1. SUBSPECIALTY BLENDED TEAMS 13-14 ACADEMIC YEAR

2. Blended Subspecialty Experiences
Endo GI
Cardio,
Nephro/Rheum, ID
Inpatient Mornings
Rounds at 830
Wed 915
Outpatient Afternoons
After Morning Rounds Call the Service to reach person on call
WHY: Continuity Clinic, Post- call, Duty-Hours, Didactics, Vacation (ID & Nephro)
Residents Role:
They should be providing contact info to their pt’s nurses daily
CARDIO/GI (DYAD)
“BLENDED EXPERINCES” = INPATIENT MORNINGS  OUPATIENT AFTERNOONS
CAPS AT 10 TO START; WE WILL MONITOR FOR DUTY HOUR VIOLATIONS
INPATIENT COVERAGE 24/7 WITH FOLLOWING EXCEPTIONS:
POST CALL DAY- 5 TIMES PER MONTH
MUST BE GONE BY 930 (ROUNDS ARE AT 830 EXCEPT WED) TO AVOID DUTY HOUR VIOLATIONS
NOTES WILL BE PREPARED ON INPATIENTS PRIOR TO LEAVING
ATTENDING/FELLOWS/EXTENDERS TO COVER SERVICE
CONTINUITY CLINIC AFTERNOONS- 1 AFTERNOON PER WEEK (DECREASED FROM 2)
ATTENDING/FELLOWS/EXTENDERSTO COVER SERVICE
SUNDAY’S AFTER 10 PM- CURRENT PLAN
CHIEF- WORKS 1-3 SUNDAYS PER MONTH TO SUPPORT SUBSPECIALTY COVERAGE
SICK
PLAN FOR COVERAGE DURING WEEKDAY DAY:
ATTENDING/FELLOWS/EXTENDERS
PLAN FOR COVERAGE DURING WEEKDAY NIGHT:
SIGN OUT TO SUBSPECIALTY RESIDENT AT 530 (VERBAL AN WRITTEN)
PLAN FOR COVERAGE DURING WEEKENDS:
DYAD
ROUND AT 830 WITH YOUR ASSIGNED RESIDENT
-UPDATE HOSPITALISTS TEAMS AT YOUR DISCRETION
4 WCH  GEN PEDS
5 WCH  FP
TEAM X  6 AND BEYOND SENIOR RESIDENT AND ATTENDING
SUBSPECIALTY BLENDED EXPERINCES
NEW ROTATIONS (BLENDED): NEED NEW G&O, ROTATION EVALUATIONS; CAN BE ADAPTED FROM CURRENT WITH INCORPORATION OF MILESTONES
REVIEW G&O EACH MONTH; SIGN OFF
MODULE DEVELOPMENT FOR MONTHLY ROTATION
NOON CONFERNCES (DIDACTIC CURRICULUM)- HOPKINS WIL CONTACT
MORNING REPORT – INCREASE SUBSPECAILTY PARTICIPATION
COMPLETE MONTHLY EVALUATION
TEACHING ROUNDS FOR RESIDENTS & STUDENTS” FOR GI/CARDIO/ID/NR/ENDO”??
SOME MORNING REPORT
AFTERNOON
FOR STUDENTS  ROTATE EACH DAY AT 830 (POP INTO ROUNDS)
PREPARED BY ASSIGNED RESIDENT/ATTENDING/FELLOW
BENEFITS
GEOGRAPHIC TEAMS
IMPROVED WORK FLOW OF ADMITS, DISCHARES, NURSING COMMUNICATION RESPECT FOR EDUCATIONAL TIME
PRELIM ORDERS EASIER TO PREPARE FOR ADMITS TO IMPROVE TOC
CLEARER DESIGNATION OF TEAMS
SUBSPECIALTY OFF TEAMS (EXCEPT PULMO)
IMPROVED WORK FLOW AND RESPECTED EDUCATIONAL TIME
ACGME COMPLIANT
NOTE:
SOME MONTHS, ESPECIALLY NEXT YEAR, WHERE YOU MIGHT HAVE A SECOND PERSON PL3 TRANSITIONING
PARTICIPATE IN GI CONFERENCE, TUMOR BOARD, ETC.
