Policy on Resident Supervision in Pediatrics

General Statements:

• The attending physician has the responsibility for the plan and implementation of care for each of his/her patients. This plan must be devised in conjunction with house staff and consulting physicians when they are integral to the patient's care.

• Every patient has an attending of record that is ultimately responsible for their medical oversight, supervision, and coordination of treatment.

• The attending physician is responsible for providing oversight and supervision for all care provided by trainees, and must themselves be credentialed in procedures requested for implementation by the resident.

• Attending physicians are expected to behave in a professional manner at all times, and are to encourage trainee questions and interactions.

• If a resident team requests attending presence, either the attending or an appropriate surrogate/supervisor will come to the medical setting for direct assessment and guidance.

Attending Physician Supervisory Responsibilities:

1. The attending physician must develop or confirm a plan for the medical management of each patient in conjunction with the house staff and consulting services. This plan must be placed into the medical record within 24 hours of patient admission.

2. The attending physician must participate in the daily assessment of patients overall health status, including updates in laboratory, specialist, nursing, and psychosocial information.

3. The attending physician is responsible for the implementation of the plan of care and for documentation of the plan in the medical record as standardized by current Medicare guidelines.

4. The attending of record or appropriate surrogate (e.g. practice associate) must see and examine his/her inpatients every day, and communicate with a member of the housestaff team regarding the day's plan.

5. The attending of record or appropriate surrogate is responsible to ensure that housestaff know how to contact them at any time during the child's medical course (e.g. noting a pager number, cell phone number, back line office number, times of availability, coverage contact for the weekend, etc.) Clear contact information is to be entered in the written documents on the patient's active medical record.

6. If any circumstance arises in which a resident cannot locate an attending physician, or a resident cannot resolve a question or conflict with an attending physician, the resident should contact a more senior physician The designated physicians are, in ascending order: senior resident on duty, pediatric chief resident, inpatient medical director, pediatrician-in-chief/chair of pediatrics.

7. Any concerns regarding policies as outlined above are to be brought to the attention of the Medical Inpatient Director.