Inova Fairfax Medical Campus Lung Transplant Program and Advanced Lung Disease Programs Fellow & Resident Survival Manual

Transcription

1 Inva Fairfax Medical Campus Lung Transplant Prgram and Advanced Lung Disease Prgrams Fellw & Resident Survival Manual updated 07/13/16 1

2 Get Ready Instructins and Directins 1) Credentialing a. Please make sure that yu have a cpy f yur Virginia license r temprary license, r that a cpy has been sent t the Inva Fairfax GME ffice. b. Cntact GME ffice i. Crystal Hall t start the credentialing prcess ii. Lri Speidell (703) with any ther questins iii. Maureena Crawfrd (703) with any ther questins Sectin 1 will need t be cmpleted by yu, Sectin 2 will need t be cmpleted by yur Prgram Directr and GME Directr. Sectin 3 will need t be cmpleted by Dr. Shlbin r Dr.Nathan. After Sectins 1-3 have been cmpleted, please frward the applicatin t Crystal Hall fr review and she will have it signed by Dr. Erari. Once the applicatin has been signed, Crystal will wrk with yur GME ffice t draft an agreement fr the rtatin. c. GME ffice will set up EPIC training unless yu have rtated thrugh Fairfax previusly. 2) Please arrive by 8am n yur first day and present t the Advanced Lung Disease and Transplant Clinic area, lcated n the grund flr f the Inva Heart and Vascular Institute (IHVI) (Inva Fairfax Hspital Gallws Rad, Falls Church, VA 22042). a. Yu can best reach the IHVI frm Wdburn Rad and then turning nt Wellness Bulevard. Cntinue straight past the Twer building (n the right) and under the pedestrian bridgeway that cnnects the Twer building t a parking garage n the left. Surgical Center will be n yur right, fllwed by the IHVI building n yur right after the stp sign. T get t the parking garage, cntinue past the access rad t the IHVI building t the Grey garage entrance n the right (underneath the building). Yu will enter the building frm the Grey garage n the grund level t immediately find the Advanced Lung Disease Clinic n yur right hand side. If yu reach the funtain in the main IHVI lbby, yu have gne t far. 3) Ask the receptinist t cntact either Dr.Shlbin, Dr.Nathan, Dr.Brwn r Dr.King. 4) Yu will be escrted t the GME ffice, where yu will be registered and further instructin n hw t btain a badge, parking, etc. will be prvided Please make sure t ask the Parking ffice t give yu the access t the Original building 3 rd flr where the Lung Transplant physician ffices are lcated. 5) Please arrive fr rtatin by 8am every days (except the days when there is a 7:30am cnference). 2

3 6) Yur wrk area will be the all-purpse rm lcated in ur clinic area where 2-3 f ur research crdinatrs are lcated, as well as ur Pulmnary Techs (nt there all the time). There are tw desk spaces (see pic belw) with cmputers fr ur Fellws and Residents. Please write yur cell phne number n the bard. 7) Fellws and residents will be expected t take call tw f the weeks and tw ut f the fur weekends. 8) Lung jurnal club is held mnthly. Fellws and residents will be expected t present 1 article. 9) Please wash yur hands befre and after entering patients rms, utside (nt inside) f the rm. 10) We lk frward t having yu! 3

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5 Advanced Lung Disease and Transplant Fellwship Rtatin Objectives 1) T learn the evaluatin prcess f ptential lung transplant candidates 2) Evaluatin f ptential lung transplant candidates: types f advanced lung diseases fr which transplantatin is an ptin indicatins fr bilateral vs. single vs. heart-lung transplant indicatins fr transplantatin cntraindicatins t transplantatin 3) Evaluatin f the ptential lung dnr with an pprtunity t bserve rgan recevery at a dnr hspital if transplant is perfrmed during the time f the rtatin 4) Observatin f lung transplant surgery 5) Brnchscpy f lung transplant recipients 6) In-huse management f lung transplant recipients in the peri-perative perid: Ventilatr management f lung recipients Hemdynamic management f lung recipients Infectius disease prphylaxis Diagnsis and management f acute allgraft rejectin Immunsuppressin 7) Outpatient management f lung transplant recipients: Outpatient mnitring f the lung allgraft, inlcluding evaluatin fr acute cellular and antibdy-mediated rejectin PFT interpretatin in lung recipients Outpatient immunsuppressin management Recgnitin and management f lng-term cmplicatins including chrnic rejectin 8) Management f patients with pulmnary hypertensin: Assessment and wrk-up f patients with pulmnary hypertensin Indicatins fr the varius available therapies and apprpriate indicatins and use f the available ral therapies Initiatin and nging management f patients with cntinuus intravenus epprstenl, treprstinil, SQ treprstinil and inhaled ilprst therapies An pprtunity t bserve a RHC and read PH ECHOs Participatin in the mnthly PH cnference 9) Diagnsis and management f patients with interstitial lung disease Participatn in the multidisciplinary pathlgy cnference Assessment and wrk up f varius ILD diseases Initiain and nging management f patients n immunsppresive and anti-fibrtic therapy 10) Diagnsis and management f patients with cystic fibrsis and nn-cf brnchiectasis Indicatin fr genetic therapy Treatment f chrnic disease and acute exacerbatin 5

