Hand-Offs and Care Coordination/Sign-Outs

HAND-OFFS 

Two types of hand-offs occur on the Gen Med Consult service: 

1. Consult Hospitalist hands off the service for cross-cover overnight:

Hospitalists staffing the Consult Service are expected to safely hand off the service to the Fairview House Physician (Moonlighter – Job Code 6633) at the end of every scheduled shift and receive a hand off from the House Physician at the start of every shift.

• Written hand-off:

INTERIM: Print a patient list from FCIS and write any important “to do list” items directly on the printed list; place the list on the “pulmonary sign-out” board in the fishbowl on 7A.

LONG TERM: COMING SOON – shared patient lists will allow the house physician to access the Consult Service list directly in FCIS eliminating the need for the above written hand-off procedure.

• Verbal hand-off:

Hospitalists staffing the Consult Service are expected to contact the House Physician at the time the House Physician is scheduled to start taking cross cover calls (i.e. 6PM M-F, 3PM on weekends) via telephone to offer a verbal hand-off of the most critically important issues for patients on this service.

The Hospitalist is encouraged, at his/her discretion, to contact the Staff on long call for Teaching Firms to make him/her aware of any potential issues for which the House Physician may require attending-level support.

2. Consult Hospitalist hands off service to the next scheduled Consult Hospitalist:

• Dr. Wood’s administrative assistant, Sarah Bialka, will provide the email address of the Hospitalist scheduled to take over the Consult Service via email on the Friday prior to the change in scheduled staffing. 
• The current Consult Hospitalist is expected to email your billing form and important follow-up information for all patients being seen by the Consult Service to the next scheduled Hospitalist by Monday morning.

1. The Consult Hospitalist and/or Non-physician Provider are expected to meet with either the Social Worker or Care Coordinator on each Patient Care Unit on which Med Consult patients are hospitalized to discuss discharge milestones and safe transition to post-hospital care.
2. The last item in each patient’s problem list in every daily progress note is expected to contain information that communicates anticipated transition to post-hospital care; this information will directly be accessed daily by Social Workers and Care Coordinators.