Swedish Medical Center
Per Danielsson, MD
Medical Director, Adult Hospitalist Team
Purpose: To provide an opportunity
to work as an integral member of an experienced and proficient hospitalist
Description: Available to senior level Internal Medicine
residents (R2 and R3 years), this one month long elective rotation is
offered to one resident per month. Residents will join the Swedish Adult
Hospitalist Team (AHT), directed by Dr. Per Danielsson. The Swedish Adult
Hospitalist Team has 19 physicians, three to four of whom are working
during the day at the First Hill campus where this rotation is located.
There are also 2 dedicated nocturnists at First Hill, but this elective
rotation does not involve any overnight call for residents.
As a member of the team, it is expected that residents
will admit patients to the ICU and medicine wards, and manage their care
during the hospitalization until discharge. Efforts will be made to select
the patients who offer the greatest learning opportunity. Residents will
be expected to build and care for a limited panel of inpatients (six to
eight) as determined by patient complexity and resident ability and interest.
Residents are expected to start at 7 a.m. when the physicians meet in their
team room to get sign out from the nocturnist. As integral members of
a hospitalist team, residents will be expected to dictate both admission
notes and discharge summaries, following a prescribed format that is specific
to the hospitalist team.
Residents will work approximately 45-50 hours per week,
with evenings and weekends off. Residents will sign out their patients
at night to the covering nocturnist, and are not expected to provide care
to their patients at night. Similarly, on weekends, residents will sign
out their patients to the attendings on the Swedish Adult Hospitalist
Team. Throughout this rotation, the residents will be supported and supervised
by Swedish AHT physicians, and all admissions will need to be reviewed
by a Swedish AHT attending shortly after admission.
The rotation offers exposure to all the activities of a busy hospitalist
service caring for inpatients at a large urban tertiary care hospital.
Emphasis will be placed on creating a valuable learning experience rather
than meeting the service needs of the medical group. Issues encountered
will include appropriate utilization of resources, triaging efficiently
and effectively, end of life care, relationships with subspecialty consultants,
and coordination of care with outpatient physicians as well as allied
health professionals (PT, OT, Nutrition, Social Services, Discharge Planner
etc). There will also be opportunities to participate in some of the ongoing
quality improvement projects that Swedish AHT physicians are working on,
and if there is interest, to explore some of the economic challenges and
opportunities that are presented to hospitalist teams today. The resident
will discuss cases in more detail with the supervising attendings as 2
or more physicians from the team frequently meet for lunch in their team
room. We hope this venue will give the residents a unique opportunity
to discuss with practicing hospitalists not only medical aspects of a
case, but also practice-specific issues for hospitalists. In addition,
updates from the medical literature on 8-10 topics will be reviewed each
month with the resident on the team.