resident:va
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| resident:va [2023/07/12 08:57] – taylor | resident:va [2026/04/17 13:21] (current) – [Clinic] ariel | ||
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| ==== VA Faculty ==== | ==== VA Faculty ==== | ||
| - | [[resident: | ||
| - | [[resident: | ||
| + | [[resident: | ||
| + | [[resident: | ||
| ==== Generic Monthly Schedule ==== | ==== Generic Monthly Schedule ==== | ||
| - | Subject to change! | + | Subject to change! Melissa |
| - | Hand fellow usually covers Weds hands cases--check weekly with fellow or Melissa. \\ | + | |
| + | General Schedule | ||
| ^ ^ Tuesday ^ Wednesday ^ Thursday ^ | ^ ^ Tuesday ^ Wednesday ^ Thursday ^ | ||
| - | |Week 1 - Dr. Mathes |Gordon 8 AM Plastic Clinic (door code is 3-2-4), PM Gordon Hand Clinic | AM Gordon Hand OR (Fellow covers), | + | |Dr. Mathes |AM/ |
| - | |Week 2 - Dr. Gordon| Mathes 8 AM Plastic Clinic, PM Gordon Hand Clinic | AM Gordon Hand OR (fellow), AM/PM Hand Clinic | Gordon Plastic OR - 7:45AM Start | | + | |
| - | |Week 3 - Dr. Mathes | + | |
| - | |Week 4 - Dr. Gordon | Mathes 8 AM Plastic Clinic, PM Gordon Hand Clinic | AM/PM Gordon Hand Clinic | Gordon Plastic OR - 7:45AM Start | | + | |
| - | |Week 5 - Dr. Mathes | Gordon 8 AM Plastic Clinic, PM Gordon Hand Clinic| AM Gordon Hand OR (fellow), AM/PM Hand Clinic | Mathes Plastic | + | |
| ==== VA Templates ==== | ==== VA Templates ==== | ||
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| ^ Phone Numbers ^ Role ^ ^ | ^ Phone Numbers ^ Role ^ ^ | ||
| - | | Vocera | Calling system, return pages | 303 299 8020 | | + | | Vocera | 15239 | 720-857-5239 |
| - | | IT | 14681 | 855 637 4357| | + | | IT | 14681 | 8556734357 |
| | ED | 16298 | | | ED | 16298 | | ||
| | DJ | Plastics RN | 303 803 5199 | | | DJ | Plastics RN | 303 803 5199 | | ||
| - | | Mary | Plastics | + | | Zeina Omisola |
| | Jenn Hutton | SCI Wound Care RN | 720 469 8217 | | | Jenn Hutton | SCI Wound Care RN | 720 469 8217 | | ||
| - | | Melissa Munkwitz | Ortho Hand PA | 414 587 8491 | | + | | Melissa Munkwitz | Hand/PRS PA | 414 587 8491 | |
| + | | IT Help Desk| 855 673 4357 | | ||
| VA Prefixes: 720-857-xxxx or 720-723-xxxx. Use this last number to call back pages. ie. 1-2345, call 720 723 2345 skipping the 1.\\ | VA Prefixes: 720-857-xxxx or 720-723-xxxx. Use this last number to call back pages. ie. 1-2345, call 720 723 2345 skipping the 1.\\ | ||
| - | Vocera: | + | Vocera: |
| + | |||
| + | ==== VA APP'S ==== | ||
| + | The VA now has APP's that help manage inpatient needs and consults. There are sometimes gaps in coverage. If you admit a patient, please sign out to them so that they know the plan in case they get called (this limits phone calls to you!) | ||
| + | |||
| + | {{: | ||
| + | {{: | ||
| ==== VA Remote Access ==== | ==== VA Remote Access ==== | ||
| - | Get Card reader either from VA (will loan, but may lock you up if you lose it) or Amazon. Make sure MAC compatible if user\\ | + | Get Card reader either from VA IT (as of June 2024 they don't write down your info and don't care about getting |
| - | https:// | + | https:// |
| - | https:// | + | https:// |
| Make sure you have received Welcome Letter in email giving remote access. IF you have not, email Ashley.Herrera@va.gov \\ | Make sure you have received Welcome Letter in email giving remote access. IF you have not, email Ashley.Herrera@va.gov \\ | ||
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| ==== General Information & Onboarding ==== | ==== General Information & Onboarding ==== | ||
| - | Welcome to the VA. The senior resident has good autonomy at this location and you are expected to run the service. We no longer have a PA or interns on service (including night coverage). Mary Maddox is the plastics scheduler. For cases at the VA, it is VERY important to make sure you have everything ordered beforehand. They won't have anything like Integra or implants on consignment.\\ | + | Welcome to the VA. The senior resident has good autonomy at this location and you are expected to run the service. We no longer have a PA or interns on service (including night coverage). For cases at the VA, it is VERY important to make sure you have everything ordered beforehand. They won't have anything like Integra or implants on consignment.\\ |
