Coverage 101

1. Coverage 101

2. Coverage according to Wikipedia • Coverage may refer to: • Insurance coverage, the amount and extent of risk covered by an insurer • Coverage (telecommunication), a measure of cell phone connectivity • Radio frequency • News ("press coverage", "media coverage") • Code coverage, a measure used in software testing • Coverage data, the mapping of one aspect of data in space, in geographic information systems • Coverage (album), a 2003 album by Mandy Moore

3. Coverage according to a resident ?

4. Why? • Professionalism • Quality patient care • Makes a good impression on the attendings, patients, staff, and other departments • Educational opportunity • Makes for a comprehensive team

5. Professionalism • ACGME definition • Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population. • Residents are expected to: • demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and society that supercedes self-interest; accountability to patients, society, and the profession; and a commitment to excellence and on-going professional development • demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices • demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and disabilities

6. Professionalism • UAMS definition • HOW YOU ACT • Demonstrate integrity, honesty and empathy. •  Respect patients’ autonomy and diversity. • Be timely and respond promptly.

7. Why is professionalism important? • It makes you a PIMPPS • You must prove proficiency with the six competencies to graduate and to re-certify when in practice • Dr. Means must address this when you are seeking a job for the rest of your life

8. Coverage according to policy • A coverage resident is equivalent to an on-service resident. • You are responsible for everything the on-service resident would do.

9. What if you are listed on the schedule as coverage?(your name appears on the leave coverage section at the bottom of the call schedule)

10. What if you are listed as rounding coverage? • You should obtain checkout from on-service resident and contact attending regarding time of rounding on the day before your scheduled assignment. It is your responsibility to be fully informed. • Discharge paperwork should be completed by the on-service resident prior to leave if the patient’s discharge is planned. The on-service resident should leave information in regards to the patient’s hospital course up to the time of leave or pre-dictate the DC Summary. • The coverage resident is responsible for all unplanned discharge paperwork and dictating the DC summaries that occur during their coverage time periods. • You should arrive in time to see your patients before attending rounds unless otherwise specified by the attending themselves • If you have any questions regarding expectations you should speak with the attending personally

11. What if you are listed to cover admissions? • You should contact the attending before 9am on the coverage date and identify yourself as admitting resident • Provide the attending with your pager number as well as any other pertinent contact numbers • You MUST be available to the attending! • Once notified you should be present within 30 minutes to assist. • If for any reason you must be present elsewhere, you must then find coverage for the time period in which you will be unavailable.

12. What if you are listed to cover clinic? • You should arrive in clinic 5 minutes prior to the first scheduled patient. • You are responsible for all dictations and paperwork related to all patients seen by you.

13. What if you are listed to cover consults? • You should arrive by 8am. • Contact the attending to specify when and where rounding will occur. • All consults should be completed prior to attending rounds. • Consults will be accepted until 4pm.

14. What if you are asked to cover call? • VA am call- Pick up the pager from the MOD at 7am and hold until 8am. • BHRI call- Pick up the pager at 5pm and hold until 7:30am on weekdays, and from 8am to 8am on Saturday and Sunday.

15. What if you must cover more than one service? • Plan to come early and stay late • Notify both attendings of the situation • Inpatient and clinic duties take priority, consults should be completed before and after other duties, however, consults will still have to be completed within 24 hours

16. What kind of attitude should I have? A GOOD ONE!!!

17. Consequences • If you are called to cover on short notice you must make yourself available, if you cannot you will be charged a day of leave. • If you are scheduled to cover and do not fulfill your duties, you will be assigned an extra Saturday call for which you will receive no points. • If behavior is repeated it could result in probation, remediation, and/or suspension.

18. Benefits • We will continue to be able to take vacation, sick days, and educational leave based on resident request. • We will function as a cohesive team!