1. END OF THE DAY RELIEF: WHEN EXPECTATIONS MEET REALITY SCOTT HOFFMAN, M.D. DEPARTMENT OF ANESTHESIOLOGY VANDERBILT UNIVERSITY SCHOOL OF MEDICNE NASHVILLE, TENNESSEE

2. PREMISE: EVERYONE WANTS TO GO HOME.....EVENTUALLY!!!

3. SO……. WE NEED A PLAN!!!

4. SUCH A PLAN WILL…. ALLOW FOR SOME DEGREE OF PREDICTABILITY FOR FACULTY BE A TOOL TO ASSIST THE AIC IN PLANNING STAFFING FOR THE NEXT DAY PROVIDE STAFFING INFORMATION/PLANNING FOR THE EVENING/NIGHT CALL TEAM

5. CHARACTERISTICS OF OUR PLAN FAIRNESS CONSISTENCY FLEXIBILTIY

6. SUCH A PLAN WILL…. MEET END-OF-DAY STAFFING NEEDS TAKE INTO ACCOUNT SUPERVISION RATIOS HAVE BUY-IN BY THOSE AFFECTED CAN BE EASILY MODIFIED AS NEEDS DICTATE

7. OUR PLAN AT VANDERBILT DOES NOT INCLUDE OUR CARDIAC ANESTHESIOLOGY DIVISION DOES NOT INCLUDE OUR OB ANESTHESIOLOGY DIVISION MIGHT INCLUDE AN ON-CAMPUS AMBULATORY SURGERY CENTER

8. END-OF-DAY RELIEF BASED ON PRE- AND POST-CALL STATUS

9. OUR PRIORITY LIST

10. OUR PLAN IS A GOOD ONE… BUT NOT PERFECT OOR LOCATIONS LATE CALL SWITCHES FACULTY WHO “ARRANGE” THEIR OWN RELIEF A SHORT CALL TEAM

11. OUR PLAN IS A GOOD ONE…. BUT NOT PERFECT COMPLEX CASES (e.g. BIG VASCULAR CASES) FACULTY WHO WANT TO FINISH THEIR CASES

12. TEMPORARY RELIEF DURING THE CLINICAL WORK DAY WHAT ABOUT RELIEF FOR FACULTY WHO MUST ATTEND MEETINGS DURING THE CLINICAL WORK DAY?

13. WAIT….. NOT ONLY ATTENDING FACULTY WANT TO GO HOME!!!

14. THE C-1 POSITION MANAGES COVERAGE FOR IN-ROOM STAFF ABSENCES COORDINATES AFTERNOON RELIEF FOR IN- ROOM PROVIDERS

15. RESIDENT RELIEF EDUCATION VS. WORK HOUR REQUIREMENTS

16. TRACKING WORK HOURS WE TRACK OUR RESIDENTS’ AND SRNAs’ WORK HOURS

17. 24/7 VANDERBILT UNIVERSITY HOSPITAL’S MAIN OPERATING ROOM IS A 24/7 OPERATION

18. THE END EVERYONE HAS GONE HOME! SEE YOU TOMORROW!

19. LIAM IS WAITING AT HOME!