{"id":2014,"date":"2020-08-18T20:30:59","date_gmt":"2020-08-18T20:30:59","guid":{"rendered":"http:\/\/hfhpulm.com\/info\/?page_id=2014"},"modified":"2020-08-27T13:36:32","modified_gmt":"2020-08-27T13:36:32","slug":"wbh-pulmonary-consults","status":"publish","type":"page","link":"https:\/\/hfhpulm.com\/info\/?page_id=2014","title":{"rendered":"WBH Pulmonary Consults"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/hfhpulm.com\/info\/?page_id=1537\">Curriculum<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Welcome to the consult service at West Bloomfield Hospital (WBH).\u00a0 Below are the essentials for a successful rotation at WBH.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">PARKING<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Physician parking is on the \u201chill\u201d outside of the main entrance.&nbsp; The patient and family parking lot is the lower lot outside the main entrance.&nbsp; Of note the parking by ED is no longer available to fellows or residents.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">ROUNDS<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Rounds will typically begin in the afternoon after the ICU staff has completed rounding in the ICU.&nbsp; The consulting staff will be either the 2C ICU rounder or the 1C MICU rounder, and that staff rounds for a week at a time on consults.&nbsp; Please consult momentum to determine which staff is rounding each day<\/p>\n\n\n\n<figure class=\"wp-block-embed\"><div class=\"wp-block-embed__wrapper\">\nhttps:\/\/hfhpccm.bio-optronics.com\/Momentum\/Forms\/frmReadOnlyStaffRolesByDate.aspx?Mode=0&#038;Filter=626\n<\/div><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">CONFERENCES<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">On Friday afternoons, it is expected by the program that you attend fellow conference.&nbsp; If there is no conference on a given Friday, you are expected to remain at WBH until the end of the workday.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">PROCEDURES<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">All bronchoscopies are part of your responsibilities.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">To schedule a bronchoscopy:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Call 248-661-6602 and ask to speak to the scheduling nurse.&nbsp; They will ask for the usual information and give you a time.<\/li><li>Obviously, schedule for a time that your staff and you are available to do the procedure<\/li><li>An order should be placed in Epic for \u201cBronchoscopy Flexible\u201d<ul><li>Remember the \u201cBronchoscopy- Pulmonary Medicine\u201d order is for a bronchoscopy at HFH-Detroit; if you enter this order, you will schedule the patient for a bronch in Detroit.<\/li><\/ul><\/li><li>Make sure that you communicate with the primary team to keep the patient NPO, etc.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">It is possible that staff\/fellows from HF-Columbus will contact you regarding bronchoscopies for their outpatients.&nbsp; Please do your best to accommodate these providers and their patients as best you can.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you wish to do other pulmonary procedures as an inpatient (thoracentesis), that would be fine also.&nbsp; The hospital has a procedure team (or IR) who do many of these for the GPU patients.&nbsp; However, if you are consulted for a patient and wish to do the procedure yourself, discuss with your staff.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">RIGHT HEART CATHETERIZATIONS<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">These procedures are performed with low frequency at HF-West Bloomfield.&nbsp; However, there is a distinct possibility that there is no cardiology fellow to assist.&nbsp; If you have an interest in doing these procedures with the interventional cardiologist, please contact Dr. Modi (<a href=\"mailto:smodi1@hfhs.org\">smodi1@hfhs.org<\/a>), the cardiology chief at WBH, to show your interest.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Some things to keep in mind<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>WBH does relatively few RHC procedures, so volume will be low<\/li><li>Participation vs observation should be clarified. The former should include the fellow to participate in the consent and H&amp;P, as that falls on the shoulders of the interventionalist at WBH. If time will be taken to go through and guide a procedure, as well as review and assess hemodynamic tracings, then the cardiology team deserves direct input and assistance.<\/li><li>clarification of contact # and availability to do the procedures, as more commonly they are inpatient procedures and only known about the morning of the procedure (i.e you will often not get a ton of warning time)<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">You are not obliged to participate, so the lack of communication to Dr. Modi at the beginning of the month indicates that you do not wish to do them.&nbsp; You will not be rewarded\/penalized in any way based upon your decision.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Finally, your consultation workload takes precedence over right heart catheterizations.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">WEEKENDS<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">You have the weekends off.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">CONSULTS<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Around 8am, the operator will likely send a HALO message to Fellow\/Staff listed per schedule in HALO with pulmonary consults overnight and any new consults during the day.