Updated 7/19/2023

HARBORVIEW CONSULTS

Responsibilities

  • Triage all consults: You will get pages from the ER and inpatient services, typically trauma surgery and neurology. Occasionally from MICU/Medicine or other services.

  • Supervise the team which consists of an anesthesia intern and often 1-2 medical students and provide teaching when things are slow.

  • Read 20 ECGs each day + CAM monitors. ECGs will be assigned to you in MUSE every morning ~9am and CAMs will be emailed to you.

  • Attend HMC case conference every Tuesday at 12:00-1:00 PM. Bring a case to discuss. No need to prepare a formal presentation but know your case well.

DAILY SCHEDULE

  • Monday - Saturday 7:00 AM - 5:00 PM

  • 7:00AM: obtain sign out from the overnight hospitalist about overnight events, new consults, and new cath requests.

  • 7:30 - 8:00AM: Check in with residents, medial students, and your attending EARLY about the plan for the day. Discuss timing of rounds with attending before 9 AM. Triage any urgent cath requests for the day. Start seeing consults as they come in.

  • ~10-11 AM: Start rounding (timing variable).

  • Afternoon: Continue triaging patients, typically you’ll round again in the afternoon on new consult patients and run the list on olds.

  • 5:00 PM: Sign out to the CCU resident on call. Evening and weekend consults from 5-7pm are fielded by the CCU on-call R2 and then by the cardiology nocturnist from 7pm-7am

tips

  • See urgent consults immediately. See all other consults within an hour of being paged.

  • Do not block consults, but if it is a simple question (eg how to order a stress test or get outpatient follow up, etc) then feel free to clarify if a formal consult was their intent.

  • Remember your resident is an intern so please keep this in mind as you deploy them to see consults.

  • Touch base daily with primary teams for patients you are continuing to follow. It is ok to suggest signing off and ask the teams to re-consult if you are no longer active managing the patient.

  • It is ok to drop brief notes on patients to document ongoing assessment/recommendations without repeating the entire consult note.