Physician - Resource

• Position: Per Diem OBGYN Physician

OB-GYN Physician Coverage Program

Endeavor Health

2024

OB Coverage Program

Resource Physician (RP) Responsibilities - Days, Nights, Weekends, Holidays

The Resource Physician is responsible for enhancing the safety of our patients, providing excellent clinical care and actively participating in the ongoing education of our learners in the Department of Obstetrics and Gynecology.

Availability Arrive on time to begin your shift. If there is an unavoidable delay, contact the RP on duty to arrange for continuous coverage until your physical arrival on the unit.

Sign out RP-to-RP as shifts change. Sign out should include the status of obstetric and gynecologic NorthShore Community Health Center (NCHC) patients, concerning private patients in Labor and Delivery (L&D), Emergency Department (ED) status and pending services such as tubal ligations, circumcisions, etc.

Provide contact information. Ensure the charge nurse, residents and unit secretary have your preferred method of reaching you during your shift, e.g. pager, in-house phone.

Record start and end times properly. Compensated payroll hours are calculated based on actual hours worked and must have appropriate documentation in at least one or both of the following methods.

Sign-in the duty log book when arriving and completing the shift. This log book is located in the "Chart Room" in L&D. All RPs will sign in on arrival and when completing their shift. It should also be used to record each billable service provided during the shift in addition to completing billing sheets, as described in the "Billing" section below.

Enter start and end times in API Timecards for payroll processing. Non-Medical Group physicians must enter their start and end times in API; Medical Group physicians must enter their hours as a calendar entry in API.

Remain physically on-site during the entire shift. RPs must remain within the confines of Evanston Hospital and should be readily available in the event of an emergency. RPs are not required to be in the Women's Hospital when their presence is not needed, but may not leave hospital buildings. Specifically, the medical office buildings at 1000 Central Street or 2500 Ridge are not considered within the confines of Evanston Hospital. Inform the various staff when you leave the Women's Hospital.

Serve as the team leader and general resource for Labor and Delivery staff. The Resource Physician has a key role in maintaining safety by working in concert with other team members to monitor the clinical course of all patients in L&D, including those being managed primarily by other physicians, whether those physicians are on- or off-site. The resource physician should be available for consultation or provision of assistance for any patient at the request of any member of the team. The RP should initiate such interactions if s/he has concerns about management.

Schedule major procedures for private patients outside of scheduled OB Coverage shifts. Do not schedule non-obstetric procedures for private practice patients while on duty. During scheduled hours, RPs may engage in other professional activities as long as these activities will not interfere with RP responsibilities.

Arranging for substitute physician coverage for any schedule changes. Covering physicians must be contracted Resource Physicians.

During normal business hours, the scheduled RP will notify the Department Administrator at x2521 or jkurtz@northshore.org and L&D at x2222 of all changes.

After normal business hours, when the scheduled physician is unable to report for or complete their shift as scheduled due to an emergency, he or she will page Jennifer Kurtz at 6896 and Deanna Hanks at 7158 to coordinate timely coverage.

Clinical Activities Supervise all clinical care for NCHC patients. This includes obstetric patients in L&D, the Women's Hospital and other locations in the hospital who have had vaginal deliveries, cesarean sections, tubal ligation, amniocentesis, NSTs, AFIs, versions, other procedures and encounters. It does not include antepartum patients who are followed by Maternal-Fetal Medicine (MFM). The RP should alert the MFM attending or the antepartum residents that a patient has been admitted to the MFM service.

This also includes supervision of gynecologic patients Emergency Department evaluations, admissions, surgery, pre- and post-operative examinations and rounds, and requested inpatient consultations.

Evaluate and document patients in a timely manner. The RP must see all NCHC patients whether they present in L&D or another location, evaluate patients in the Emergency Department and/or admit patients to the hospital in a timely fashion and document their notes in the Epic chart. When patients are in labor over more than one RP shift, each RP is required to write a note on his or her shift.

Provide urgent, emergent or attending coverage for all patients, as indicated, or if requested by nursing or a resident

Assist the multi-disciplinary team. Provide assistance to any attending, resident, student or the nursing staff with various tasks as indicated or if requested, especially when the service is busy.

Review and sign-off on all EFM records. Review, document and sign-off on monitor strips, NSTs and AFIs before the end of the shift for patients who are evaluated and then discharged undelivered. The sign-off must be documented in the patient chart, noted in the 'Monitoring Log Book' and include any strip which may have been overlooked from a previous shift.

Billing Complete pink billing sheets for all billable services. Pink sheets are found in the Chart Room. Billable services include, but are not limited to, deliveries (NSVD, CS, VAVD, twins, terminations), gyn surgeries, NSTs, AFIs, ER evaluations, non-surgical gynecological admissions, antepartum admissions, discharge day visits for non-surgical patients, circumcisions, consultations, amniocentesis, versions, etc.

Document NSTs. Women presenting to L&D at or beyond the point of fetal viability (generally >24 weeks of gestation) who have fetal heart rate monitoring will have an NST ordered, performed and interpreted. Exceptions to this clinical expectation would need to come from the covering attending physician. The RP will complete a pink billing sheet in addition to documenting in the patient record and the 'Monitoring Log Book' (see section 2.H. above). This RP responsibility is applicable to service patients and private patients unless the private attending physician chooses to review and document contemporaneously in Epic.

Document AFIs. The RP is responsible for completing a pink billing sheet in addition to documenting in the patient record and the 'Monitoring Log Book' (see section 2.H above) when a Limited U/S is performed.

Enter billable events in the log book.

Safer Healthcare Duties Function as special teams member. The RP is a member of the OB Hemorrhage/Rapid Response Team, will carry that pager during assigned shift and respond to all events as requested.

Participate in Team Briefings and Debriefings. The RP will participate in Briefings in the morning, evening and as indicated. The RP will also participate in debriefings following an event or as requested.

Serve as the Team Leader for staff in L&D (see 1F above).

Teaching Activities Participate in Resident sign-out. RP will participate at resident sign-out at 0700 and 1800 on weekdays and 0900 and 1800 on weekends. Follow-up on any inpatient GWS patients with the GYN team.

Round on inpatients. Make inpatient rounds every morning for the day shift RP on OBS and GWS patients, supervising the residents and students.

Seek opportunities to teach and include the residents and students in patient care.

Additional Physician Teaching Responsibilities for the Weekday Daytime RP

Attend scheduled weekly conferences with residents and students whenever possible (Perinatal conference, Grand Rounds, etc.)

Participate in article discussion at Wednesday resident presentations. The PGY-3 resident on night float rotation presents an article from the list on the educational depot or an article suggested by the RP. The presentation follows Resident Rounds at 0730 and the RP acts as a discussant. The article should be available to the RP prior to Rounds and the presentations should take approximately 10 minutes.

Meet with all available residents for GYN rounds Monday and Friday afternoons - as arranged with the residents. This may include a review of patients currently in the hospital or case presentations and should include relevant diagnostic studies and pathology review whenever possible.

Participate in periodic performance reviews for appropriate department members.

Evaluate all learners on the OB and GYN service. At the completion of each rotation RPs are responsible for completing evaluations for residents and students with whom he/she has interacted.

Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. For more information, visit www.endeavorhealth.org.

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