Updated 7/2/2024

HARBORVIEW CONSULTS

Responsibilities:

Triage all consults: You will get pages from the ER and inpatient services, typically trauma surgery and neurology. Occasionally from MICU/Medicine or other services.
Supervise the team which consists of an anesthesia intern and often 1-2 medical students and provide teaching when things are slow.
Read 20 ECGs each day + assigned CAM monitors + assigned RhythmStar monitors. ECGs will be assigned to you in MUSE every morning ~9am and CAMs/RhythmStar monitors will be emailed to you.
Attend HMC case conference every Tuesday at 12:00-1:00 PM. Bring a case to discuss. No need to prepare a formal presentation but know your case well.

Monday - Saturday 7:00 AM - 5:00 PM
7:00AM: obtain sign out from the overnight hospitalist about overnight events, new consults, and new cath requests.
7:30 - 8:00AM: Check in with residents, medial students, and your attending EARLY about the plan for the day. Discuss timing of rounds with attending before 9 AM. Triage any urgent cath requests for the day. Start seeing consults as they come in.
~10-11 AM: Start rounding (timing variable).
Afternoon: Continue triaging patients, typically you’ll round again in the afternoon on new consult patients and run the list on olds.
5:00 PM: Sign out to the CCU resident on call. Evening and weekend consults from 5-7pm are fielded by the CCU on-call R2 and then by the cardiology nocturnist from 7pm-7am

See urgent consults immediately. See all other consults within an hour of being paged.
Do not block consults, but if it is a simple question (eg how to order a stress test or get outpatient follow up, etc) then feel free to clarify if a formal consult was their intent.
Remember your resident is an intern so please keep this in mind as you deploy them to see consults.
Touch base daily with primary teams for patients you are continuing to follow. It is ok to suggest signing off and ask the teams to re-consult if you are no longer active managing the patient.
It is ok to drop brief notes on patients to document ongoing assessment/recommendations without repeating the entire consult note.