| Signing up for the VA can be a huge hassle. Please start the process as early as possible. You will need the following processes to get started with onboarding\\ | Signing up for the VA can be a huge hassle. Please start the process as early as possible. You will need the following processes to get started with onboarding\\ | ||
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| *Complete VHA Mandatory Training for Trainees-Refresher (if done before), VHA Mandatory Training for Trainees (if not done)\\ | *Complete VHA Mandatory Training for Trainees-Refresher (if done before), VHA Mandatory Training for Trainees (if not done)\\ | ||
| *If you need help with your TMS Account when you log in please contact 1(855) 673-4357 or email VHAECHTMSHelpDesk@va.gov\\ | *If you need help with your TMS Account when you log in please contact 1(855) 673-4357 or email VHAECHTMSHelpDesk@va.gov\\ | ||
| - | *Please email Selena | + | *Please email PRS Program Coordinator |
| *Review VA Policies and then sign the VA Local Policies Acknowledgement Form and return it to Selena.\\ | *Review VA Policies and then sign the VA Local Policies Acknowledgement Form and return it to Selena.\\ | ||
| *{{ : | *{{ : | ||
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| *Recommended: | *Recommended: | ||
| *VA WOC Letter\\ | *VA WOC Letter\\ | ||
| - | *Selena | + | *Program coordinator |
| *If completed and held up at this stage Please reach out to VHAECHSurgeryPSA@va.gov .Michael T. Kilmer is the director who signs the letters\\ | *If completed and held up at this stage Please reach out to VHAECHSurgeryPSA@va.gov .Michael T. Kilmer is the director who signs the letters\\ | ||
| *VA Badging (after completion of fingerprints)\\ | *VA Badging (after completion of fingerprints)\\ | ||
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| |Men's Locker #59 | 8008 | | |Men's Locker #59 | 8008 | | ||
| |Woman' | |Woman' | ||
| + | |||
| + | ====Expired Badges==== | ||
| + | * OH NO I HAVEN' | ||
| + | * EMERGENT: Call Police Dispatch 720-723-5800 and request reactivation for emergent purposes. This gets recorded in Facility Access Section for follow-up and verification with the supervisor/ | ||
| + | * NON-EMERGENT: | ||
| + | * If you are already on campus when you realize this, use intercom button at entrance of staff garage marked " | ||
| ==== Meals ==== | ==== Meals ==== | ||
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| ==== Clinic ==== | ==== Clinic ==== | ||
| - | Plastics Clinic | + | Hand clinic and Plastics Clinic: |
| - | + | 1st floor, building E. Code 251 enter. On Tuesdays it is you, Mathes, Dr. Tebockhorst | |
| - | Hand clinic: | + | |
| - | 1st floor, building E. Code 154 enter. On Tuesdays it is you, Dr. Gordon | + | |
| Clinic names on CPRS: \\ | Clinic names on CPRS: \\ | ||
| Plastics: Rmr Surg Plastc (MD MPR, MD Oper, MD/PA, MD/PA postop, Md/PA preop, MD/Res Eval) (VVC is video)\\ | Plastics: Rmr Surg Plastc (MD MPR, MD Oper, MD/PA, MD/PA postop, Md/PA preop, MD/Res Eval) (VVC is video)\\ | ||
| Hand: Rmr Surg Hand (MD, MPR, OPer, Md/PA urgent, Pa post, pa screen)\\ | Hand: Rmr Surg Hand (MD, MPR, OPer, Md/PA urgent, Pa post, pa screen)\\ | ||
| - | Make sure if scheduling patient for follow-up via RTC in orders, you select the correct follow-up clinic\\ | ||
| - | If you have a case to schedule, the patient should be provided a business card with the contact information for the office (Krysta has those available). | + | Note Formats on CPRS:\\ |
| + | I recommend | ||
| + | When you click "new note" it will pop up with progress note title:\\ | ||
| + | Plastics: PLASTIC SURGERY RESIDENT/ | ||
| + | Hand: Type in Hand --> will pop up options, select HAND RESIDENT CLINIC NOTE\\ | ||
| + | Sign notes by right clicking and selecting "sign note now" | ||
| + | It will show a prompt saying "are you the primary for this encounter" | ||
| + | You have to select encounter type, complexity, add Dr. Gordon, and diagnosis for encounter, then sign\\ | ||
| + | |||
| + | For pre-ops patients, patients need: an H&P (select " | ||
| - | For pre-ops, patients | + | For pre-op labs: Women < |
| - | For pre-op labs: Women <50 need HCG (under pre/post procedure orders-pre-labs-urine pregnancy), BINAX (under labs- POC), pre-procedure (NPO/ | + | If ordering studies/labs that require follow-up or change management |
