Revised June 2008, M. Haydel, MD
LOUISIANA STATE UNIVERSITY HEALTH SCIENCE CENTER – NEW ORLEANS
EMERGENCY MEDICINE RESIDENCY PROGRAM
POLICIES TO SUPPLEMENT LSUHSC HOUSE OFFICER MANUAL & ROTATION GUIDE
“Prepared For the Worst ~ Providing the Best”
TABLE OF CONTENTS LSU EM Residency Manual
INTRODUCTION 4
POLICIES – ACGME 5
ACGME Core Competencies 5
Core Competencies 5
Core Competencies & LSU EM 6
Resident Duty Hours and the Working Environment 9
Duty Hours - Emergency Medicine 11
POLICIES - LSUHSC 12
Ethics Code - LSUHSC Emergency Medicine Residency 12
Code Of Professional Conduct 13
Honor Code 13
Grievance Policy - Academic 14
Ombudsman 17
MCLNO Quality of care statement 18
Job Description - EM house officer 19
House Officer I 19
House Officer II 19
House Officer III 20
House Officer IV 20
HOUSE OFFICER CONTRACT 21
LEAVE: 22
Pay Scales - LSUHSC House Officer 26
Emergency Fund for Residents 27
House Officer Selection and Eligibility LSUHSC 28
Campus Assistance Program 30
Fitness For Duty And Substance Abuse Policy 31
Work Related Injury/Illness 32
Dress Code 33
LIBRARY - LSUHSC 42
WELLNESS CENTER 44
HOUSE STAFF CLEARANCE FORM 45
POLICIES – Section of EM 47
Mission Statement 47
Role of the Residency in the Emergency Department 48
EM Residency Applicants 49
Residency Promotions 50
Satisfactory Academic Standing 51
Evaluations 52
Emergency Department Resident Monthly Evaluation 53
360 degree Annual Evaluation 55
Annual Self-Evaluation 57
6-month Faculty Advisor Meeting 60
Faculty Advisors 61
Procedure and Patient Experience Documentation 62
Ultrasound 63
Common Procedures 64
Follow-Up Log 66
Residency Partner 68
Educational Stipend 69
Travel Forms 70
Mailboxes/ Email 71
Beepers 72
Vacation 73
Yearly Schedule Requests 73
ED Schedules 74
Disaster Call 75
Disaster Call Scheduling 76
Disaster Call & Duty Hours 77
Code Grey – Hurricane Guidelines 78
Advanced Life Support Programs Policy 82
Moonlighting Policy 84
Call Room 85
Sick Leave 86
Conference Attendance Policy 87
Monthly CORD Exam 88
Journal Club Literature Critique Form 91
M & M Presentations 92
Medical Records 94
Electronic Signature 94
LSU EM Reading Topics 2008-09 95
Research Requirement 99
Resident's Research Proposal And Progress Form 100
Chief Resident Responsibilities 101
Chief Resident Questionnaire 101
Residency Curriculum 102
Model For Emergency Medicine 102
Reference Book Loan-Out Policy 103
Medical License 104
105
DEA number 105
NPI number 105
Notary 105
Guidelines To Rotations/Goals & Objectives 107
UH/ MCLANO Emergency Department 108
EMS Guidelines: NOHD & Acadian 108
ANESTHESIA 115
CHABERT Medicine Wards 117
CHILDREN’S HOSPITAL 120
MICU 123
OBSTERICS 126
OLOL Pediatric ED 129
OCHSNER ED 132
SLIDELL ED 136
TOXICOLOGY 139
TRAUMA SURGERY 143
WEST JEFFERSON ED 146
ELECTIVE 150
INTRODUCTION
Welcome to the LSU Emergency Medicine Residency Program. This LSU EM Policies To Supplement LSUHSC House Officer Manual & Rotation Guide is meant to augment the LSUHSC School of Medicine, Office of Graduate Medical Education, House Officer Manual. The House Officer Manual is updated each year and is available on the LSUSHC website at:
http://www.medschool.lsuhsc.edu/medical_education/graduate/HouseOfficerManual.asp
A hard copy of this manual is available in the emergency medicine offices and online at the LSU EM yahoo website. http://health.groups.yahoo.com/group/LSUEM/
POLICIES – ACGME
ACGME Core Competencies
Core Competencies Guidelines (ACGME 2007)
Core Competencies
You MUST MEMORIZE this list of the 6 Core Competencies for ACGME accreditation purposes. Click on each item to for more details.
