A recent Wall Street Journal article highlighted the importance for trainees – both interns and residents to know when to call their Attending for guidance and help. The article describes how 4 hospitals developed guidelines to improve communications and decreased their proportion of critical events that weren’t conveyed to an attending from 33% to just 2%.
At UTSW Internal Medicine program, we support our trainees and remind them that Interns and Residents are encouraged and expected to inform their Faculty members in these following situations:
Events that require prior notification to attending physicians
- Procedures: Cardioversion, pericardiocentesis, thoracocentesis
- Therapies: Emergency dialysis, exchange transfusion, thrombolytic therapy, or initiation of mechanical ventilation if using 1) oscillation or 2) jet ventilation
- Events: End-of-life discussions, order of protective custody, or transfer of patient to higher level of care
Events that require concurrent notification to attending physicians
- BiPAP initiated on non-ICU patient for hypoxic or hypercapneic respiratory insufficiency
- Code Blue/Unexpected Death
- Cardiopulmonary arrest/acute respiratory compromise
- Patient leaves AMA
Also our regular Patient Safety and Quality Improvement conferences are opportunities for us to learn as a system on how to care for patients even better.
More information on our Resident Website under Resident Manual: imweb.swmed.edu.