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Page history last edited by Patrick 7 years, 8 months ago

 

Resident Handoff Guidelines

 

COVERAGE

  • It is your responsibility to arrange coverage for your patients with interns during your days off
  • You are required to stay in-house until at least 3 PM on weekdays and 12 PM on weekends to address patient care issues
  • You are required to answer pages until 7 PM unless it is your day off.  If the senior resident is off, arrange for the attending to carry the team pager until 7PM

 

CROSS COVERAGE

  • Routine checkout of all patients to on call interns will not occur
  • The senior resident is expected to field calls for patients every day until 7pm, after which OCD will take over
  • On days that the senior resident is off, the attending should take calls until 7pm
  • If you have left the hospital and an issue arises that you cannot take care of over the phone, call the appropriate day call intern and give checkout/instructions.  
  • Interns should not go home with the team pager.  This is a senior resident or attending duty.

 

Daily verbal check-out to cross-cover.

Acceptable forum:

  • Handoffs/checkouts are preferably done face to face, over the phone is acceptable
  • This should include a mechanism for ensuring that the receiving physician demonstrates knowledge and understanding of significant issues. This is best accomplished by the receiving physician reiterate the significant issues to the presenting physician (ie "Teach back").

 

Unacceptable:

  • Passing off check-out sheet without verbally reviewing the patients.

 

Minimum information to be given during verbal handoff:

  • ID

Patient Name, location, general comment on current status/level of concern for overnight problems, and code status.

  • List active medical problems

Admitting diagnosis and any other problems which are requiring active intervention.

  • Recent changes or issues such as new medications, change in mental status, fever pattern, oxygen requirement, urine output, etc.
  • Specific concerns which the primary team has for the next 24 hours – e.g. pending consults, pending diagnostic tests (including whether or not the receiving physician is expected to pursue these results or if they should expect to be called), patient leaving AMA (are they competent to do so), etc.  Obviously, it is impossible to anticipate every possible problem, but these items should focus on things which are likely to be issues given the primary team’s level of concern, the patient’s active medical problems, and recent issues.

 

 

Verbal checkout from the cross-cover back to the primary team.

 

 

  • This should be face to face, verbal communication if possible.
  • Every patient whom cross-cover was called regarding should be discussed with the primary team.
  • The information should include:
    • Patient name and location.
    • The problem for which the cross-cover was called and the time.
    • Whether or not the patient was seen by the cross-cover. (Every time a patient is seen by cross-cover, or there is a change in therapy a note must be placed in the patient’s chart.)
    • What the cross-cover did in response to the call.
  • If cross-cover was given specific tasks (such as following up on a test or consult) the results should be reported to the primary team, as well as what the cross-cover did in response to the result.

 

 

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