Pediatric Hospitalist Job Description

From Guide to YKHC Medical Practices

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Peds Day Hospitalist (Labeled P on the 'Peds Scheduling' Spreadsheet): 8 a.m.–6 p.m.

  • Assumes the pediatric service and opts into tiger text roll for ‘Peds Wards On Call’, in person, at or before 8am
  • 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.
  • Rounds with Family Medicine DW/NF docs and peds nurses about concerning peds patients.
  • 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.
  • (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 patients in the morning early enough to arrange any discharges by noon if possible
  • 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.
  • Responsible for all chronic pediatric Radio Medical Traffic (RMT) and helps with any urgent/emergency pediatric RMT as required.
  • Goes on medevacs for possible preterm (less than 36 weeks) or anticipated high risk delivery in villages. (1.)
  • 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.
  • 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

NOTES:

  1. 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.
  2. 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.

Peds Night Hospitalist (Labeled P+ on the 'Peds Scheduling' Spreadsheet): 6 p.m.–8 a.m.

  • Assumes the pediatric service and opts into tiger text roll for ‘Peds Wards On Call’, in person, at or before 6 p.m.
  • 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.
  • Rounds with Family Medicine NF docs and peds nurse about all concerning pediatric patients
  • 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.
  • (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 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.
  • Covers both CPP, emergency and regular pediatric RMT as requested
  • 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

  • Flexible time 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.

  • 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...