| - | ==== PACS ==== | + | ==== IMAGING |
| - | PACS is IMPAX here. Click the icon on the desktop and search by using the last #4 of patient' | + | PACS is IMAGING PACS (XERO Viewer) here. |
| - | You can also access | + | Access |
| 1. Tools | 1. Tools | ||
| 2. Imaging Apps | 2. Imaging Apps | ||
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| 4. Type in patient' | 4. Type in patient' | ||
| - | ==== Clinic Notes ==== | ||
| - | |||
| - | Make sure you always set up an encounter by right clicking note, select edit encounter and select yourself as a primary provider. Also select billing level of complexity, whether condition is service related, and a diagnosis for the encounter. Then write the note - there are specific plastic surgery headings to select. You can create your own template or use a pre-populated one. When you sign the notes - you are the " | ||
| - | |||
| - | If you are seeing a NEW patient consult: | ||
| - | If you are seeing a patient for follow-up, post-op: | ||
| - | If you are seeing a pre-op: “Surgical pre-op H&P” then follow the prompts and check all the boxes\\ | ||
| ==== Surgery ==== | ==== Surgery ==== | ||
| + | Find surgery schedule by selecting clinic schedule RMR SURG PLASTC MD OPER. All Gordon hand cases are now under this schedule as well\\ | ||
| + | \\ | ||
| + | \\ | ||
| The plastic surgery operating room day is Thursday. The first case is supposed to roll into the room before 08:00 AM to not be deemed " | The plastic surgery operating room day is Thursday. The first case is supposed to roll into the room before 08:00 AM to not be deemed " | ||
| - | Residents wear blue scrubs at the VA. There is a scrub card that can be obtained from the administrator' | + | Residents wear blue scrubs at the VA. There is a scrub card that can be obtained from the administrator' |
| To check the OR status, go to Sharepoint and search for "VA ECHCS Perioperative Services" | To check the OR status, go to Sharepoint and search for "VA ECHCS Perioperative Services" | ||
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| You can also go into VistA under " | You can also go into VistA under " | ||
| - | Prior to procedure, patients need orders, a pre-op H&P (by attending) and a consent. You do not need to write note on day of surgery. | + | Prior to procedure, patients need orders, a pre-op H&P (by attending) and a consent. You do not need to write note on day of surgery. |
| + | |||
| + | Ordering Tumescent: Go to surgery main menu, order tumescent\\ | ||
| ==== Admitting Patients ==== | ==== Admitting Patients ==== | ||
| - | Under orders, "Write Delayed Orders" | + | Under orders, "Write Delayed Orders" |
| - | "Admit to Plastic Surgery", | + | "Admit to Plastic Surgery", |
| - | Surgery Main Menu - can use general surgery | + | Click inpatient orders for all the below orders, and start by going through all the " |
| - | Go through each tab | + | Next in same menu, click " |
| + | Select NURSING free text (0) for free text wound care instructions\\ | ||
| + | Click " | ||
| + | Labs can be found under own menu listed on left of CPRS\\ | ||
| + | Restarting home meds: click on meds tab at bottom of CPRS--> Select all outpatient meds you wish to restart --> open action menu at top left of CPRS--> select transfer to inpatient.\\ | ||
| + | Vitals and I& | ||
| + | Pre-op attending H&P counts as admission H&P, but you need to write a Life-Sustaining Treatment note to be able to order their code status and admit them. Click New Note and type in Life to find note template. \\ | ||
| + | Can sign a bunch of orders at once by clicking File > Refresh Patient Information.\\ | ||
| ==== Discharging Patients ==== | ==== Discharging Patients ==== | ||
| Admitted patients will go to the Building K - 3rd floor.\\ | Admitted patients will go to the Building K - 3rd floor.\\ | ||
| Prior to discharge INPATIENTS, the patients will need:\\ | Prior to discharge INPATIENTS, the patients will need:\\ | ||
| + | (Clicking discharge menu under orders will walk you through this)\\ | ||
| - Discharge order\\ | - Discharge order\\ | ||
| - | - Discharge Instructions (under Notes-discharge instructions)\\ | + | - Discharge Instructions (under |
