Tuesday June 17 th, 2014

Transcription

1 Tuesday June 17 th, 2014

2 FACULTY AND STAFF Dr. Philip Orlander The Program Director is supported by 5 Associate Program Directors Dr. Gabriel Aisenberg Dr. Jammie Barnes Dr. Amber Podoll Dr. Jennifer Swails Dr. Robby Wesley Each Associate Program Director is assigned a college. This is designed to give Residents more one on one attention.

3 In addition, 9 Core faculty represent a majority of the Internal Medicine subspecialties and are available to help you in specific areas including fellowship match, curriculum questions FACULTY AND STAFF Dr. Neel Shah Division of Endocrinology Dr. Aleksandra DeGolovine Division of Renal Disease Hypertension Dr. Anneliese Gonzalez Division of Oncology Dr. Modupe Idowu Division of Hematology Dr. Sushovan Guha Division of Gastroenterology Dr. Cristina Bocirnea Division of Geriatric Palliative Medicine Dr. Brandy McKelvy Division of Pulmonary and Critical Care Dr. Rodrigo Hasbun Division of Infectious Disease Dr. Stefano Sdringola Division of Cardiovascular Diseases Dr. Rhoda Chang Division of General Medicine

4 Housestaff Office Staff Catherine Gunn Program Manager Charity Sembera Residency Coordinator Amber McNutt Residency Coordinator

5 WELCOME TO UT Houston! Chiefs Andrew Jackson Wafi Momin Zeena Nawas Jade Teakell Lisa Torres

6 Residency Information Site chiefs corner/ Monthly Conference Schedules Administration Contact Info Pictorial Roster Online Evaluations Chief s Corner Articles, core lecture series, orientation manuals Rotation Curriculum & Objectives Policy & Procedures Manual Important Links for Survival

7 BlackBoard Login and Password same as

8 TMC Library

9 GMEIS Login and Password same as Attending / Rotation evaluations Duty Hours Log Update your duty hours During / After EVERY ROTATION Procedure log Print your immunization history Input your sick days and vacation days Paystubs Now through ADP (link via gmeis)

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11 Online Procedure Log Information input into GMEIS Advanced cardiac support Abdominal paracentesis Arterial puncture Arthrocentesis Lumbar puncture Nasogastric intubation Pap smear and endocervical culture Central venous line placement Thoracentesis * In order to qualify as a supervisor in central lines and thoracentesis 5 must be performed

12 Hermann Checkout

13 LBJ Checkout

14 Pagers To directly page someone: or (4 PAGE) at Hermann Enter 5 digit pager number of the person you want to page Enter call back # (include area code) HH extension: 4xxxx; LBJ 6xxxx Sign page with * and your pager # Or call the page operator: Hermann: dial 0 or LBJ: or To Text Page Amion Metrocall: and send a message Type in PAGER NUMBER

15 Educational Resources TMC Library Register for remote access FREE Chief s Library in CMR LBJ and Hermann Dynamed available at Hermann Up to Date available at LBJ and Hermann With citrix portal you can use this anywhere ACP / MKSAP

16 Parking LBJ Free parking (must get permit at security office) with HCHD badge MHH UT Professional Bldg (GME orientation) with UT Badge MDACC UT Professional Bldg. SLEH UT Professional Bldg.

17 Vacation/Duty Hours Vacation (3 weeks + 4 day holiday) Two weeks by request, plus all interns are off last week of June (without pay plan accordingly!) Schedule Changes: may swap with another intern, but must be approved by CMR and APD Setup switch well in advance Days Off: 1 day per week averaged over 4 week period Hours: 16 hours per shift max with 10 hours off between shifts

18 Calling In Sick Page the CMR on call as soon as you know you will not be able to work pager number Need to speak to a CMR directly Text/ /Sticky note/raven/owl NOT acceptable!! Notify your attending and senior resident If you are in clinic that day you must notify the clinic staff as well We will worry about you if you just don t show up please let us know if you can t be at work for any reason!

19 Schedules Password: uthim Rotation, Call, and Clinic Schedules Vacation schedule Yearly rotation schedule Send Text pages Scheduling Chiefs: Jade Teakell (Interns) Lisa Torres (Residents)

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21 Block Schedule Four week Call Blocks Wards/ICU/Cards Two week Ambulatory Block Includes Continuity and Subspecialty Clinics Vacations during Amby Blocks Two week Variety Block MHH/LBJ Inpatient Consults, MDACC Heme, ER, SLEH Pulm/Cards, Float Jeopardy, Geriatrics

22 Clinics Everyone assigned to a Continuity Clinic QM, UTPB, LBJ, VA Two week Ambulatory Block every 6 weeks Includes Continuity and Subspecialty Clinics Includes Ambulatory Didactic Curriculum Please see Amion/ for clinic assignments Ambulatory Chief Wafi Momin

23 June 23rd June 24th Day 1 Page resident on service or intern coming off service via Amion Obtain checkout from resident/intern Request Resident to Proxy EMR lists Ask for time and location of rounds Will meet with attending and rest of the team to discuss goals, expectations, scheduled days off, etc.