6 Cnference Schedule Mnday Tuesday Wednesday Thursday Friday 8am Weekend Update 12pm Research Lunch 7:30am PH Cnference 4pm Cllabrative LTx Meeting 8am Weekend Update 4pm Quality meeting 12pm Research Lunch 7:30am Pathlgy/Radilgy cnference 4pm Cllabrative LTx Meeting 8am Weekend Update 8am Weekend Update 12:30pm Medical Grand Runds 12pm Jurnal Club 4pm Cllabrative LTx Meeting 4pm Cllabrative LTx Meeting 12pm Lecture 12pm WRTC Dnr Review 6

7 Advance Lung Disease Rtatin Overview Please wash yur hands befre yu enter patients rms (nt nce yu are inside) t stay in cmpliance with Inva handwashing plicy. Inpatient Service The fellw n call during the weekend will help with the inpatient service with new cnsults, fllw up patients and inpatient brnchs. One inpatient MD (n call MD fr the weekend) runds fr the week Runds n inpatients Sees the new inpatient cnsults New patient cnsults that arrive after 4pm will be the respnsibility f the MD n call that day (t decide t see ASAP r hld till the next mrning) Des inpatient brnchs One inpatient/utpatient helper MD Runds n all inpatients in am Participate in clinic until 1pm at the earliest Helps with new inpatient cnsults Des utpatient brnchs Clinic Service There are 1-2 MDs in clinic wh will see the new cnsults and fllw ups. There are several clinics running at the same time and we are always adjusting ur clinics flw t meet the need f ur patients. S we ask yu t be patient. Belw is a brief summary f ur clinics t help yu thrugh this rtatin. Advance Lung Disease clinic incrprates the fllwing: Interstitial Lung Disease Clinic. We were apprved as an ILD Center f excellence by the Pulmnary Fibrsis Fundatin in January Pulmnary Hypertensin Clinic. We became ne f the first accredited Pulmnary Hypertensin Cmprehensive Care Center s in the cuntry in September Cystic Fibrsis Clinic is currently underging accreditatin. COPD Sarcidsis Other rare lung diseases and diagnstic dilemmas Pre-lung transplantatin clinic Pst-transplant clinic Clinic starts M-Th at 8:30am and runs thrugh 2:30pm with an hur lunch break between 12:00-1:00 pm. Urgent ALD patients are seen n Fridays at 9 and 11. 7

8 There are 3 new cnsultatins Mnday - Thursday (9:30am and 1300) and fllw up patients are seen every 30 minutes. New cnsult visits are alltted 1 ½ hurs t be seen, presented t the attending and discharged. The fellws will preferentially see the new cnsults. Please be cgnizant f the time spent reviewing the recrds and with patients. Prlnged patient visits affect clinic flw and ther patient visit times. Residents/fellws are assigned the patients in the mrning. It is essential t review the recrds befre hand (prir clinic ntes and the media sectin). Crdinatrs will give the testing t the fellws/residents when the patients are ready. The ALD Crdinatr t be in rm fr summatin and plan. Please d nt allw new patient t leave clinic befre patient is discharged by the crdinatr. Brnchscpy Fellws are t arrive and cnsent the patient 15 minutes prir t brnchscpy appintment time. The tw cnsent frms are: i. Cnscius sedatin ii. Prcedure Please check the patient histry, recent labs and radigraphic studies. Fill ut the Pre-prcedure frm (template). Attending will put in the rders. Brnchscpy nte is dne in Endwrks. 8