Resident Handbook - UC Davis Health System

• Status can be changed from inpatient to observation if an error occurred in the patientregistration process and the physician’s intent for observation is clearly documented inthe record.• Inpatient status can be changed if the patient has not been discharged and upon review itis found that the patient meets observation criteria.• The three-day qualifying stay required for Medicare coverage in a skilled nursing facility(SNF) begins on the day of admit to inpatient and will only qualify if inpatient criteria ismet per InterQual.Page 56 of 153C:\Documents and Settings\dhutak\Desktop\rshb13.docINTERNAL MEDICINE-NIGHT SHIFTA. Service GoalsThe purpose of this rotation is to maintain the internal medicine educational goals whiledecreasing the amount of call and fatigue associated with traditional call. The night shift rotationhelps us maintain our educational and service objectives while adhering to the ACGME workhour restrictions. The educational goals of the night shift rotations are similar to those describedon the internal medicine service. The service provides resident physicians with experiences ingeneral medicine, primarily managing common medical problems. In addition, residents willlearn to recognize uncommon problems and obtain consultations when needed. Residents areexpected to develop the full set of defined Medicine Competencies over the course of their threeyears’ experiences. (See also Residency Goals and Competencies)B. Service DescriptionThe service is staffed by a single resident working closely with the internal medicine service andinternal medicine service attending. PGY3s will have one 2-week block of night shift. PGY2’swill have two 2-week blocks. PGY1s will have one 2-week block later in the academic year.PGY1s will always have an upper level resident available on the Night float Ob/Pediatricsservice to provide supervision. The night shift resident will work from 5:30 p.m. to the 7 a.m.check out. The night shift resident will work five shifts Monday-Friday. In addition, the nightshift resident has family practice clinic on Monday afternoons. Admission policies are describedin the internal medicine rotation section above. The night shift should review all admissionswith the attending physician during the night or prior to end of shift – this assures both quality ofcare for the patient and education for the resident.C. Service DutiesThe night shift resident duties are as follows:• Admit new patients from the ED• Supervise first year residents on short –call• Perform Consults• Follow-up on patient care issues as requested during check-out• Update computer sign-outs as necessary• Assist with Saturday morning rounds if the combined number of patients onFPS/Medicine exceeds ten.If the combined number is: