As of 12/4/2020, the roles of staff and time working have changed. Please contact ICU leadership to determine which hours in the ICU you are expected to work.
MICU White– Will be covered under the previous resident/fellow/staff model with 12 patients in pod 1 and an additional 3 overflows in geographically distant units, capped at 15 patients. 4 Residents covering the 15 patients, with q4 call or night float system depending on number of residents
Availability: On Call- 7am-5pm, In-Person 8:30 am-5pm, Gap Staff coverage as prior
Weekend/Holiday Coverage: By combined MICU White/Red Rounder from 7 am-completion of rounds in person. Alternating call availability by White/Red and Green Staff. The Yellow staff is available for urgent issues. The Yellow staff is available for urgent issues.
Fellow Coverage: MICU White Fellow Weekdays (Wednesday off covered by floater) 7am-5pm, Short call for Pod 1,2,4 Monday 7am-8pm
MICU Red- Will be covered under the previous resident/fellow/staff model with 12 patients in pod 2 and an additional 3 overflows in geographically distant units, capped at 15 patients. 4 Residents covering the 15 patients, with 3 on days and one on week-long night float blocks.
Availability: On Call- 7am-5pm, In-Person 8:30 am-5pm, Gap Staff coverage as prior
Weekend/Holiday Coverage: By combined MICU White/Red Rounder from 7 am-completion of rounds in person. Alternating call availability by White/Red and Green Staff. The Yellow staff is available for urgent issues. The Yellow staff is available for urgent issues.
Fellow Coverage: MICU Red Fellow Weekdays (Thursday off covered by floater) 7am-5pm, Short call for Pod 1,2,4 Tuesday 7am-8pm
MICU Blue– Will be covered under the previous resident/fellow/staff model with 16 patients in pod 4 and no additional overflows in geographically distant units, capped at 16 patients. 4 Residents covering the 16 patients, with q4 call. Extra residents will be preferentially placed into pod 4 to overcome the extra census and implication on filling all pod 4 beds prior to opening overflow beds for Pods1/2
Availability: On Call- 7am-5pm, In-Person 8:30 am-5pm, Gap Staff coverage as prior
Weekend/Holiday Coverage: By Yellow Rounder from 8 am-completion of rounds in person. The Yellow staff is available for urgent issues. Weekends off.
Fellow Coverage: MICU Blue Fellow Weekdays (Tuesday off covered by floater) 7am-5pm, Short call for Pod 1,2,4 Wednesday 7am-8pm
MICU Green– Will be covered under the previous APP/ staff model with 20 patients in pods 5 and 6 and no additional overflows (unless ECMO), capped at 20 patients. 4 APP’s covering 20 patients. Weekday fellow coverage through the Green rotation is removed.
Availability: On Call- 7am-5pm, Rounds 9:30 am-12pm availability through 5 pm. Gap Staff coverage as prior
Weekend/Holiday Coverage: The weekday green rounder will staff the Green service as part of a 7 day rotation. Overnight fellow moonligher will present new admits plus follow ups (up to 7 patients) to the green rounder at 7am, the Nocturnist may have time to round overnight with the overnight fellow. The Green staff will round with the daytime fellow moonlighter on an additional 7 patients. The remaining 6 patients will be seen by the Green staff with notes completed prior to signout to the daytime fellow moonlighter. Emergent SICU/CICU/NeuroICU consults by Green Rounder and Green Fellow.
Fellow Coverage: None on weekdays, the Green fellow rotation is transitioned to yellow as below. Weekend moonligthers day/night providing direct coverage from Friday 5 pm-Sunday 7 pm. MICU Moonlighters responsible for 7 notes each. Green staff providing AM half day support and documentation for 6 patients.
Nocturnist- Provide APP supervision for the Green Service Sunday-Thursday night from 7 pm-7am and direct care of the 8 patients in Pod 3. Provides additional support to MICU Triage fellow in POD 1,2 and 4 overnight from 7pm-7am (Yellow staff swing is the backup to this role from 7-11pm, see below).
Friday and Saturday 7pm-7am, providing direct care for 8 patient yellow service only. Nocturnists will help staff new admissions in other MICU pods if available and round with the overnight Green moonlighter if able.
Nocturnal APP’s– 3-4 APP’s Provide direct coverage for MICU Pod 5 and 6 (20 patients) from 7 pm-7am Sunday night, and 5pm-7am Monday-Thursday night.
MICU Yellow AM Staff- Providing direct coverage for MICU Pod 3 with the Yellow Fellow, including rounding with multidisciplinary team of RN and RT. Pharmacy support will be provided after their formal rounds with the resident pods. Direct care includes daily documentation with H&P or Progress note, Critical Care notes when justified are encouraged for ease of documentation, procedures, family meetings, etc. Work should be evenly split-shared with the Yellow Fellow on the four weekdays they are present.
Availability: In person 7am- 3pm Sunday-Thursday, 7am-2pm Friday-Saturday , no gap staff responsibility. Sign out to MICU Yellow Swing Shift at 3 pm Sunday-Thursday, 2pm Friday-Saturday (when present, fellow will overlap coverage until 4pm). On the fellow off day (Tuesday) support may be needed from the ICU consult staff
Weekend/Holiday Coverage: Start times as above, rounding on the Blue service’s 16 patients with house staff, and primary coverage of yellow with the yellow fellow, including 2 notes. Hand off to swing shift staff begins upon their arrival 2pm/3pm depending on the day. The Yellow staff is available for urgent Gap Staff issues for pods 1,2 and 4.
Fellow Coverage: Weekdays 7 am-4pm, 4 notes to staff. Tuesdays off, Triage phone and Short call for Pod 1,2,4 on Thursdays until 8pm. Weekends 7am-3pm, no cross coverage duty, Yellow staff rounds in blue and covers 2 notes on the yellow service on weekends, the fellow covers 6 to staff.
MICU Yellow Swing Shift- Providing direct coverage for MICU POD 3 during the afternoon, new admissions, procedures, family meetings, etc. Direct coverage until 11pm new admissions until 10pm, with signout to Nocturnist. After 7pm, availability as a backup to the nocturnist to review new admissions and staff procedures offloading the triage fellow during the critical fellow signout period, if the yellow service is quiet.
Availability: In person 3-11pm Sunday-Thursday, handling Pod 3 admissions until 10 pm and Resident/Fellow backup supervision 5-10pm. On Friday-Saturday when fellows moonlighting in Green (see below), coverage will be from 2 pm-8 pm.
Weekend/Holiday Coverage: Friday-Saturday 2-8pm with same responsibility as weekday. The Yellow staff is available for urgent issues. Sunday 3pm-11pm. Protected time Monday after ICU block will be given. Holiday coverage from 3-11pm with same responsibility as weekday.
Fellow Coverage: None
ICU Consult Staff- Critical Care consult service providing Medical Critical Care consultation to patients admitted in the SICU/CICU/CTICU/NeuroICU for the purposes of medical optimization, ventilator management, delirium management, and non-interventional Bronchoscopy. This will help reduce long term patient transfers into the MICU for medical management for surgical patients unable to liberate from intensive care. Family meetings should be directed by primary team, with consultant to join if needed.
Additional collaborative role with Yellow Day staff to help offload any procedural or documentation burden as needed.
Availability: In person 8:30am-5pm Monday-Friday. On call/emergency responsibilities are deferred to the primary team or in house MICU triage fellow or nocturnist if indicated. On Tuesdays, ICU Consult staff to be available as backup to MICU Yellow staff
Weekend/Holiday Coverage: None, emergent transfers (ie ARDS management, etc) deferred to MICU triage. Urgent consults deferred to weekend Green Fellow/Staff.
Fellow Coverage: None