Service Design March 19, 2012

Ambulatory Model Every 4 th month dedicated Ambulatory/Continuity Clinic month 2 - PGY 3’s, 2 - PGY 2’s (and 2 - PGY 1’s) in each pod PGY 1’s & combined program residents will stick to ½ day CC/week Approximately 300 patients/pod 13 pods Rescue clinics dropped in 1x monthly 6 half day continuity clinics/week 2 half day admin days to work on QI/return patient calls/respond to labs/ s 2 half days for non-medicine subspecialty clinics

Macroscopic View – the POD ResJulyAug Sept OctNovDecJanFebMarApr MayJune Block A PGY -3a XXX Block B PGY -3b XXX Block C PGY -2a XXX Block D PGY -2b XXX PGY -1a PGY -1b

Sample Schedules Block A- PGY3 Block A- PGY2 Block B- PGY3 Block B- PGY2 Block C- PGY3 Block C- PGY2 Block D- PGY3 Block D- PGY2 July UIM Gen MedVA UCVA MedCards c/sMICUGI c/s Aug Heme c/sMICUUIM NFCardsNFGen Med Sept Gen MedPall c/sVICUMICUUIM Pall c/sMICU Oct MICUNFVA MedGen MedMICU UIM Nov UIM VA UCHemeGEMVICUGen MedVICU Dec NFVICUUIM OncDay FloatVA MedOnc Jan VA UCGen MedLuminalCardsUIM Rheu c/sVA med Feb LiverVA MedGEMPulmEndo c/sVA MedUIM Mar UIM NFVICUCards c/sGen MedEndo c/sNF April GEMCardsUIM VA MedNFGEMPulm May ID c/sPulmNeph c/sGI c/sUIM LiverDay Float June CardsGen MedGI c/sNFRheu c/sHeme c/sUIM

POD #1 Block A (PGY 3)Block B (PGY2)Block C (PGY2)Block D (PGY3) JulyUIMVA UCCards c/sMICU AugHeme c/sUIMCardsNF SeptGen MedMICUUIMPall c/s OctMICUGen MedMICUUIM NovUIMHemeVICUGen Med DecNFUIMDay FloatVA Med JanVA UCCardsUIMRheu c/s FebLiverPulmVA MedUIM MarUIMVICUGen MedEndo c/s AprilGEMUIMNFGEM MayID c/sGI c/sUIMLiver JuneCardsNFHeme c/sUIM

Inpatient Services

VA The VA will have 3 teams Q6 16 hour overnight call for interns with alternate Q6 day call until 8pm Resident Night float – q 3 until 8pm for day resident (except when day float covers) Weekends – Resident overnight 24+4 Day Float – Resident 8-5 M-F, alternating weeks 10-8 M-F.

GEM 2-3 residents/month Responsibilities include both inpatient wards and clinics 1/3-1/2 of month residents also rotate to act as the 2 nd night float resident on GI/HO (Sun- Thurs)

Cardiology 3 teams One upper level resident and 2 Interns each day Team will be on call q 3 until 8pm RESIDENT Night float (2 residents – 1 for CCU coverage, 1 for crosscover and floor coverage) – Alternate admissions (CCU resident to take admit calls and divide) Weekends – Resident overnight 24+4 Interns will do staggered call on Friday/Saturday – Intern 1 from 8a-8p; Intern 2 from 8p-12p

General Medicine 4 Teams 10 Interns – 2 Teams will have 2 Interns – 2 Teams will have 3 Interns (these interns will do 5 nights each) 4 residents – q 4 until 8pm Resident Night Float Weekends – Resident overnight 24+4

GI/Heme/Onc 4 residents during the day – Residents q4 until 8pm 4 Interns during the day – Interns q4 until 8pm RESIDENT Night float (2 residents – 1 for Admits, 1 for floor coverage) – Working together as a team Weekends – Resident overnight 24+4 – Interns will do staggered call on Friday/Saturday Intern 1 from 8a-8p; Intern 2 from 8p-8a (but staying through rounds)

MICU 5 residents 6 days of night float each -Night float resident expected to be out by 930am Interns will be in the MICU (5 nights of night float each)

VICU 3 residents Q 3 overnight call Shift will be 24+4