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Department of Neurology

 
 

 

INNOVATIVE ON-CALL AND TEAM STRUCTURE


 

 


  Our Neurology Department adopted a new service schedule in 2012 that optimized the team structure seven days a week, both during the day and night. Teams include the day teams, short-call evening team, and the night service team.

Day Teams:  During the day, the Stroke and General services admit patients and see consults in their respective specialties.  The General and Stroke teams have an attending, senior neurology resident (PGY4), an assistant senior neurology resident (PGY3), and 2 or 3 junior neurology residents (PGY2). In addition, there are rotating residents from internal medicine, emergency medicine, and psychiatry, as well as 4th year acting interns and 3rd year medical student clerks. The Stroke Team also has a Vascular Neurology Fellow. 

Short Call Evening Team:  From 4 pm through 10 pm, the Short Call Evening Team consistent of a supervising PGY3 resident, one junior neurology PGY2 resident, as well as rotating residents from other services and medical students. This team covers new admissions and consults up to 10 PM as well as covering the patients previously admitted on the Stroke and General Services. Attendings from the General, Stroke, Epilepsy, and NeuroICU services are on pager call all evening.

Night Service Team: From 10 pm through 8 AM, the Night Service Team consistent of a senior PGY4 neurology resident and a junior PGY2 neurology resident.  The Night Service covers all consults and admissions, as well as taking care of issues on the regular Stroke and General Teams. Attendings from the General, Stroke, Epilepsy, and NeuroICU services are on pager call all night.

There are formal verbal and electronic sign-outs twice a day, between the day and evening teams; and between the evening and night service team.

The advantages of our system are  the following:

●  All neurology residents will sleep in their own bed at home every day during the residency.
●  Working all day and then being on call at night no longer exists.
●  No resident will work longer than a 16 hour shift.
●  Junior residents on the Stroke and General Services will never need to miss rounds where in the past they where required to leave post-call.

●  Junior residents on the Stroke and General Services will never need to miss any of their continuity clinics where in the past they where required to leave post-call. If their clinic time fell on a date post-call, the clinic needed to be cancelled in the past.
●  Junior residents on the Stroke and General Services are able to attend more educational conferences, as in the past they where required to leave post-call and where not permitted to stay, even to attend teaching conferences later in the day.