Patient Safety

Specific Events that Mandate a Call to the Attending Physician

Our GME Priorities

  • Our GME priorities remain focused on your Safety, your Wellbeing & your Education

  • Incidents of bias or mistreatment directed towards patients, learners, or others should be reported immediately to your PD or GME leadership

  • Reach out to your PD or GME leadership with any concerns not otherwise reflected

academics@medstar.net

Specific Events that Mandate a Call to the Attending Physician

MUST CALL

  • Timely notification following patient admission or consult

  • Significant hemodynamic instability requiring intervention or code

  • Upgrade in level of care (i.e. floor to icu; heightened level of patient monitoring)

  • Unplanned surgery or invasive procedure (i.e. intubation. central line placement)

  • New onset neurologic finding

  • Unanticipated change in code status or unexpected death

  • Change in condition that would result in procedure cancellation within 8 hrs

  • Patient planning to leave AMA or refusal of treatment that could lead to harm

  • Medication or treatment errors

  • Patient or caretaker request

Clinical Precepting Best Practices

MUST PRESENT

In addition to standard presentation elements, residents MUST PRESENT and highlight these elements verbally to the preceptor:

  • All vital signs, including fetal heart tones/rate in OB, or chart open during presentation

  • Abnormal physical exam findings or new abnormal diagnostic findings (ECG, rads, etc.)

  • High risk conditions or high-risk medications – i.e., anticoagulation, active immunosuppression, complex cardiac history, HIV, congenital anomalies or failure to thrive in peds, concern for self or other harm

Reflect with every patient encounter:

  • Are there any red flags?

  • Has the worst case been ruled out?

  • What doesn’t fit?

  • What serious diagnosis could be missed?

Clinical Precepting Best Practices

MUST SEE

After precepting, the supervising attending physician MUST personally SEE and evaluate the patient if:

  • Considering admission, transfer to a higher level of care, or procedure cancellation within next 24 hrs

  • AMA or declining to go to ER or higher level of care

  • Patient with high risk conditions for which there is still an uncertain diagnosis after presentation

  • Any resident request for in-person attending evaluation (in setting of primary care exception)

Reflect with every patient encounter:

  • Are there any red flags?

  • Has the worst case been ruled out?

  • What doesn’t fit?

  • What serious diagnosis could be missed?