Balboa PCCM

Consult Turnover 

Turn over between consult fellows to consult fellow represents a large and important transition of care within the fellowship and is a potential vulnerability in terms of potential to loose track of important clinical information.

Weekly Staff Turnover:

  • During the rotation turnver occurs weekly with the fellow, offgoing staff and oncoming staff, this occurs after the  pending pathology at Friday Conference and should include a brief discussion of all ative inpatients and outpatinets who have ongoing needs that will need addressed in the following week and procedures occuring during the following week.

Fellow Monthly Turnover:

  • Off-going consult fellow sends below information via encrypted email to 1.) The oncoming consult fellow, 2.) Both the off going and oncoming consult attendings.
  • Format
    • Active Inpatient Consults (A brief history, and important upcoming details)
      • Ex: John Doe (DODID: 1122334455), 5N, 27 yo M with R PSP. Chest tube placed 12/1/22, currently clamped overnight. Ideally removing 12/2 if imaging is stable.
    • Active Outpatient Consults (A brief history, and important upcoming details)
      • Ex: Jane Doe (DODID: 1122334455), 58 yo F with metastatic breast cancer, possible immune related lung toxicity. Plann for cxr on 12/8 and will need coordination of f/u immediately after on 12/9 for potential bronch later that week if progressive disease noted.
    • Upcoming Tumor Board Cases (should cc oncoming fellow with tumor board submission sheet)
      • Ex: Joe Camel  (DODID: 1122334455), 65 yo M on for tumor board 12/5/23. Emailed you with prep sheet. Anticipate SBRT.
    • Upcoming Procedures (Brief history, pre-op process status, location of pre-op paperwork and date of procedure)
      • Ex: Joe Smith (DODID: 1122334455). R lung mass. Nav BX planned for 12/7/23. Paperwork in Dr. Foley’s file cabnet.
    • Upcoming Outpatient Appointments (generally new SPECs or important pre-procedure follow ups).
      • Ex: Sally Smith (DODID: 1122334455), 87 yo F with a 1.2cm RML lung nodule discovered in ED. Scheduled with you for consult fellow spec appt on 12/5/23 at 0900 (booked in genesis)
    • Pathology to follow up: Suffice to state that items in beast are up-to date for pending pathology and to specifiy names/DODIDs to follow up).
      • Beast is up to date. Follow up bx results for Scott Smith (DODID 1122334455) and Maria White (DODID 2233441133)