&nbsp; If you don\u2019t find your name in HALO listed under consults please contact Dr. Starosta to add you to the schedule via phone 313-986-8713 or email dstaros1@hfhs.org<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In epic, the consults will be listed under following;<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>please check this several times during the day in case operator misses a consult:<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Patient lists -&gt; Available Lists -&gt; West Bloomfield -&gt; Consults-Physicians -&gt; Pulmonary.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This is the best and most accurate place to retrieve new consultations.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">When a consult is placed, the hospital expectation is the following:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Routine consult: seen within 24 hours<\/li><li>Stat consult: seen within 1 hour<\/li><li>Consults in CDU: seen within 4 hours<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>It is the expectation of the hospital and the rotation that you will directly contact the consulting physician\/APP and provide him\/her with pulmonary recommendations.<\/em><\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong><em>Any pulmonary specific imaging and\/or laboratory testing can be ordered by our service as long as this is communicated to responsible staff<\/em><\/strong><\/li><li><strong><em>It is an expectation to follow up on any tests ordered for or by our service<\/em><\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">SIGNOUT<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Before leaving for each day, please let your staff know.&nbsp; As you will also have clinic during this month frequently, please work with the staff to confirm what mornings your will not be present.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">ICU<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">You do not have any ICU responsibilities during this rotation.&nbsp; If anyone attempts to give you ICU duties, please ask them to contact Dr. Geneva Tatem or me to resolve this issue.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">EDUCATION<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">As part of the rotation, you will have the responsibility to create a \u201clunch and learn\u201d pulmonary topic to review with the APP\u2019s and nursing from the ICU.&nbsp; The APPs, your staff and you should mutually agree upon the topic at the beginning of the month.&nbsp; You can either provide a handout or a short PowerPoint presentation to those who attend.&nbsp; The presentation should take between 30-60 minutes.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Please feel free to contact me with any questions or concerns.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Thanks.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Dominik Starosta<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Possible Topics for \u201cLunch and Learn\u201d sessions<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>ILD<\/li><li>PFT&#8217;s<\/li><li>COPD<\/li><li>Asthma<\/li><li>Pulmonary embolism<\/li><li>Pulmonary nodule\/lung cancer<\/li><li>Pneumonia (HCAP or CAP)<\/li><li>Dyspnea<\/li><li>Sarcoidosis<\/li><li>Hemoptysis<\/li><li>Pleural effusion, w\/u and management<\/li><li>Pulmonary hypertension<\/li><li>Pulmonary vasculitis (this can include: Goodpasture\u2019s syndrome, Granulomatosis with polyangiitis (formally Wegener&#8217;s Granulomatosis), Microscopic polyangiitis)<\/li><li>Unusual pulmonary infections\u2014Mycobacterial disease, fungal disease.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Topics already used for Lunch and Learn Sessions<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><strong>Topic<\/strong><\/td><td><strong>Month presented<\/strong><\/td><\/tr><tr><td>Pleural effusion<\/td><td>August 2015<\/td><\/tr><tr><td>COP and other pulm vascular diseases<\/td><td>September 2015<\/td><\/tr><tr><td>Pulmonary hypertension<\/td><td>October 2015<\/td><\/tr><tr><td>Pneumonia<\/td><td>January 2016<\/td><\/tr><tr><td>Hemoptysis<\/td><td>February 2016<\/td><\/tr><tr><td>Eosinophilic pneumonia<\/td><td>March 2016<\/td><\/tr><tr><td>Pulmonary embolism<\/td><td>April 2016<\/td><\/tr><tr><td>Sarcoidosis<\/td><td>August 2016<\/td><\/tr><tr><td>Obesity and pulmonary disease<\/td><td>November 2016<\/td><\/tr><\/tbody><\/table><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Curriculum Welcome to the consult service at West Bloomfield Hospital (WBH).&nbsp; Below are the essentials for a successful rotation at WBH. PARKING Physician parking is on the &ldquo;hill&rdquo; outside of the main entrance.&nbsp; The patient and family parking lot is the lower lot outside the main entrance.&nbsp; Of note the parking by ED is no [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"","_lmt_disable":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-2014","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/pages\/2014","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2014"}],"version-history":[{"count":2,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/pages\/2014\/revisions"}],"predecessor-version":[{"id":2044,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/pages\/2014\/revisions\/2044"}],"wp:attachment":[{"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2014"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}