More Focused Care in AM & PM Support

3. Blended Subspecialty Experiences
Endo
PL-1
Tower 4
Supervised by PL-2, Fellow and Attending
GI, Cardio, Nephro/Rheum, ID*
PL-2
Everywhere
Supervised by Fellow* or Attending
More Focused Care in AM & PM Support
CARDIO/GI (DYAD)
“BLENDED EXPERINCES” = INPATIENT MORNINGS  OUPATIENT AFTERNOONS
CAPS AT 10 TO START; WE WILL MONITOR FOR DUTY HOUR VIOLATIONS
INPATIENT COVERAGE 24/7 WITH FOLLOWING EXCEPTIONS:
POST CALL DAY- 5 TIMES PER MONTH
MUST BE GONE BY 930 (ROUNDS ARE AT 830 EXCEPT WED) TO AVOID DUTY HOUR VIOLATIONS
NOTES WILL BE PREPARED ON INPATIENTS PRIOR TO LEAVING
ATTENDING/FELLOWS/EXTENDERS TO COVER SERVICE
CONTINUITY CLINIC AFTERNOONS- 1 AFTERNOON PER WEEK (DECREASED FROM 2)
ATTENDING/FELLOWS/EXTENDERSTO COVER SERVICE
SUNDAY’S AFTER 10 PM- CURRENT PLAN
CHIEF- WORKS 1-3 SUNDAYS PER MONTH TO SUPPORT SUBSPECIALTY COVERAGE
SICK
PLAN FOR COVERAGE DURING WEEKDAY DAY:
ATTENDING/FELLOWS/EXTENDERS
PLAN FOR COVERAGE DURING WEEKDAY NIGHT:
SIGN OUT TO SUBSPECIALTY RESIDENT AT 530 (VERBAL AN WRITTEN)
PLAN FOR COVERAGE DURING WEEKENDS:
DYAD
ROUND AT 830 WITH YOUR ASSIGNED RESIDENT
-UPDATE HOSPITALISTS TEAMS AT YOUR DISCRETION
4 WCH  GEN PEDS
5 WCH  FP
TEAM X  6 AND BEYOND SENIOR RESIDENT AND ATTENDING
SUBSPECIALTY BLENDED EXPERINCES
NEW ROTATIONS (BLENDED): NEED NEW G&O, ROTATION EVALUATIONS; CAN BE ADAPTED FROM CURRENT WITH INCORPORATION OF MILESTONES
REVIEW G&O EACH MONTH; SIGN OFF
MODULE DEVELOPMENT FOR MONTHLY ROTATION
NOON CONFERNCES (DIDACTIC CURRICULUM)- HOPKINS WIL CONTACT
MORNING REPORT – INCREASE SUBSPECAILTY PARTICIPATION
COMPLETE MONTHLY EVALUATION
TEACHING ROUNDS FOR RESIDENTS & STUDENTS” FOR GI/CARDIO/ID/NR/ENDO”??
SOME MORNING REPORT
AFTERNOON
FOR STUDENTS  ROTATE EACH DAY AT 830 (POP INTO ROUNDS)
PREPARED BY ASSIGNED RESIDENT/ATTENDING/FELLOW
BENEFITS
GEOGRAPHIC TEAMS
IMPROVED WORK FLOW OF ADMITS, DISCHARES, NURSING COMMUNICATION RESPECT FOR EDUCATIONAL TIME
PRELIM ORDERS EASIER TO PREPARE FOR ADMITS TO IMPROVE TOC
CLEARER DESIGNATION OF TEAMS
SUBSPECIALTY OFF TEAMS (EXCEPT PULMO)
IMPROVED WORK FLOW AND RESPECTED EDUCATIONAL TIME
ACGME COMPLIANT
NOTE:
SOME MONTHS, ESPECIALLY NEXT YEAR, WHERE YOU MIGHT HAVE A SECOND PERSON PL3 TRANSITIONING
PARTICIPATE IN GI CONFERENCE, TUMOR BOARD, ETC.
