November 1st, 2011. 11-1-11. A palindrome. For those numerologistically inclined, it's a date we can say, "I survived 11-1-11", similar to the way I can say that I was alive when 1-1-2000 rolled around and the computers did not cause a global cyber-crash.
For the Hospitalist services, 11-1-11 marks a shift in the way we care for patients at LLUMC. To the credit of my colleagues, it was a shift that required a lot of input from colleagues, residents, and other stakeholders.
- First, I preached the gospel of 7 on/7 off. I still believe in that model, it works well for the DHS teams
- 10 days before launch, a course correction was required for the MOD services to maintain coverage
- Schedules had to be revamped, plans adapted, and services adjusted
In the meantime, the Hospitalists have risen to the call of duty and covered the HSH services for day and night coverage for October. Thanks goes to all the attendings who pitched in. Specifically, I appreciated Drs. Michel and Natla for covering in a pinch, Drs. Hans and Cotton for generating a schedule so quickly, and everyone else for rolling up their sleeves in pitching. Truly remarkable and inspiring.
DHS: Really showed initiative and courage in covering the vacant shifts from the emergent family leave that Dr. Natla faced. I am thankful and proud to work with such honorable colleagues.
- Handoffs:
- 7am: any PM physician responsible for patient care has to connect with any AM physician responsible for that patient's care
- PM handoff: when does that happen?
- Dealer responsibilities
- Distribute judiciously
- Update "Dealer Tally"
- Handoff of patient care and pager
- Direction of various groups
- Managing up expectations of the Residents
- Refresh and support the need for patient centered care
- Judiciously set expectations for duty hours
- Handoffs paramount
- Medication reconciliation paramount
- Communication to the Stakeholders
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