| + | - Med rec (Meds tab, under Inpatient Meds. Click on med you want to prescribe and click Action > | ||
| - Pharmacy Consult\\ | - Pharmacy Consult\\ | ||
| - | - Pain medication\\ | + | - place a nurse free text order for drain teaching if applicable\\ |
| - Operative Note must be dictated the same day\\ | - Operative Note must be dictated the same day\\ | ||
| - | - Discharge summary (under D/C Summ tab)\\ | + | - Discharge summary (under D/C Summ tab, click new summary, DISCHARGE SUMMARY)\\ |
| - | (Clicking discharge menu under orders will walk you through this)\\ | + | |
| Prior to discharge OUTPATIENTS, | Prior to discharge OUTPATIENTS, | ||
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| For narcotic prescribing, | For narcotic prescribing, | ||
| + | \\ | ||
| + | Can sign a bunch of orders at once by clicking File > Refresh Patient Information.\\ | ||
| ==== Dictations/ | ==== Dictations/ | ||
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| 1. To access dictation system:\\ | 1. To access dictation system:\\ | ||
| From within the facility, dial x15075\\ | From within the facility, dial x15075\\ | ||
| - | From outside the facility, dial 800-394-3845\\ | ||
| When the call is answered, you will be greeted with a voice prompt which gives you instructions.\\ | When the call is answered, you will be greeted with a voice prompt which gives you instructions.\\ | ||
| 2. Enter your USER ID, followed by the # key. \\ | 2. Enter your USER ID, followed by the # key. \\ | ||
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| 3. REWIND AND PLAY\\ | 3. REWIND AND PLAY\\ | ||
| + | DRAGON SUPPORT: | ||
| + | \\18006541187 | ||
| + | \\18008337776 | ||
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| SCI - This is the inpatient spinal cord unit (first floor of H). This unit is run by PMNR doctors and wound care. | SCI - This is the inpatient spinal cord unit (first floor of H). This unit is run by PMNR doctors and wound care. | ||
| * There are no longer MDC meetings | * There are no longer MDC meetings | ||
| - | * Krysta typically gets first call. Whoever you are in clinic or OR that day is who I tend to staff the patient with. | + | * See Plastic Surgery TEAMS spreadsheet for pending SCI consults. You keep this up to date |
| + | * Whoever you are in clinic or OR that day is who I tend to staff the patient with. | ||
| * Our criteria is that their co-morbidities are relatively well-controlled, | * Our criteria is that their co-morbidities are relatively well-controlled, | ||
| * Intraoperatively, | * Intraoperatively, | ||
| * Postoperatively, | * Postoperatively, | ||
| - | * Patients are typically seen every Tuesday after clinic. Will see with Krysta. Have her or the charge nurse call for wound care nurse (Jen) to help you turn and go over what they have been doing for wound care. Unless ongoing concern for a wound, we typically stop following a week or two into their motion protocol. | + | * Patients are typically seen every Tuesday after clinic. Have her or the charge nurse call for wound care nurse (Jen) to help you turn and go over what they have been doing for wound care. Unless ongoing concern for a wound, we typically stop following a week or two into their motion protocol. |
| * Criteria: | * Criteria: | ||
| * Co-morbidities are relatively well-controlled, | * Co-morbidities are relatively well-controlled, | ||
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| ==== End of rotation Tasks ==== | ==== End of rotation Tasks ==== | ||
| - | Set up a Surrogate: In CPRS - under “Tools” —> select “Options” —> select Surrogates —> select “Add Surrogate” put in name of next resident coming onto rotation and select start date as your last Friday on rotation (just make sure you clear your inbox your last day of rotation) | + | Set up a Surrogate: In CPRS - under “Tools” —> select “Options” —> select Surrogates —> select “Add Surrogate” put in name of next resident coming onto rotation and select start date as your last Friday on rotation (just make sure you clear your inbox your last day of rotation)\\ |
| + | |||
| + | Make sure TEAMS spreadsheets for SCI consults & Tasks to follow up are updated.\\ | ||
resident/va.1689166638.txt.gz · Last modified: 2023/07/12 08:57 by taylor