OUTPATIENT MEDICINE Intern Bootcamp 2019 2020 Outpatient Schedule

OUTPATIENT MEDICINE Intern Bootcamp 2019 -2020

Outpatient Schedule AM Clinic: 8: 00 AM, but variable depending on clinic PM clinic: 1: 00 PM Location: IPT, OPD, or Rand Schrader Clinic Locatio n AIDS/ID Rand Monday Schrade r nd Tuesday (2 fl) Cardiology Endocrine GI/Liver Hematology A 4 A A 4 B 5 p 1 A 4 A Start Time 8: 30 AM Clinic Locatio n Start Time Neurology A 4 A Monday 8: 00 AM A 4 B Wednesday 8: 00 AM Friday (Epillepsy) 8: 00 AM Monday (Breast) 8: 00 AM, 1: 00 PM 8: 30 AM, 1: 00 PM Wednesday 9: 00 AM, 1: 00 PM Monday 1: 00 PM Wednesday 1: 00 PM Tuesday (GI) 8: 00 AM Wednesday 9: 00 AM Wednesday (Neuro/ Melanoma/ Sarcoma) 8: 00 AM Thursday (H&N, Other) 8: 00 AM Friday 1: 00 PM Pulmonary A 4 B Wednesday 1: 00 PM Monday (Hepatitis) 8: 00 AM Renal 5 p 1 Tuesday 1: 00 PM Wednesday (GI) 8: 00 AM Thursday 1: 00 PM Friday (Liver) 8: 00 AM Monday (RA) 1: 00 PM Tuesday (Malignant) 1: 00 PM Tuesday (SLE) 8: 00 AM Thursday (Benign) 8: 00 AM, 1: 00 PM Oncology A 2 C Rheumatology 5 p 1

General Tips ■ New or returning patient? ■ Resident- or fellow-level patient? ■ Previously ordered labs/diagnostics completed? ■ Stay focused on consulting problem: – If deferring workup/management of other, nonurgent issues to PMD, make sure they have a PMD and/or close follow-up (can send message to 4 p 1 clinic staff) – Document any changes to management, labs/diagnostics and follow up – If patient needs to go to ED, call Resus (91619) and obtain approval from Resus attending (document in note attending’s name, location to be sent) ■ Complete the following tasks in clinic for each patient: – Charge completion (billing) – Medication reconciliation – All orders (lab/MRI/future appts) – Complete note and sign**if unable to complete all notes by end of clinic, let attending know

Overview ■ Rand Schrader ■ Cardiology ■ Endocrine ■ GI/Liver ■ Hematology ■ Oncology ■ Neurology ■ Renal ■ Rheumatology ■ Pulmonary

Rand Schrader Location: 1300 N Mission Rd, Los Angeles, CA 90033 Schedule ■ Monday: Core Lecture @ 8 am on 3 rd floor, Clinic begins 8: 30 am on 2 nd floor ■ Wednesday: Clinical Case Conference @ 8 am on 3 rd floor ■ Lectures/conferences are required for ID consult team, +1 interns/residents Workflow ■ Paper charts (pending resident/fellow panels) ■ Look up patients by MRN Tips ■ Ask ID team if lectures/conferences are scheduled night prior to clinic ■ Give yourself ample time for parking and/or walking ■ Know microbiology, serologies, antibiotics (duration, interruptions)

Cardiology Location: CT A 4 A Schedule ■ Monday: 1 pm ■ Wednesday: 1 pm Workflow ■ Paper charts (pending resident/fellow panels) ■ Look up patients by MRN Tips ■ EKG available in clinic (until 4 pm) ■ Ordering TTE: – CV Echocardiogram Transthoracic Complete – Priority (Routine) – Transport mode (Ambulatory, Wheelchair) – To be scheduled at: LAC+USC Appointments ■ Ordering Stress tests: always order these together – CV Exercise Nuclear Stress Test – NM Myocard Perfusion Gated Spect Multi

Endocrine Location: CT A 4 B Schedule ■ Wednesday (General): 9 am ■ Thursday (Thyroid): 8 am ■ Friday (Thyroid): 1 pm Workflow ■ Paper charts (pending resident/fellow panels) ■ Look up patients by MRN Tips ■ Hypo-/Hyper-thyroidism: TSH, FT 4 (other tests: T 3, anti-TPO or TSI antibodies) ■ Thyroid nodules: T 4, T 3, radionuclide scan (consider FNA biopsy) ■ Thyroid cancers: TSH (suppression), thyroglobulin (residual thyroid tissue), thyroglobulin antibodies (surveillance); for MTC, get calcitonin and RET for possible MEN 2 A/2 B) ■ Pituitary disorders: pertinent pituitary hormones, MRI brain ■ Can perform supervised thyroid biopsies in clinic!

