Transition of Care - Internal Medicine Residents

DEPT: MEDICAL EDUCATION
POLICY #: 8240.13

GOAL

To ensure that transitions of care facilitate both continuity and patient safety.

POLICY

1. Every patient cared for by the Internal Medicine residents’ service must have complete information entered on the electronic handoff database by the resident team.

2. Signouts from the resident caring for a patient to the resident (PGY 1) covering will be done by discussing in person the printed handoff database list.

3. ICU Signouts will be done in person in the ICU at 8:30pm between the departing ICU resident and the residents (PGY 1 Night Medicine ICU, and Night Float Senior Resident) covering the ICU overnight. In addition, the ICU signout list on the ICU computer should be updated each evening prior to signout.

4. The overnight cross-coverage PGY 1 and Night Float Senior Resident will attend morning intake rounds to present new patients and discuss overnight events with the Attending physician(s) as well as with the residents who will be assuming care of those patients. The handoff of new overnight admissions will generally occur during morning report, or during team rounds immediately after morning report (both of which involve direct Attending oversight, feedback and involvement).

5. Attending weekend signout for patients will be accomplished by direct communication between the Attending faculty member and the covering faculty member, both on Friday afternoon and in reverse at the end of weekend call.

6. To ensure that residents are competent in communicating with team members in the hand-over process the program director or core faculty will observe and assess a handover for each PGY1 resident and document the evaluation.

7. The program and clinical sites will maintain and communicate schedules of attending physicians and residents currently responsible for care.

8. The program maintains backup plans to ensure continuity of patient care in the event that a resident may be unable to perform their patient care responsibilities due to excessive fatigue or illness, or family emergency. See Resident Well-Being Policy for more information.

9. At the end of every rotation, the resident leaving the service will update the electronic signoff as well as provide direct communication directly to the oncoming resident with a summary of the patient’s hospitalization, active problems and important management updates. 

COTTAGE HEALTH POLICY

Original Policy Effective Date: 07/2011
Last Review Date: 1/2024
Last Revision Date: 1/2023
Owner Title: Program Director, Internal Medicine Residency
Owner Approval Date: 1/2023
Committee Approval: Graduate Medical Education (GMEC)
Committee Approval Dates: 1/2023
VP Approval: E. Wroblewski, M.D.
VP Approval Date: 1/2023