Faculty Chairs: Howard Uman, MD & Elizabeth Meade, MD
Contact Information:
Pediatric Hospitalist
Pager 206-969-7500
Phone 206-369-4307 (cell)
9 East – 206-215-3409
Howard Uman – 206-940-7653
Elizabeth Meade – 206-228-6780
If you need to miss a day or part of a day for any reason, let both the hospitalist and that day’s teaching attending (either Howard or Elizabeth) know immediately. You will also need to notify your program (FHFP Chiefs and Liz Stahl). If you miss more than 2 days of inpatient pediatrics, you will be required to make up the time during another rotation.
Location/Other notes:
DAYS:
On day 1 of rotation, report to 9 East (Resource Room behind the nurses’ station) at 7:45 am and find Peds Hospitalist.
R1 will give a brief presentation during 8:30 am multidisciplinary rounds, then full formal presentations during 9:30 am teaching round.
Minimum expected patient volumes: 3-4 patients early in the year, 4-5 patients later in the year
R1 should be primary “point person” for nursing or other questions for their patients
Additional experiences available: time with RT, bedside RN, pharmacy, lactation, PT/OT/SLP, child life, pediatric infectious diseases.
Possible procedures: LP, catheterization, I&D
Daily Schedule:
<7:45am – it is expected that you preround on all your patients prior to signout. This should include vitals, labs, notes, and overnight events.
7:45am – morning signout from overnight hospitalist, occurs in hospitalist office
8:30-9:15am – multidisciplinary rounds
9:15-10am – examine patients/enter urgent orders/consults with day hospitalist, notes
10am – Teaching with Howard/Elizabeth
Bedside/FCR. R1 will present identifying statement and any sensitive information outside the room, and other information in the room with parents.
Afternoon – work rounds, note-writing. Try to sign notes for HU/EM as early in the day as possible. Discharge summaries should be completed on the day of discharge.
5:30pm – evening signout, occurs in hospitalist office. R1 is expected to sign out his or her patients to the evening hospitalist.
Special note: Thursdays radiology rounds occur in 4 East from 8:30-9:30am. Resident should attend these rounds and skip multidisciplinary rounds that day.
Evaluation:
Feedback should occur at several points during the rotation. Informal feedback may occur at the end of a string of days working with a particular hospitalist, or “on the fly”. Please solicit feedback directly if you have spent several days in a row with one hospitalist!
Formal feedback will be given by Howard or Elizabeth halfway through the rotation, and again at the end of the block. It may also be given at other times if there are specific reasons to do so. We will explore our shared goals and reflect together on your learning.
Evaluations will be filled out by Howard/Elizabeth at the end of each block.
NIGHTS w/ Pediatrician in the First Hill-ED:
For inpatient shifts, report to 9 East and attend hospitalist signout at 5:30pm.
The R1 should stop taking new patients in the ED at 10pm in order to finish work by ~midnight.
For Pediatric ER shifts- Plan to arrive @ 500pm; stay until 1100pm; do not take patients after 10pm so you have time to finish charting at a reasonable hour.
All notes will be attested by Ped ER Attending.
If ED is slow and interesting stuff @ Peds or PICU, you can go there--totally flexible.
Meet at Dr Goetz's office--this is where Ped-in-ER charts and there is a computer for you as well. ED Unit Assistant or RN's can direct you.
The inpatient Peds block is not “vacationable.”
RCR Curriculum Link:
Required Readings:
• A Pediatrics Resource Binder with key recent updates/clinical guidelines is available in the 9E charting area. It is recommended that residents review the binder when able.
Rotation Goals:
Gain competency in the diagnosis and treatment of common pediatric conditions requiring inpatient care.Recognize impact of developmental stages of pediatric patients symptomatology and patient understanding.Learn to effectively communicate with patients and family.Continuity of Care - see pediatric patients in Emergency Room setting, follow patient to ICU (not responsible for ICU care), and develop outpatient care plan for family education.Introduction to and management of common pediatric inpatient diagnoses, including (but not limited to!): bronchiolitis, asthma, pneumonia, febrile neonates, hyperbilirubinemia, behavioral health, appendicitis, abdominal pain, seizures, skin and soft tissue infectionsRecognize clinical deterioration requiring intensive care. Enhanced recognition of "Sick" vs "non-sick". (Residents will be encouraged to continue to follow patients who have worsened & participate in PICU rounds & collaboration with the Pediatric intensivist.)
Rotation Objectives:
Patient Care
Gather essential and accurate information about the patient.Recognize key diagnoses, fluid management, use of more specialized diagnostic testing.Develop an appropriate management plan that anticipates patient needs, including outpatient.Provide transfer of care that ensures seamless transitions.Develop a comprehensive differential diagnosis for pediatric patients with undifferentiated signs, symptoms, or health concerns, and prioritize an appropriate evaluation and treatment plan.Complete certification for nitrous oxide administration. View the training video and witness 3 nitrous sedations.Medical Knowledge
Recognize & describe pediatric psychopathology, patient risk factors, signs and symptoms with emphasis on patient comfort.Recognize key diagnoses; acquiring fluid management, use of more specialized diagnostic testing, rationale for using antibiotics.Systems Based Practice
Work in intra-professional teams to enhance patient safety and improve patient care quality.Understand how the pediatric patient’s community can affect the patient’s health.Make appropriate referrals & coordinate care with pediatric specialists when necessary.Practice-based Learning & Improvement
Self identify strengths, deficiencies, and limits in knowledge and expertise.Analyze practice using quality improvement methods, and implement changes with the goal of practice improvement
Professionalism
Arrive on time to all scheduled rotation elements & participate in the learning experience meaningfully.Actively seek constructive feedback from outside attendings.Demonstrate humanism, compassion, integrity, and respect for others; based on the characteristics of an empathetic practitioner. Communication
Demonstrate ability to communicate effectively with patients & families.Communicate effectively & collaboratively with teaching attendings.
Reviewed and Updated: 7/2018, Ben Davis & 8/2018 Howard Uman
Effective: through June 2019