GI/Liver Location: OPD 5 p 1 Schedule ■ Monday (Hepatitis): 8 am ■ Wednesday (GI): 9 am ■ Friday: 8 am Workflow ■ Assigned panels on check-in ■ Home tab > Patient dropdown>USC GI Resident or USC Liver Resident Tips ■ GI: most residents will be scheduled to see NEW patients (write full H&P) ■ Liver: MS 3 style presentation, have all pertinent labs/diagnostics available ■ Send patients who need stat labs to OPD lab immediately in clinic (otherwise, send to ED)

Hematology Location: CT A 4 A Schedule ■ Tuesday (Malignant): 1 pm ■ Thursday (Benign): 8 am, 1 pm Workflow ■ Paper charts (pending resident/fellow panels) ■ Look up patients by MRN Tips ■ Resident or Fellow-level patient ■ Start presentation with: “Patient is here for (Hematologic Dx)” ■ Know pertinent labs and recent changes in therapy ■ If patient needs urgent labs or transfusions, will need to send to ED

Oncology Location: CT A 2 C Schedule ■ Monday (Breast): 8 am, 1 pm ■ Tuesday (GI): 8 am ■ Wednesday (Melanoma/Sarcoma/Neuro): 8 am ■ Thursday (Head/Neck, Other): 8 am Workflow ■ Paper charts (pending resident/fellow panels) ■ Look up patients by MRN Tips ■ Resident or Fellow-level patient ■ Know recent labs, results of latest staging scans, interruptions to therapy ■ If patient needs urgent labs or transfusions/infusions, will need to send to ED ■ Tuesday: Wear a tie!

Neurology Location: CT A 4 A (Mon), A 4 B (Wed/Fri) Schedule ■ Monday (General): 8 am Huddle w/attending, 8: 30 am clinic starts ■ Wednesday (General): 8 am Huddle w/attending, 8: 30 am clinic starts ■ Friday (Epilepsy): 8 am for Didactics, 8: 30 am clinic starts Workflow ■ Check in with Luz/Tony (RN’s) for chart assignments ■ Complete the following tasks in clinic for each patient: – Charge completion (billing) – Medication reconciliation – All orders (lab/MRI/future appts) – Complete note and sign Tips ■ Ask for neurology tool kit before clinic begins ■ Watch neurology exam video: https: //vimeo. com/mphonline/review/132984587/

Nephrology Location: OPD 5 p 1 Schedule ■ Tuesday: 1 pm ■ Thursday: 1 pm Workflow ■ Assigned panels on check-in ■ Home tab > Patient dropdown> Nosrati, Saeid (labels sticky notes for pts to see) Tips ■ Send patients who need stat labs to OPD lab immediately during clinic

Rheumatology Location: OPD 5 p 1 Schedule ■ Monday (Rheumatoid Arthritis): 1 pm ■ Tuesday: Didactics @ 8 am with Dr. Quismorio ■ Tuesday (Lupus/Other) clinic starts at 8: 30 am Workflow ■ Assigned panels on check-in ■ Home tab > Patient dropdown> USC Rheum Lupus or USC Rheum Arthr Tips ■ Be prompt for 8 am Tuesday didactics ■ Order pertinent labs as recurring order (eg CBC, CMP, ESR/CRP, anti-ds DNA, vit D lvl)

Pulmonary Location: CT A 4 B Schedule ■ Wednesday: 1 pm Workflow ■ Assigned panels on check-in ■ Home tab > Patient dropdown> USC Pulm MD (check with RN) Tips ■ Resident or Fellow level patient? ■ Speak to RNs to help schedule diagnostic studies