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Inpatient Medicine

Educational Goals & Overview

The goal of rotations on the general medicine wards is to train residents to competently care for patients with a broad range of medical problems who require hospital admission to the general medicine ward service. The rotation is designed to increase diagnostic skills, reasoning ability, therapeutic acumen, objective knowledge, overall patient care skills and team management skills. Training occurs over the course of three years and across three clinical sites.

General Medicine Wards

The general medicine ward service at Olive View-UCLA Medical Center consists of 8 teams, each comprised of an attending physician, one resident (PGY-2/3), at least two interns (PGY-1), and usually a medical student. Admissions are accepted on an 8-day call cycle with Long call being every 8 days. Most patients are admitted through the Emergency Department.

Please watch this orientation video prior to starting your wards rotation!

Before You Start

  • Complete any necessary employee paperwork (e.g. human resources, health clearance) when notified by the Program Coordinator.
  • Check AMION to verify your schedule as recent changes may have been made.
  • Read the Wards Orientation Packet prior to arriving for details of the rotation
  • If not previously done so, watch ORCHID Training videos and complete online assessment: http://www.uclaoliveview.org/orchidtraining
  • Expect an email from the Chief Residents, which will include hand-off assignments and the AMION password.
  • One day prior to your rotation, contact the outgoing housestaff for sign-out. You can find contact information in the email or AMION.

When You Start

  • If you are a rotator, be sure to pick up your pager from the call suites. If you haven’t been at OV before, you can get your badge and parking pass from either the Chief Residents or in the Department of Medicine
  • If you’re an intern, be sure to receive hand-off from the overnight cross-cover by meeting the Night Float Intern in the call suite (5B-106 from 6:30-7:00am latest)
  • If you’re a resident and admitting (on call), check for new admissions to your team by meeting the Hospitalist Attending and Night Admitting Residents between 7:30-8:00am, currently in the 5B Call Suite (5B105).
  • Make sure your pager is unforwarded!

For Rotators

  • On the day you leave: Please make sure to return the pager in the appropriate place, as instructed by the chiefs
  • MedHub: Please complete your evaluations on your OV MedHub account.  Please contact Gus Chavez (gchavez@dhs.lacounty.gov) for any questions about MedHub.

Important Information

  • For change in level of care from ED, place new Request for Admit and Admit to Inpatient orders with the new level of care.  Do not place the Transfer Patient order as this will signal that the patient should be transferred to outside facility.
  • For admissions/transfer to Telemetry, you must follow appropriate use of telemetry by reviewing the accepted indications and place the Telemetry Monitoring/Level of Care order to specify the indication and duration for cardiac monitoring.  See the OVMC Telemetry Guidelines.
  • For transfers in/out of the Step-Down Unit and ICU, you must enter the Transfer Inpatient Service/Level of Care and perform the Transfer Medication Reconciliation. For the reconciliation, go to the Orders page, click the Reconciliation drop-down menu, and select Transfer.
  • For routine lab orders, routine collection times start at 0400 (AM Draw), 0800, 1300, 1700, 2100, and 0000.  Use AM Draw for routine 4am morning labs. Do not use Timed Routine (phlebotomy cannot see these orders)
  • Certain antibiotics are restricted and require ID approval, however you can still get the first dose without approval
  • For personal items, there are lockers available in the Resident Lounge (2C160). Please bring your own lock to secure items.
  • Stroke Protocol: Visit the OVMC Intranet > Departments > Neurology > Stroke

RR-UCLA General Medicine Wards

The general medicine ward service at Ronald Reagan-UCLA Medical Center consists of 6 primary teams, each comprised of an attending physician, one resident (PGY-2/3), two interns (PGY-1). Interns rotate on service for 4 weeks.

Orientation

Please go to the UCLA MedRes site for the rotation nuts & bolts, as well as the most up-to-date helpful hints for your RR rotation.  Link here: UCLA Medres Inpatient Rotations

Before You Start

  • Complete CareConnect training if this is your first time working in the UCLA Health System.
  • Make sure you receive MedNet and CareConnect access. Please contact CareConnect at 310-267-2273 if you haven’t logged-in in over 30 days to remove any block on your account prior to your start date and try logging in to ensure access.
  • Information for Duo is found here: mednet.uclahealth.org/multi-factor-authentication.