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Patient Care
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Medical Knowledge
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Practice Based Learning
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Interpersonal & Communication Skills
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Professionalism
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Systems Based Practice
Annual Competency Assessment – The programs must define competencies that are expected for each year of training taking into account the defined ACGME core competencies. Multiple tools may be used to evaluate these competencies. Competency evaluation of chief complaints, procedures, resuscitations and off-service rotations may be used as part of the annual competency evaluation.
The RRC will review:
What competencies are expected for each year of training?
What are the measurable competency objectives for each year of training?
How are these objectives measured?
How are deficiencies remediated?
Deficiencies in specific areas do not necessarily mean that the resident is held back in progressing to the next year; however, plans must be in place to achieve the required competencies.
Chief Complaint Competency - The RRC expects that programs will assess the competency of residents to handle key chief complaints in emergency medicine. At the time of program review, the program will demonstrate how it assesses resident competency for 3 chief complaints over the course of the training program. The program can use a variety of tools including direct observation, check-lists, simulations, etc.
Procedural Competency – The primary responsibility for the determination of procedural competency rests with the program director and the faculty. The RRC accredits programs, and does not certify or credential individuals.
The RRC expects programs to assess the competency of residents to perform key index procedures. At the time of program review, the program will need to demonstrate how it assesses competency of residents for 3 procedures.
Selected index procedures should consequentially impact patient care, and ideally facilitate competency assessment initiatives across disciplines.
One of the selected procedures must be ED bedside ultrasound (PR V.B.2.b; appendix 1)
Resuscitation Competency – The RRC expects programs to assess resident competency in the resuscitation of critical patients. These include adult and pediatric medical and trauma resuscitations. At the time of program review, the program will demonstrate how it assesses competency in one type of resuscitation. The program may use a variety of techniques including simulations and direct observations.
Off-Service Rotations – The program should define measurable competency objectives for off-service rotations, how the objectives are assessed and remediated when necessary. At the time of program review, it is expected that measurable objectives and the tools used for evaluation will be available for half of the off-service rotations.
Core Competencies & LSU EM
The residency program must require that its residents obtain competence in the six areas listed below to the level expected of a new practitioner. Programs must cite examples how these competencies are taught and evaluated within the training program.
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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.
Among other things, residents are expected to:
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Gather accurate, essential information in a timely manner.
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Generate an appropriate differential diagnosis.
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Implement an effective patient management plan.
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Competently perform the diagnostic and therapeutic procedures and emergency stabilization.
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Prioritize and stabilize multiple patients and perform other responsibilities simultaneously.
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Provide health care services aimed at preventing health problems or maintaining health.
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Work with health care professionals to provide patient-focused care.
Residency Experience: each clinical rotation and every off site ED rotation, didactic/lecture sessions, skill labs, simulation labs, US, Tox, all orientations, teaching ACLS/PALS/ATLS and freshman anatomy labs.
Residency Assessments: Direct observation and documentation of Daily, Monthly and Yearly evaluations, simulation cases, oral board cases, Morbidity and Mortality cases 360 evaluations.
2. Medical Knowledge: Residents must 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.
Among other things, residents are expected to:
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Identify life threatening conditions, the most likely diagnosis, synthesize acquired patient data, and identify how and when to access current medical information.
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Properly sequence critical actions for patient care and generate a differential diagnosis for an undifferentiated patient.
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Complete disposition of patients using available resources.