Nurses need to know
Service, Attending & Resident

4. Blended Subspecialty Experiences
NIGHT 5 PM-7 AM:
SUBSPECIALTY PAGER
for GI, Cardio, ID*, Nephro/Rheum
Sunday-Thurs
pts signed out to one of the above PL-2’s
Twice a month PL-3 on Admin/Research month
On Friday and Sat
cross covering PL-3
MORNING SIGN 7 AM
Post- call resident must leave by:
930 AM (Duty Hours)
Nurses need to know
Service, Attending & Resident
CARDIO/GI (DYAD)
“BLENDED EXPERINCES” = INPATIENT MORNINGS  OUPATIENT AFTERNOONS
CAPS AT 10 TO START; WE WILL MONITOR FOR DUTY HOUR VIOLATIONS
INPATIENT COVERAGE 24/7 WITH FOLLOWING EXCEPTIONS:
POST CALL DAY- 5 TIMES PER MONTH
MUST BE GONE BY 930 (ROUNDS ARE AT 830 EXCEPT WED) TO AVOID DUTY HOUR VIOLATIONS
NOTES WILL BE PREPARED ON INPATIENTS PRIOR TO LEAVING
ATTENDING/FELLOWS/EXTENDERS TO COVER SERVICE
CONTINUITY CLINIC AFTERNOONS- 1 AFTERNOON PER WEEK (DECREASED FROM 2)
ATTENDING/FELLOWS/EXTENDERSTO COVER SERVICE
SUNDAY’S AFTER 10 PM- CURRENT PLAN
CHIEF- WORKS 1-3 SUNDAYS PER MONTH TO SUPPORT SUBSPECIALTY COVERAGE
SICK
PLAN FOR COVERAGE DURING WEEKDAY DAY:
ATTENDING/FELLOWS/EXTENDERS
PLAN FOR COVERAGE DURING WEEKDAY NIGHT:
SIGN OUT TO SUBSPECIALTY RESIDENT AT 530 (VERBAL AN WRITTEN)
PLAN FOR COVERAGE DURING WEEKENDS:
DYAD
ROUND AT 830 WITH YOUR ASSIGNED RESIDENT
-UPDATE HOSPITALISTS TEAMS AT YOUR DISCRETION
4 WCH  GEN PEDS
5 WCH  FP
TEAM X  6 AND BEYOND SENIOR RESIDENT AND ATTENDING
SUBSPECIALTY BLENDED EXPERINCES
NEW ROTATIONS (BLENDED): NEED NEW G&O, ROTATION EVALUATIONS; CAN BE ADAPTED FROM CURRENT WITH INCORPORATION OF MILESTONES
REVIEW G&O EACH MONTH; SIGN OFF
MODULE DEVELOPMENT FOR MONTHLY ROTATION
NOON CONFERNCES (DIDACTIC CURRICULUM)- HOPKINS WIL CONTACT
MORNING REPORT – INCREASE SUBSPECAILTY PARTICIPATION
COMPLETE MONTHLY EVALUATION
TEACHING ROUNDS FOR RESIDENTS & STUDENTS” FOR GI/CARDIO/ID/NR/ENDO”??
SOME MORNING REPORT
AFTERNOON
FOR STUDENTS  ROTATE EACH DAY AT 830 (POP INTO ROUNDS)
PREPARED BY ASSIGNED RESIDENT/ATTENDING/FELLOW
BENEFITS
GEOGRAPHIC TEAMS
IMPROVED WORK FLOW OF ADMITS, DISCHARES, NURSING COMMUNICATION RESPECT FOR EDUCATIONAL TIME
PRELIM ORDERS EASIER TO PREPARE FOR ADMITS TO IMPROVE TOC
CLEARER DESIGNATION OF TEAMS
SUBSPECIALTY OFF TEAMS (EXCEPT PULMO)
IMPROVED WORK FLOW AND RESPECTED EDUCATIONAL TIME
ACGME COMPLIANT
NOTE:
SOME MONTHS, ESPECIALLY NEXT YEAR, WHERE YOU MIGHT HAVE A SECOND PERSON PL3 TRANSITIONING
PARTICIPATE IN GI CONFERENCE, TUMOR BOARD, ETC.
