The ID Attending is ultimately responsible. Must be notified immediately if there is a complication or a patient care problem. Must always remain “in the loop”. “I don’t want to bother the attending” is unwise
– Specific Roles
o Should communicate his or her expectations at the beginning of each rotation. Important to check in with the fellow by 9:30 each day, and begin rounds by 1 PM and complete rounds by 4 PM whenever possible.
o Must know the key details about every patient on the consultation service
o As an expert in ID, provides oversight and assists in diagnostic and management decisions. Knows the most up-to-date information, familiar with and follows IDSA and antibiotic steward guidelines
o Trouble-shoots for the team providing administrative assistance with problems. Must actively first order and second order problem solve.
o When >5 consults the office contacts the overflow service attending (Team C) to assist with additional consults,
o Creates many teaching moments and encourages active discussion and active learning. Emphasizes improving the systems of care, use of internet for the latest diagnostic and management. Provides guiding principles for care including differential diagnosis and cost-effective management.
o Preferred teaching method: The attending takes notes on a computer as the fellow or student is presenting. When possible the attending should prereview the chart and begin filling out the key points before meeting the fellow (this speeds up rounds and reduces typing time during rounds) The key points in the history, physical exam, and laboratory data are included. The Attending and Fellow Consultation Summary should be made visible to all the team members. Once the case has been presented the team beginning with the presenter gives their impressions. The attending summarizes and modifies these impressions as the team members make suggestions. Once the impressions are complete, the team then suggests the diagnostic followed by the therapeutic recommendations. Again the attending adds these to the typewritten document. In this way the entire team formulates the recommendations. The note is then pended and the attending in the presence of the team sees the patient and reviews the history and positive physical findings. Modifications to the document are made with the team based on any new findings or differences in assessment. The document is then signed and released to the EMR within 5 minutes of the attending’s visit to the patient providing the primary team with a timely summary of the Infectious Diseases Consult service’s recommendations.
o Must be available 24/7 for resident consultation
o Should see all new consults within 24 hours of request by the primary service
o Maintains a positive attitude and maintains good morale among the team members and watches for fatigue and overwork. Assist with management of workload.
o Expects and provides the highest quality care for his/her patients