24 Rotation Specific Wards and Consult Services: Get checkout the day before and meeting time from outgoing intern/resident; Be prepared to see all your patients and write SOAP notes before rounds MICU (LBJ and MHH) No checkout given Show up at 7 am ready to work (will get checkout during rounds) On call show up at 6:30 pm for check out from day team CCU / Cards Wards (MHH) Contact the 6/23 on call resident (may rec checkout via ) On call show up at 6:30 pm for check out from day team Ambulatory: No checkout given Float (LBJ and MHH): No checkout given; Receive checkout from the 4:45 in the 4B resident lounge (LBJ) or 3 rd floor checkout room (MHH) MDACC and SLEH Page your resident/attending in the AM; Baylor CMR SLEH Contact: Natalia Khalaf (khalaf@bcm.edu) MDACC Chief Fellow *** (***@uth.tmc.edu)

25 MEMORIAL HERMANN TMC

26 Hermann

27 Hermann

28 Hermann Pavilions Memorial Hermann is composed of 5 Pavilions: Robertson Pavilion: Cafeteria on 1st floor Operating Rooms, Day Surgery and Surgical Pathology on 2nd floor Other floors are Admin and Call rooms (6 th floor). Residents Lounge 4 th Floor; Entry via UT Badge Bagels/Muffins/Coffee in the AM and Fruit/Cheese/Soda in the PM Jones Pavilion: Patient Rooms on all floors Radiology on 2nd floor Hemodialysis unit on the 9th floor Hermann Pavilion: Women and Children s Hospital 2nd floor PACU 3rd floor Transplant ICU, Surgical/Shock Trauma ICU

29 Hermann Pavilions Cullen Pavilion: MRI and Cullen Atrium on 1st floor; MIMU, MICU and ICU Call rooms on the 2nd floor Internal Medicine on 3 CULLEN MHUTS Hospitalist on 4 5 Cullen ACE Unit (Geriatrics) 4 WEST CULLEN Private Internal Medicine 5 th Floor (signature suites) The House Staff Association Office is located on the 1st floor of Cullen Pavilion. This office manages call room keys, scrub cards, and parking. Heart and Vascular Institute (HVI): Cardiac Catheterization Labs on 2nd floor Cardiac Imaging on 3rd floor CCU /CIMU on 4 th floor, Heart Failure ICU 5 th floor CVICU on 8 th floor, ORs on 7 th floor

30 Hermann Call Rooms Opened with Key Card C 240 MICU fellows room call (call room 1) C 242 MICU resident room (call room 2 ) C 244 MICU intern room (call room 3) C 246 Medicine Ward Team Resident HVI 2nd floor CCU Resident HVI 2nd floor CCU Intern Robertson 539: Ward Resident/Intern Robertson 631: Ward Resident/Intern Robertson 675: Float Resident Robertson 676: Float Intern MEAL TICKETS Pick up from Gen Med Office (1 st floor MSB), see Charity Sembera/ Amber McNutt on first day of rotation

31 Hermann Cafeteria Weekdays and Weekends: 6 am 2am Other options: Café Brioche Accepts meal tickets Au Bon Pain Starbuck s Refrigerator and Microwave available in 4 Robertson lounge

32 Lyndon Baines Johnson Hospital 5656 Kelley Street, Houston TX 77026

33 LBJ LBJ Hospital, UT Annex Building, Outpatient Center First Floor: Emergency Center/Observation Radiology Cafeteria Security Second Floor: IM Wards (2B), Pediatric Clinic, Nursery, OB/Gyn wards Third Floor: Medicine Floor/Telemetry/IMU (3A, 3B, 3C) 3C workroom (door code = 0911) MICU/SICU (3D) Blood Bank, Pathology, Nuclear Medicine, ECHO, GI Lab Fourth Floor: Medicine Floor, Oncology Floor (4A, 4B, 4C) 4A workroom (no door code yet); 4B workroom (door code = 0911) Library / Rounding Room (Harris Health badge access) Call rooms

34 LBJ Call Rooms USE Call Room Key Card (from physicians services) 4A: 2 call rooms acr0ss from rooms 5 & 6 Inside ICU 3 IC ICU Team Outside 4B unit (across from stairs) 4 SP ab Ward Team 4 SP ab Ward Team Sterile Processing Hall (Hall near the library) Float Call Room 4 SP ab Ward Students 4 SP ab Ward Students MEAL TICKETS collect on first day of rotation from Dana Whittaker in the Medicine Office (4 th floor near 4B entrance)

35 LBJ UT Annex: Medical Records (1 st Floor) Annex Auditorium on the 2nd floor Classrooms (210 and 212) Physicians Services Faculty Offices Gift Shop / ATM machine is located by the front entrance of the hospital

36 LBJ Cafeteria Hours Vending Machines available 24 7 Monday Sunday: 6:30am 5:30 am Refrigerator and Microwave available in Library Coffee machine for residents in 3C workroom

