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2014-2015 House Staff Orientation

2014-2015 House Staff Orientation. Sign-in/out Times T oday …. 7:30-8:00 AM: Registration & morning session Mandatory Sleep Deprivation session (1 :00-1: 3 0 ) No one may leave during this session . 3:00 PM: At completion of the day: turn in paperwork and pick up your ID badge.

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2014-2015 House Staff Orientation

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  1. 2014-2015 House Staff Orientation

  2. Sign-in/out Times Today … 7:30-8:00 AM: Registration & morning session Mandatory Sleep Deprivation session (1:00-1:30) No one may leave during this session. 3:00 PM: At completion of the day: turn in paperwork and pick up your ID badge. Sign in/out sheets will be in the lobby/hallway outside this room.  The Sleep Deprivation sheet will be passed around during the presentation.

  3. Can You Start? If You Are NOT CLEARED To Start Working . . . Breanna will call you out of this meeting You cannot begin your program until your credentialing is complete Breanna must clear you for hire NOTICE! You are not credentialed!

  4. University of Utah GME 72 ACGME accredited programs 26 Residency programs with 558 residents 47 Fellowship programs with 157 fellows 34 Non-accredited fellowship programs with 32 fellows 10 dental residents Total of 757 residents and fellows for 2014-2015 256 new residents and fellows for 2014-15

  5. GME Growth

  6. Match Numbers

  7. GME Organization

  8. GME Contact Information Location • School of Medicine Building, Level 1 Southeast Corner (1C412) Webpage • http://medicine.utah.edu/gme Email • gme@hsc.utah.edu Phone • 801-581-2401

  9. A few of the services provided by the GME Office Maintains your permanent training record Issues your annual contract Ensures that you receive your contracted salary and benefits Processes your loan deferments and forbearances Assists with your License Applications Issues your graduation certificate Provides Notary service

  10. Resident Resources Resident representatives on Hospital, School of Medicine, and Department committees Resident members of the Graduate Medical Education Committee (GMEC) Resident Interdisciplinary Council representatives

  11. Email You are expected to read your email regularly To access email electronically from off campus: www.umail.utah.edu

  12. Policies and Procedures House staff Policies and Procedures Manual are posted on the GME website http://www.medicine.utah.edu/gme/

  13. ACGME Requirements

  14. Duty Hours The ACGME requires Institutions to track duty hours across all accredited programs You will be required to enter your duty hours in the GME E*Value system. (more about this from Renn later today)

  15. Duty Hour Requirements 80 hours per week maximum averaged over 4-week period, including all approved moonlighting (PGY-1 residents may not moonlight). One day off in 7 over a 4-week period; at-home call may not be assigned on your free day.

  16. Duty Hour Requirements Maximum duty period length: • PGY-1: 16 hours maximum • PGY-2 and above: maximum 24 hours of continuous duty plus 4 hours for transitions of care. Minimum time off between duty periods: • PGY-1: should have 10 hours, must have 8. • PGY-2 and above: should have 10 hours, must have 8, but may be shortened in selected circumstances.

  17. Levels of Supervision Direct Supervision • Attending physically present with resident and patient (PGY-1) Indirect Supervision • Direct supervision immediately available –Attending physically within site of patient care, and immediately available to provide direct supervision (PGY-1) • Direct supervision available –Attending not physically present within site of patient carebut immediately available via phone, and available to provide Direct Supervision (Intermediate level) when needed Oversight • Attending available to review procedures/encounters with feedback provided after care is delivered

  18. Professionalism, Personal Responsibility and Patient Safety Understand your personal responsibility to: • Appear for duty appropriately rested and fit to provide the services required of your patients • Actively participate in interdisciplinary clinical quality improvement and patient safety programs • Assure the safety and welfare of patients entrusted to your care • Manage your time before, during & after clinical assignments • Recognize impairment, including illness and fatigue in yourself and your peers • Honestly and accurately report duty hours, patient care information (EMR), and clinical experience data (e.g., logs) • Comply with the Social Media Policy

  19. Professionalism Professional Conduct Policy (GME 8.4) Social Media Policy (GME 9.7) Copies in your folder – read and be familiar with them

  20. Transitions of Care Develop competence in communicating with team members in the hand-over process Inform all members of the health care team of current responsibilities for each patient’s care Alertness Management and Fatigue Mitigation Learn to recognize signs of fatigue and sleep deprivation Transfer care when unable to perform clinical duties

  21. Teamwork Work as a member of effective interprofessional teams that are appropriate to the delivery of care in your specialty

  22. ACGME Resident/Fellow Survey Core specialty programs (regardless of size) and subspecialty programs (with 4 or more fellows) surveyed annually between January and June Survey data used in decisions affecting your program’s accreditation status ACGME emails link directly to you Takes about 10-20 minutes to complete

  23. Survey Areas Duty hours Faculty supervision and teaching Evaluations (access to & opportunity to evaluate faculty and program; confidentiality) Educational content (goals & objectives; fatigue management; scholarly activities; education/service balance)

  24. Resident/Fellow Survey Areas Resources (access to reference materials; use of EMR) Patient safety (pts informed of resident & faculty roles; culture reinforces pt safety; participate in QI activities; process to address concerns) Teamwork (work in interprofessional teams) Overall evaluation of program

  25. Survey Report to Program

  26. ACGME Next Accreditation System (NAS)

  27. What is NAS? Accreditation system based on continuous oversight rather than episodic sampling Program site visits at ~ 10 year intervals Emphasis on program effectiveness as evidenced by resident advancement through the Milestones

  28. Milestones Specific benchmarks of skills, knowledge, and behaviors that each resident is expected to achieve at identified stages of residency training. Milestones associated with the six ACGME general competency domains: • Medical Knowledge • Patient Care • Professionalism • Communication and Interpersonal Skills • Systems-based Practice • Practice-based Learning and Improvement

  29. Milestones Designed to allow tracking of discrete and measurable educational outcomes Progress of each resident/fellow assessed by program’s Clinical Competency Committee (CCC) CCC members = Core Faculty + Program Director; chief residents can attend but not vote

  30. Milestones Example (Neurosurgery) Neurological Surgery Milestones

  31. Level 1 Milestone? “Whoa! Watch where that thing lands – We’ll probably need it.”

  32. Questions?

  33. Thank You and Welcome!

  34. Empathy: The Human Connection to Patient Care - YouTube

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