More Focused Care in AM & PM Support

5. Blended Subspecialty Experiences
Although we will try to minimize gaps in the schedule, when a resident is Post call, on Vacation, at Continuity Clinic, etc.
The service will be responsible for their service during that gap
If sign-out is provided to the night team
The night team will cover those patients at night
Including new admissions
CARDIO/GI (DYAD)
“BLENDED EXPERINCES” = INPATIENT MORNINGS  OUPATIENT AFTERNOONS
CAPS AT 10 TO START; WE WILL MONITOR FOR DUTY HOUR VIOLATIONS
INPATIENT COVERAGE 24/7 WITH FOLLOWING EXCEPTIONS:
POST CALL DAY- 5 TIMES PER MONTH
MUST BE GONE BY 930 (ROUNDS ARE AT 830 EXCEPT WED) TO AVOID DUTY HOUR VIOLATIONS
NOTES WILL BE PREPARED ON INPATIENTS PRIOR TO LEAVING
ATTENDING/FELLOWS/EXTENDERS TO COVER SERVICE
CONTINUITY CLINIC AFTERNOONS- 1 AFTERNOON PER WEEK (DECREASED FROM 2)
ATTENDING/FELLOWS/EXTENDERSTO COVER SERVICE
SUNDAY’S AFTER 10 PM- CURRENT PLAN
CHIEF- WORKS 1-3 SUNDAYS PER MONTH TO SUPPORT SUBSPECIALTY COVERAGE
SICK
PLAN FOR COVERAGE DURING WEEKDAY DAY:
ATTENDING/FELLOWS/EXTENDERS
PLAN FOR COVERAGE DURING WEEKDAY NIGHT:
SIGN OUT TO SUBSPECIALTY RESIDENT AT 530 (VERBAL AN WRITTEN)
PLAN FOR COVERAGE DURING WEEKENDS:
DYAD
ROUND AT 830 WITH YOUR ASSIGNED RESIDENT
-UPDATE HOSPITALISTS TEAMS AT YOUR DISCRETION
4 WCH  GEN PEDS
5 WCH  FP
TEAM X  6 AND BEYOND SENIOR RESIDENT AND ATTENDING
SUBSPECIALTY BLENDED EXPERINCES
NEW ROTATIONS (BLENDED): NEED NEW G&O, ROTATION EVALUATIONS; CAN BE ADAPTED FROM CURRENT WITH INCORPORATION OF MILESTONES
REVIEW G&O EACH MONTH; SIGN OFF
MODULE DEVELOPMENT FOR MONTHLY ROTATION
NOON CONFERNCES (DIDACTIC CURRICULUM)- HOPKINS WIL CONTACT
MORNING REPORT – INCREASE SUBSPECAILTY PARTICIPATION
COMPLETE MONTHLY EVALUATION
TEACHING ROUNDS FOR RESIDENTS & STUDENTS” FOR GI/CARDIO/ID/NR/ENDO”??
SOME MORNING REPORT
AFTERNOON
FOR STUDENTS  ROTATE EACH DAY AT 830 (POP INTO ROUNDS)
PREPARED BY ASSIGNED RESIDENT/ATTENDING/FELLOW
BENEFITS
GEOGRAPHIC TEAMS
IMPROVED WORK FLOW OF ADMITS, DISCHARES, NURSING COMMUNICATION RESPECT FOR EDUCATIONAL TIME
PRELIM ORDERS EASIER TO PREPARE FOR ADMITS TO IMPROVE TOC
CLEARER DESIGNATION OF TEAMS
SUBSPECIALTY OFF TEAMS (EXCEPT PULMO)
IMPROVED WORK FLOW AND RESPECTED EDUCATIONAL TIME
ACGME COMPLIANT
NOTE:
SOME MONTHS, ESPECIALLY NEXT YEAR, WHERE YOU MIGHT HAVE A SECOND PERSON PL3 TRANSITIONING
PARTICIPATE IN GI CONFERENCE, TUMOR BOARD, ETC.