Adding your virtual pager to CareConnect:

  • Contact CareConnect IT: 310-267-CARE (2273)
  • Ask to add you virtual pager to the Care Team List, so that you can be contacted regarding patient care issues.

When You Start

  • Please arrive at the following location to receive signout from the night float resident:  Wards: 7E Rounding Room (7143) by 7am
  • The UCLA online paging system is located at https://mednet.uclahealth.org/. Click on the “paging” link under the Quick Links on the top left.

Important Information

  • Olive View Housestaff: Submit duty hours and procedures performed on this rotation in the Olive View MedHub portal.
  • If you have any questions, please stop by the UCLA Chiefs office  (RRUMC, Suite 7236)

VA-WLA General Medicine Wards

The General Medicine Wards (“GMED”) rotation at the VA West Los Angeles (VA-WLA) Medical Center is an inpatient clinical training experience that trains residents to competently care for patients with a broad range of medical problems within the Veterans Administration health system.  The rotation is designed for trainees to develop diagnostic skills, clinical reasoning, therapeutic acumen, objective knowledge, and team management skills.

Orientation

Please go to the UCLA MedRes site for the rotation nuts & bolts, as well as the most up-to-date helpful hints for your VA rotation.  Link here: UCLA Medres Inpatient Rotations

Before You Start

  • Make sure you have received proper credentials including a VA identification badge and electronic access.

When You Start

 

Important Information

  • Olive View Housestaff: Submit duty hours and procedures performed on this rotation in the Olive View MedHub portal.
  • If you have any questions, please stop by the UCLA Chiefs office:  3 East Room 3252

Night Hospitalist

This is a two-week rotation that trains residents to triage, evaluate, and manage patients with a wide variety of medical diagnoses during the initial hospital admission.  The emphasized skills involve triaging of patients and medical problems, provision of initial medical evaluation and management, and progressive autonomy in clinical practice.

Before You Start

  • Review the Night Hospitalist Orientation Packet.
  • Review your schedule on AMION, including night shift assignments.

When You Start

  • When you arrive, check in with the Hospitalist Attending by paging Medicine On-Call. Receive sign-out on any hold-over admissions and patients under the Hospitalist service.
  • If this is your first night admitting shift, inform the Hospitalist Attending so he/she can provide orientation to workflow with FirstNet.
  • Add yourself to the OVMC Medicine Night care team. All hold-over patients should be added to this list, regardless of level of care.
  • Make sure your pager is unforwarded!

Night Float

Medicine ward patients at Olive View-UCLA Medical Center are cross-covered by night float overnight. The night float team consists of two interns who are supervised by the night hospitalist resident and hospitalist attending. The swing hospitalist attending on duty will engage the interns in the night float curriculum.

Before You Start

  • Review your schedule on AMION.
  • Find the Night Float Survival Guide here on the website (you must be logged-in).

When You Start

 

  • Get ready to receive hand-off from the primary teams in your respective call rooms at 4:00pm.
  • Make sure your pager is unforwarded!
  • Learn how to manage common situations on the wards with the Night Float Curriculum Modules, a companion to the Night Float Survival Guide.

Procedure Service Elective

The Procedure Service is available for bedside procedures for inpatients and scheduled outpatient appointments during weekday business hours.  Residents on the rotation are expected to reach the level of competency for procedures, including understanding the indications and demonstrating proper technique, under the supervision of a proceduralist attending.

Common bedside procedures:

  • Paracentesis
  • Lumbar Puncture
  • Thoracentesis
  • Skin biopsy
  • Central venous catheter insertion
  • Dialysis/Leukapheresis catheter insertion
  • Ultrasound-guided peripheral IV insertion
  • Midline peripheral IV insertion

To request a procedure during business hours, page the Procedure Service pager through amion.com.

To request an elective rotation on this service, contact Dr. Vincent Chan to confirm availability and submit an Elective Request form.

 

Goals & Objectives

When You Start

  • Add yourself to this Care Team in ORCHID:
    • Medicine | OVMC Procedure Service
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