Residency Experience: each clinical rotation, every off site ED rotation, didactic/lecture sessions, skill labs, simulation labs, US, Tox, all orientations, teaching ACLS/PALS/ATLS and freshman anatomy labs.
Residency Assessments: National In-service Exam, Quarterly local in-service exams, Quarterly question sets, Daily, Monthly and Yearly evaluations, 360 evaluations, oral board cases, simulation cases and journal club.
3. Practice-Based Learning: Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence and improve their patient care practices.
Among other things, residents are expected to:
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Analyze and assess their practice experience and perform practice-based improvement.
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Locate, appraise and utilize scientific evidence related to their patient’s health problems.
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Apply knowledge of study design and statistical methods to critically appraise the medical literature.
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Utilize information technology to enhance their education and improve patient care.
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Facilitate the learning of students and other health care professionals.
Residency Experience: each clinical rotation, every off site ED rotation, didactic/lecture sessions, skill labs, simulation labs, US, Tox, all orientations, journal club, teaching ACLS/PALS/ATLS and freshman anatomy labs.
Residency Assessments: Daily, Monthly and Yearly evaluation, 360 evaluations, oral board cases, simulation cases, journal club, Trauma Conference, Toxicology rotation, RSI forms, End of Year evaluations and Ultrasound QA.
4. Interpersonal and Communication Skills: Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their families and professional associates.
Among other things, residents are expected to:
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Develop an effective therapeutic relationship with patients and their families, with respect for diversity and cultural, ethnic, spiritual. Emotional and age-specific differences.
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Demonstrate effective participation in and leadership of the health care team.
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Develop effective written communication skills.
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Demonstrate the ability to handle situations unique to the practice of emergency medicine.
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Effectively communicate with out-of-hospital personnel as well as non-medical personnel.
Residency Experience: each clinical rotation, every off site ED rotation, didactic/lecture sessions, skill labs, simulation labs, US, Tox, all orientations, bedside teaching, teaching ACLS/PALS/ATLS and teaching freshman anatomy labs.
Residency Assessments: Daily, Monthly, Yearly evaluation, 360 evaluations, oral board cases and simulation cases.
5. Professionalism: Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to a diverse patient population.
Residents are expected to demonstrate a set of model behaviors that include but are not limited to:
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Treats patients/family/staff/paraprofessional personnel with respect.
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Protects staff/family/patient’s interests/confidentiality.
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Demonstrates sensitivity to patient’s pain, emotional state and gender/ethnicity issues.
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Able to discuss death honestly, sensitivity, patiently and compassionately.
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Unconditional positive regard for the patient, family, staff and consultants.
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Accepts responsibility/accountability.
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Openness and responsiveness to the comments of other team members, patients, families and peers.
Residency Experience: each clinical rotation, every off site ED rotation, didactic/lecture sessions, skill labs, simulation labs, US, Tox, all orientations, death notification, cultural competency, pain management, conflict resolution, AMA, teaching ACLS, PALS and ATLS.
Residency Assessments: Daily, Monthly, yearly evaluations, 360 evaluations, oral board cases and simulation cases.
6. Systems-Based Practice: Residents must 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.
Among other things, residents are expected to:
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Understand access, appropriately utilize and evaluate the effectiveness of the resources, providers and systems necessary to provide optimal emergency care.
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Understand different medical practice models and delivery systems and how to best utilize them to care of the individual patient.
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Practice cost-effective health care and resource allocation that does not compromise quality of care.
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Advocate for facilitates patients’ advancement through the health care system.
Residency Experience: each clinical rotation, every off site ED rotation, didactic/lecture sessions, skill labs, simulation labs, US, Tox, all orientations, Disaster Drills, Hazmat, EMS, chart/EMS run report reviews, patient follow ups and CQI project (RSI sheets, radiology call backs and M & M)
Residency Assessments: Daily, Monthly, Yearly evaluations, 360 evaluations, oral board cases, simulation cases, Toxicology rotation, M & M and interesting case conference
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