37 Michael E. DeBakey VA

38 VA Hospital New medicine wards rotation this year! Team structure: 1 upper level resident and 2 interns No overnight call for interns Take admissions using a drip system

39 MD ANDERSON CANCER CENTER

40 MD Anderson Orientation: June 24th or the first day of month Chief Fellow for U.T. Housestaff: *** University of Texas, M. D. Anderson Cancer Center See Cross Cover Tips at MDACC Handout Call Schedule released one month before CMR Contact: Andrew Jackson

41 Heme rotation Onc rotation

42 ST. LUKE S EPISCOPAL HOSPITAL/ THI

43 SLEH Wards, Pulmonary, or Cardiology Orientation with the Baylor Chiefs first day of the rotation Orientation will occur on the first day of the rotation in C018 (Cooley Building, B1 level) Arranged by Baylor CMR at St. Luke s Dr. Natalia Khalaf Office: Pager: ext If you are post call: Inform attending and resident so that you can go to orientation Collect the pager and go to work the next day

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45 Admission H & P An Original Document detailing the initial encounter between the patient and the housestaff physician Should include the following components (for billing purposes): Chief Complaint History of Present Illness Past Medical History Past Surgical History Medications Allergies Family History (cannot write noncontributory!) Review of Systems ( 10 Systems!) Physical Exam ( 8 organ systems!) Pertinent laboratory/imaging data Assessment Plan

46 Daily Progress Notes SOAP note format Events overnight Focused Physical Exam New/relevant laboratory/imaging data Medications Assessment Plan

47 Float Etiquette If called to see a patient, always write a note in the electronic chart. It can be as simple as a few lines to a longer note depending on the events. Remember: if you did not document it, it did not happen. You may be called to reassure a patient or his/her family. Avoid Not my patient. Be a doctor!!

48 Death Pronouncements When you are called to see a patient who has died, you must first make sure that this is not a code situation. Once the patient has died, you must contact the patient s family and the Attending physician on the primary team. Additionally, you must write a note in the chart with the following information: 1. Called to see patient regarding (cyanotic: no respiration, pulse, etc.) 2. Physical exam: pulse 0 and BP 0 HEENT: Pupils fixed and dilated Chest: No spontaneous respirations CV: No heart sounds Neuro: Unresponsive to deep pain 3. Patient pronounced dead at: (give time, date). (Specific family member) notified via (phone or in person). Dr. (Attending) notified. (Family refused or agreed to) (full or limited) autopsy. Patient (is or is not) candidate for organ donation.

49 The Chart For dictated notes, put a brief note in chart documenting the dictation SEE DICTATION PROCEDURE CARDS Print dictations and place in chart Write transfer and accept notes when applicable Don t forget documentation of procedure notes! Sign all verbal orders within 24 hours Dictate all Admission H & P s, Consult notes, Discharges and Death Notes within 24 hours of the encounter

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51 Conferences Morning MSB T/W/Th Morning report 7:30 8:20 am LBJ Case Report Dr. Fred Morning Post call Report Noon Intern Lecture Series (weekly during the first months) Core Didactic Lectures High Yield Review IM Grand Rounds Thursdays 12 1 pm MSB B.500 Case/Consult Conference Faculty Led Conference

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53 Conference Attendance All Interns and Residents are expected to attend 75% of monthly conferences You are excused if you are: Post call Travelling offsite for a clinic Attending a subspecialty conference at the same time If you have a patient emergency and can t make it to conference that s ok! That s why we only require 75% attendance You must sign in within 15 minutes of conference starting or you will not receive credit

54 Conference Attendance If you re having trouble getting to 75% of conferences let us know! We can help! Attendance lower than 75% will have consequences Reduction in ability to request preferences in next year s schedule Call/Mtg with Program Director Extra Float Nights Professionalism Note in Record Punctuality and attendance are reflective of your professionalism please be present and be on time!

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56 Post Call Assistance You are never alone! Wards Post call Coverage Team (LBJ) Gen Med Attending Pulmonary Consult Resident ICU Fellow/Attending Chief Need to Sleep? Extra Call room space for naps Call the Chief

57 EAP Employee Assistance Program / UT Counseling and Worklife Services Confidential Services Free of Charge Contact: Services include: solutions for childcare Eldercare stress management wellness, and much more. Professional Development Skills for productive employees Legal and Financial Advice IT S ALL FREE

58 Needle Stick!! If you sustain a needlestick or other body fluid exposure, page the UTHSC Exposure Hotline at (713) hours a day 7 days a week. The UTHSC Exposure Coordinator will instruct you as to the course of immediate action depending upon the type of exposure you have had.

59 Having a Voice Residency Council Chairs: Mark Hwang, PGY3 Tanima Jana, PGY3 Lauren Ridley, PGY3 Committees will form in the beginning of the academic year which you are welcome to join Education, Social, Technology, etc. Watch your for more information Resident Support meetings occur monthly at LBJ and MHH

60 GOOD LUCK! You ll Do Great! Questions???