More Focused Care in AM & PM Support

6. Blended Subspecialty Experiences
WEEKENDS:
DYADS
GI/Cardio & Nephro/ID
Ex: GI and Nephro come in on Sat
GI resident rounds on both GI and Cardio Pts
Nephro rounds on both Nephro and ID pts
GI gets signout for all the Blended experiences
On Sunday both GI and Nephro come in again but the Nephro resident gets signout for all of the Blended experiences
WEEKENDS:
Call the SUBSPECIALTY PAGER or Service
Friday from 5 PM until Monday at 7 AM
for GI, Cardio, ID*, Nephro/Rheum
CARDIO/GI (DYAD)
“BLENDED EXPERINCES” = INPATIENT MORNINGS  OUPATIENT AFTERNOONS
CAPS AT 10 TO START; WE WILL MONITOR FOR DUTY HOUR VIOLATIONS
INPATIENT COVERAGE 24/7 WITH FOLLOWING EXCEPTIONS:
POST CALL DAY- 5 TIMES PER MONTH
MUST BE GONE BY 930 (ROUNDS ARE AT 830 EXCEPT WED) TO AVOID DUTY HOUR VIOLATIONS
NOTES WILL BE PREPARED ON INPATIENTS PRIOR TO LEAVING
ATTENDING/FELLOWS/EXTENDERS TO COVER SERVICE
CONTINUITY CLINIC AFTERNOONS- 1 AFTERNOON PER WEEK (DECREASED FROM 2)
ATTENDING/FELLOWS/EXTENDERSTO COVER SERVICE
SUNDAY’S AFTER 10 PM- CURRENT PLAN
CHIEF- WORKS 1-3 SUNDAYS PER MONTH TO SUPPORT SUBSPECIALTY COVERAGE
SICK
PLAN FOR COVERAGE DURING WEEKDAY DAY:
ATTENDING/FELLOWS/EXTENDERS
PLAN FOR COVERAGE DURING WEEKDAY NIGHT:
SIGN OUT TO SUBSPECIALTY RESIDENT AT 530 (VERBAL AN WRITTEN)
PLAN FOR COVERAGE DURING WEEKENDS:
DYAD
ROUND AT 830 WITH YOUR ASSIGNED RESIDENT
-UPDATE HOSPITALISTS TEAMS AT YOUR DISCRETION
4 WCH  GEN PEDS
5 WCH  FP
TEAM X  6 AND BEYOND SENIOR RESIDENT AND ATTENDING
SUBSPECIALTY BLENDED EXPERINCES
NEW ROTATIONS (BLENDED): NEED NEW G&O, ROTATION EVALUATIONS; CAN BE ADAPTED FROM CURRENT WITH INCORPORATION OF MILESTONES
REVIEW G&O EACH MONTH; SIGN OFF
MODULE DEVELOPMENT FOR MONTHLY ROTATION
NOON CONFERNCES (DIDACTIC CURRICULUM)- HOPKINS WIL CONTACT
MORNING REPORT – INCREASE SUBSPECAILTY PARTICIPATION
COMPLETE MONTHLY EVALUATION
TEACHING ROUNDS FOR RESIDENTS & STUDENTS” FOR GI/CARDIO/ID/NR/ENDO”??
SOME MORNING REPORT
AFTERNOON
FOR STUDENTS  ROTATE EACH DAY AT 830 (POP INTO ROUNDS)
PREPARED BY ASSIGNED RESIDENT/ATTENDING/FELLOW
BENEFITS
GEOGRAPHIC TEAMS
IMPROVED WORK FLOW OF ADMITS, DISCHARES, NURSING COMMUNICATION RESPECT FOR EDUCATIONAL TIME
PRELIM ORDERS EASIER TO PREPARE FOR ADMITS TO IMPROVE TOC
CLEARER DESIGNATION OF TEAMS
SUBSPECIALTY OFF TEAMS (EXCEPT PULMO)
IMPROVED WORK FLOW AND RESPECTED EDUCATIONAL TIME
ACGME COMPLIANT
NOTE:
SOME MONTHS, ESPECIALLY NEXT YEAR, WHERE YOU MIGHT HAVE A SECOND PERSON PL3 TRANSITIONING
PARTICIPATE IN GI CONFERENCE, TUMOR BOARD, ETC.
More Focused Care in AM & PM Support