1 / 14

Outpatient Medicine

Outpatient Medicine. Intern Bootcamp 2019-2020. Outpatient Schedule. AM Clinic: 8:00 AM, but variable depending on clinic PM clinic: 1:00 PM Location: IPT, OPD, or Rand Schrader. General Tips. New or returning patient? Resident- or fellow-level patient?

knoton
Download Presentation

Outpatient Medicine

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Outpatient Medicine Intern Bootcamp 2019-2020

  2. Outpatient Schedule AM Clinic: 8:00 AM, but variable depending on clinic PM clinic: 1:00 PMLocation: IPT, OPD, or Rand Schrader

  3. General Tips • New or returning patient? • Resident- or fellow-level patient? • Previously ordered labs/diagnostics completed? • Stay focused on consulting problem: • If deferring workup/management of other, nonurgent issues to PMD, make sure they have a PMD and/or close follow-up (can send message to 4p1 clinic staff) • Document any changes to management, labs/diagnostics and follow up • If patient needs to go to ED, call Resus (91619) and obtain approval from Resus attending (document in note attending’s name, location to be sent) • Complete the following tasks in clinic for each patient: • Charge completion (billing) • Medication reconciliation • All orders (lab/MRI/future appts) • Complete note and sign**if unable to complete all notes by end of clinic, let attending know

  4. Overview • Rand Schrader • Cardiology • Endocrine • GI/Liver • Hematology • Oncology • Neurology • Renal • Rheumatology • Pulmonary

  5. Rand SchraderLocation: 1300 N MissionRd, Los Angeles, CA 90033 Schedule • Monday: Core Lecture @ 8am on 3rd floor, Clinic begins 8:30am on 2nd floor • Wednesday: Clinical Case Conference @ 8am on 3rd floor • Lectures/conferences are required for ID consult team, +1 interns/residents Workflow • Paper charts (pending resident/fellow panels) • Look up patients by MRN Tips • Ask ID team if lectures/conferences are scheduled night prior to clinic • Give yourself ample time for parking and/or walking • Know microbiology, serologies, antibiotics (duration, interruptions)

  6. CardiologyLocation: CT A4A Schedule • Monday: 1pm • Wednesday: 1pm Workflow • Paper charts (pending resident/fellow panels) • Look up patients by MRN Tips • EKG available in clinic (until 4pm) • Ordering TTE: • CV Echocardiogram Transthoracic Complete • Priority (Routine) • Transport mode (Ambulatory, Wheelchair) • To be scheduled at: LAC+USC Appointments • Ordering Stress tests: always order these together • CV Exercise Nuclear Stress Test • NM Myocard Perfusion Gated Spect Multi

  7. EndocrineLocation: CT A4B Schedule • Wednesday (General): 9am • Thursday (Thyroid): 8am • Friday (Thyroid): 1pm Workflow • Paper charts (pending resident/fellow panels) • Look up patients by MRN Tips • Hypo-/Hyper-thyroidism: TSH, FT4 (other tests: T3, anti-TPO or TSI antibodies) • Thyroid nodules: T4, T3, radionuclide scan (consider FNA biopsy) • Thyroid cancers: TSH (suppression), thyroglobulin (residual thyroid tissue), thyroglobulin antibodies (surveillance); for MTC, get calcitonin and RET for possible MEN2A/2B) • Pituitary disorders: pertinent pituitary hormones, MRI brain • Can perform supervised thyroid biopsies in clinic!

  8. GI/LiverLocation: OPD 5p1 Schedule • Monday (Hepatitis): 8am • Wednesday (GI): 9am • Friday: 8am Workflow • Assigned panels on check-in • Home tab > Patient dropdown>USC GI Resident or USC Liver Resident Tips • GI: most residents will be scheduled to see NEW patients (write full H&P) • Liver: MS 3 style presentation, have all pertinent labs/diagnostics available • Send patients who need stat labs to OPD lab immediately in clinic (otherwise, send to ED)

  9. HematologyLocation: CT A4A Schedule • Tuesday (Malignant): 1pm • Thursday (Benign): 8am, 1pm Workflow • Paper charts (pending resident/fellow panels) • Look up patients by MRN Tips • Resident or Fellow-level patient • Start presentation with: “Patient is here for (Hematologic Dx)” • Know pertinent labs and recent changes in therapy • If patient needs urgent labs or transfusions, will need to send to ED

  10. OncologyLocation: CT A2C Schedule • Monday (Breast): 8am, 1pm • Tuesday (GI): 8am • Wednesday (Melanoma/Sarcoma/Neuro): 8am • Thursday (Head/Neck, Other): 8am Workflow • Paper charts (pending resident/fellow panels) • Look up patients by MRN Tips • Resident or Fellow-level patient • Know recent labs, results of latest staging scans, interruptions to therapy • If patient needs urgent labs or transfusions/infusions, will need to send to ED • Tuesday: Wear a tie!

  11. NeurologyLocation: CT A4A (Mon), A4B (Wed/Fri) Schedule • Monday (General): 8am Huddle w/attending, 8:30am clinic starts • Wednesday (General): 8am Huddle w/attending, 8:30am clinic starts • Friday (Epilepsy): 8am for Didactics, 8:30am clinic starts Workflow • Check in with Luz/Tony (RN’s) for chart assignments • Complete the following tasks in clinic for each patient: • Charge completion (billing) • Medication reconciliation • All orders (lab/MRI/future appts) • Complete note and sign Tips • Ask for neurology tool kit before clinic begins • Watch neurology exam video: https://vimeo.com/mphonline/review/132984587/

  12. NephrologyLocation: OPD 5p1 Schedule • Tuesday: 1pm • Thursday: 1pm Workflow • Assigned panels on check-in • Home tab > Patient dropdown> Nosrati, Saeid (labels sticky notes for pts to see) Tips • Send patients who need stat labs to OPD lab immediately during clinic

  13. RheumatologyLocation: OPD 5p1 Schedule • Monday (Rheumatoid Arthritis): 1pm • Tuesday: Didactics @ 8am with Dr. Quismorio • Tuesday (Lupus/Other) clinic starts at 8:30am Workflow • Assigned panels on check-in • Home tab > Patient dropdown> USC Rheum Lupus or USC Rheum Arthr Tips • Be prompt for 8am Tuesday didactics • Order pertinent labs as recurring order (eg CBC, CMP, ESR/CRP, anti-ds DNA, vit D lvl)

  14. PulmonaryLocation: CT A4B Schedule • Wednesday: 1pm Workflow • Assigned panels on check-in • Home tab > Patient dropdown> USC Pulm MD (check with RN) Tips • Resident or Fellow level patient? • Speak to RNs to help schedule diagnostic studies

More Related