Pediatric Hospitalist Job Description

From Guide to YKHC Medical Practices

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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