Overview
Monday-Friday
Day coverage:
HMC Thoracic surgery service (Thoracic R4 and Thoracic R1)
Evening/Overnight coverage: HMC Gen Surg night team (ie. call team) (R3–for initial fielding of thoracic consults and then discuss consults with R4 who relays consult to on call thoracic surgical attending; gen surg night float R1 provides thoracic floor coverage)
Saturday/Sunday
Day coverage:
HMC Thoracic R4 or GS consult R3 will field thoracic consults and discuss with on call thoracic surgical attending. The Thoracic R4 and GS Consult R3 alternate weekend coverage.
Evening/Overnight coverage:
The on call Gen Surg R3 fields thoracic consults and discusses consult with Gen surgery R5 on Saturday or Gen Surg Night float R4 on Sunday. The expectation is that either the Thoracic R4 or Vascular R3 that was on during the day for Saturday and Sunday will serve as back-up home call and be available to come in and assist with thoracic OR/Coverage should the in-house R5 not be available due to other clinical responsibilities (i.e. trauma OR conflict) on Saturday evening/night. The R5 is responsible for notifying the thoracic back-up call person when needed. When the Thoracic R4 is not on for the weekend (i.e. weekend coverage by R1 Thoracic) the thoracic consult for both day and night will be seen by the GS consult R3’s designated for that 24 hour period.
** CONSULTATION FOR CARDIAC SURGERY SERVICE AT HARBORVIEW MEDICAL CENTER
Effective as of January 01, 2017, Inpatient/Emergency Dept/Observation- status patients requests for Cardiac surgery evaluation and consultation at HARBORVIEW MEDICAL CENTER will be first received by the same general surgery house staff personnel responsible for covering the HMC THORACIC SURGERY CONSULTS. House staff should staff these cardiac consults with the ON CALL UWMC CARDIAC SURGERY ATTENDING. Consultation documentation should follow current guidelines for HMC general surgical consultations and forward to the UWMC cardiac surgical attending for review/signature.
Follow-up and subsequent consultation management and documentation for the cardiac surgery consultation should be individually discussed at the time when the initial consultation request is staffed with the on call UWMC cardiac surgery attending and appropriately conveyed to subsequent responsible house staff teams accordingly.