Summary of today's Noon Conference

• Please note the Department of Medicine has agreed to pay for your taxi ride home and back to work if you are too fatigued to drive. Just save your receipt and turn it into Renee

Below links can be accessed easily by clicking on labels on the right side of the blog (when accessed on a computer)

• CLICK HERE to download Dr. Ragland's powerpoint from today

• CLICK HERE to download Resident Policy Manual (also give to you at orientation)

• CLICK HERE to download CIR MOU (contract) for 2014-2015 (also give to you at orientation)

• CLICK HERE  for Review of ACGME Duty Hour requirements as given in handout today

• UCLA Employee Assistance Program  phone number 1-800-730-3859

Rotation Goals and Objectives

Ladies and gentlemen,

Please download the updated Rotation Goals and Objectives (previously on evalue).
The goals and objectives are PGY level specific for those rotations you do more than once in residency. They also reflect the ACGME 6 Core Competencies.

The Journal Club Curriculum and Research Curriculum have also been updated and uploaded.

This post will always be available under the resources and acgme labels. We also added it in the link box on the right of the website

Click Here for Goals and Objectives

Patient Care
Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.

Medical Knowledge
Residents must be able to demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.

Practice-Based Learning and Improvement
Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices.

Interpersonal and Communication Skills
Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, patients’ families, and professional associates.

Professionalism
Residents must be able to demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.

Systems-Based Practice
Residents must be able to demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.

Transition of Care- Patient Signouts

Acronym for Effective Signouts 

Senior residents: you must observe your interns method for signouts at least twice a rotation and provide constructive feedback afterwards. Additionally, you are responsible for signing out all sick patients to the on call senior.

It is stongly encouraged for interns and seniors to identify sick and new patients and consider joint evaluation at bedside during signouts.

SIGNOUT?

o S: Is this patient particularly Sick or DNR
o I: Identifying data and demographic info about patient
o G: General hospital course for the patient
o N: New events or occurrences of the day
o O: Overall Health status
o U: Upcoming possibilities and things to watch for
o T: Tasks that need to be completed prior to next handoff
o ?: Any questions?

ACGME Core Competencies & Milestones

• ACGME has 6 core competencies for every resident physician to meet prior to graduating. 
• The ACGME milestones are used as a system for programs to evaluate residents and promote residents based on the 6 core competencies. 
• The Clinical Competence Committee (CCC) meets semi-annually and evaluates each resident's progression through the milestones
• Milestones are graded on a 1 - 5 scale with 1 being "critically deficient" to 5 being "aspirational."

Click links below for more details

ACGME SIX CORE COMPETENCIES

Patient Care (PC)

Medical Knowledge (MK)

Practice Based Learning and Improvement (PBLI)

Interpersonal and Communication Skills (ICS)

Professionalism (PROF)

Systems Based Practice -working with health care system (SBP)

ACGME 22 MILESTONES & HOW YOU ARE EVALUATED 

1. Gathers and synthesizes essential and accurate information to define each patient's clinical problem: monthly eval, chart review, miniCEX 

2. Develops and achieves comprehensive management plan for each patient: monthly eval, chart review 
3. Manages patients with progressive responsibility and independence: monthly eval, chart review
4. Skill in performing procedures: Met 5 required procedures
5. Request and provides consultative care: monthly eval, chart review
6. Clinical Knowledge: monthly eval, Peer review
7. Knowledge of diagnostic Testing and procedures: monthly eval, chart review
8. Works effectively within an interprofessional team: peer eval, nursing eval, patient survey
9. Recognizes system error and advocates for system improvement: monthly eval
10. Identifies forces that impact the cost of health care, and advocates for, and practices cost effective care: monthly eval
11. Transitions patients effectively within and across health care delivery systems: montlhy eval
12. Monitors practice with a goal of improvement: self eval
13. Learns and improves via performance audit: quality data (i.e. pap smears, mammograms, diabetes checklist, pcoft)
14. Learns and improves via feedback: monthly eval, peer review
15. Learns and improves at the point of care: monthly eval
16. Has professional and respectful interactions with patients, caregivers and members of interprofessional team: monthly eval, nursing eval, patient survey
17. Accepts Responsibility and follow through on tasks: monthly eval, patient survey
18. Responds to each patient's unique characteristics and need: monthly eval, nursing eval
19. Exhibits integrity and ethical behavior in professional conduct: monthly eval, peer review, nursing eval
20. Communicates effectively with patients and caregivers: monthly eval, peer review, patient survey
21. Communicates effectively in interprofessional teams: monthly eval, peer review, nursing eval, patient survey
22. Appropriate utilization and completion of health records: PCOFT, Problem/Med List, unapproved abbreviations, delinquent records

Continuity Clinic Evaluations

Many of you already know this but for those who don't, please note the following ways you are evaluated in continuity clinic:

• Mini-Cex which includes faculty bedside evaluation of residents
• Nursing evaluation
• Chart Audits
• Dan Burke Bedside Behavioral Science evaluation

Strategic napping for fatigue

ACGME recommendation implemented...STRATEGIC NAPPING

Recommended after 16 hours of continuous duty

True story, click the link