RESIDENT BOX COVERAGE/CLINIC GUIDELINES

Social Pediatrics Intern and Resident EPIC In-Basket Responsibilities

A significant part of patient care happens outside of the exam room and after the patient visit.   Your EPIC In-Basket is the main communication tool for the front desk, the lab, phone calls, other providers and your clinic preceptor. Your preceptor may use the EPIC In Basket to communicate with you about changes that would improve your visit notes and make them more a valuable part of the patient’s record.

We have provided some guidelines for inbox coverage that will:
1.     maximize your learning
2.     promote your role as the primary care provider for your patients
3.     support your communications with patient
4.     promote the safety of our patients by overseeing, and acting on, urgent matters.  

Interns - Check your EPIC In Basket folder to review labs and messages when in clinic.  Please respond with the preceptor’s guidance as needed.  The clinic preceptor is responsible for covering the intern lab results which includes all decision making and signing off on lab results. Be aware of features like MyChart because they can be confusing.

Residents- Check your EPIC In Basket folder regularly to review and respond to these labs and messages. Personal and partner In Baskets should be checked by one member of at team at least once every 24 hours (including Tuesdays, holidays and the weekend if you are expecting results).  Also ensure that you and your partner In Baskets are linked in EPIC. If for some reason you AND your partner are not going to be able to check your box for >24 hours please make sure that you have arranged for “box coverage” with the chief resident or a faculty member.  It is helpful to check your In Basket in the morning for lab results and phone calls, especially Monday morning.  For example, if you have a patient with a positive Chlamydia result you can call them in the morning and have them come in that afternoon to see you.  Checking your lab results regularly helps you learn to triage/prioritize what can wait and what needs to be acted on that moment, for example, mild anemia vs + Chlamydia and elevated HgbA1C vs low ANC.  If you do not see the preceptor in clinic you should also communicate via EPIC with the preceptor you saw the patient with when you have questions. Also ensure that if you have an emergent lab result (e.g. a bilirubin) that the attending covering results for that night is aware.

Interns and Residents: Physical Inbox Responsibilities

All residents also have a physical inbox at the front desk of clinic. When families drop off forms or other paperwork at the clinic, they are left here. Residents should check their boxes at least once per clinic session. After completing forms they should be left for pickup at the front desk, and the family should be notified the paperwork is ready. Clinic policy specifies that forms should be filled out within 7-10 business days. Please complete forms and return them to your patients as quickly as you can. If you have questions about how to fill out a form, ask your clinic preceptor.

Each intern is assigned to one SP partner pair; the intern shares the physical inbox with that partner pair. The partner pair will be responsible for monitoring the box while the intern is out of clinic, and should ensure that urgent paperwork is completely in a timely manner. The partner pair-intern coverage teams are listed at the end of this document.

Interns and Residents: General Guidelines

  • Ideally, clinic notes should be finished before you leave for the day (in all cases the note must be sent to the preceptor within 24 hours)

  • Check your In Basket to see if your preceptor has sent a clinic note back for revision

  • When ordering labs or imaging, develop a plan with the family and the preceptor you are working with during each clinic session on how results will be addressed. The results will be sent to the In Basket of you and the preceptor you are working with on that the day you see the patient.

  • Residents are expected to stay in clinic until at least 4:30pm on days they see patients at CHCC. If patient care is finished before that time, residents should ensure they have finished notes and paperwork, contacted their patients as needed, and logged procedures.

  • You are responsible for Urgent result. If your preceptor has already acted on a result, review their action for your own/education or follow up, and then you can remove the lab, result note, or telephone note from your In basket. 

    • For normal results: call patient and write telephone note OR send result letter (send letter and write result note that ‘results normal, letter sent.’)

    • For mildly abnormal: call patient/family and discuss result.  Send a letter only after 2 attempts to reach by phone.

    • Do not leave voice mail messages with any patient related information

    • Send your preceptor a copy of your result note or telephone note.

    • If you want to communicate with your preceptor through EPIC regarding the interpretation or plan for results, click on “Forward” and type your question or comment.  Be sure to change the message type to Informational only. (These types of messages will not appear in the medical record)

    • If you make a telephone call to a patient to discuss a clinical matter, please discuss the call with an attending in clinic and send the phone note detailing the call to them for review.

GENERAL REMINDER
Residents: please remember to change the PCP fields on EPIC to your name. The handoff between graduating PGY-3s and rising PGY-2s is listed below:

Dr.Gagne/Dr. Shobnam  -> Dr. Holm/Dr. Luke

Dr. Johnson/Dr. Yuan -> Dr. Cardillo/Dr. Mena

COVERAGE TEAMS 2020-2021

  •  Dr. Bathory - Dr. Baumann/Dr. Vazquez - Dr. Hermida

  •  Dr. Bathory - Dr. Cardillo/Dr. Mena - Dr. Saha

  •  Dr. Scholnick - Dr. AnthonyPillai/Dr. Ronca - Dr. Moon

  •  Dr. Scholnick - Dr. Holm/Dr. Luke - Dr. Katumgapala