requested, and if acute priorities have been fulfilled, sees pediatric patients in the ER; does routine newborn admit exams and note for FM hospitalist; and helps in whatever capacity that is needed, as a team member, for any emergencies.
  • Additional duties of the night hospitalist:
    • Checks proxy boxes for absent providers.
    • Reviews dictations and specialty notes, updating problem list/med lists and making referrals, etc.
    • For admitted patients with complex PMH, the night hospitalist should do a full chart review to ensure that all medical needs are being met, as able. This is often the only time that these complex patients encounter the medical system, so this opportunity must not be missed.
    • Helps with pharmacy medication orders or case manager requests as needed.
    • Dental Pre-ops as requested and able
    • See detailed Night Float Priority Consensus 9.29.20 in the Pediatric Job Duties and Priorities folder \\vault1\DEPTS\Pediatrics\Job Duties and Priorities

ER Pediatrician

Labeled ER on the ‘Peds Scheduling Spreadsheet)-When Staffing allows

  • Based in ER. Sees pediatric patients in the ER and in Urgent Care/Fast Track as needed.
  • Checks in with day pediatrician at beginning of shift and gets sign out about medevacs, pending ER admissions, recent ER peds consults, etc.
  • Helps peds hospitalist with emergency pediatric RMT if needed and regular CPP RMT for peds hospitalist as able.
  • Provides pediatric consultation for ER and Fast Track providers.
  • May assume medical control of sick pediatric patients from ER doc or inpatient pediatrician if needed.
  • Responds to all Code Blue and Rapid Responses, regardless of age of patient.
    • (Pediatricians can be helpful at adult codes by placing orders, taking notes, making calls, completing paperwork, talking with family, etc.)
  • May assume "Peds Wards on Duty" role if pediatric hospitalist goes out on a medevac, if appropriate and able.
  • May do clinic consults if required and able
  • This position can be flexible to meet the needs of the ER or Urgent Care depending on volume, acuity, resource, etc.
  • Checks out with night pediatrician with updates on patients that may require follow up or assumption of care, medevac or admission, etc.

Hospitalist Admin

Labeled AD on the ‘Peds Scheduling Spreadsheet): 8 hours

  • Flexible time assigned to do clinical administration, quality improvement projects and committee work.

Hospitalist Resident Precepting Responsibilities

  • see Inpatient Preceptor Pediatric Resident Supervision Responsibilities for more details
  • Support resident learning goals during their inpatient time and help them with supplemental educational opportunities (medevacs, procedures in the ER etc)
  • For 2nd and 3rd year residents, allow them take over the TigerText Peds Wards On Duty role based on preceptor assessment of resident competency
  • All inpatient notes must be addended and cosigned by the end of the day
  • For RMTs, residents must include documentation in their RMT response stating that the case and plan was discussed with the preceptor. Preceptors do not have to sign or addend the RMT if this is done
  • Review Pediatric residency precepting guide expectations in the peds residency folder \\vault1\Qemagvvik\Ykhosp\DEPTS\Pediatrics\Residency or in the WIKI Residents section. Clarify any precepting or specific resident questions with residency site director


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