Residency
Infectious Disease Consult Service Rotation
Preceptors:
Don Alexander, PharmD
Site Description:
ID Consult Service is responsible for all non-HIV consults for University Hospital (430 beds) and Huntsman Cancer Hospital (50 beds). There are 2 teams consisting of general infection consult and the immunosuppressed patient infectious diseases consult teams. Each consult team carries an average patient load of 6-8 patients. The teams consist of an attending physician, fellow, clinical pharmacist, and occasionally 1 medical Resident. The teams round daily in the afternoon.
Rotation Description:
The resident is responsible for optimizing anti-infective therapy for all consult team patients and is an integral member of the small consult team. The resident participates actively in daily patient-care rounds, literature evaluation, patient presentations, and disease and drug analyses and discussions. This rotation provides in depth training in antimicrobial management of the following infections: bone and joint, nosocomial, CNS, skin and soft tissue, respiratory, cardiovascular, and more. The resident is challenged to develop INDIVIDUALIZED therapeutic recommendations and monitoring plans daily. Development of critical thinking skills is paramount in this rotation. The team has daily rounds in the afternoons, usually 2-6 pm. The resident will be responsible to round for the entire period the team is rounding.
RLS Goals:
R2.1 As appropriate, establish collaborative professional relationships with members of the health care team.
- Implement a strategy that effectively establishes cooperative, collaborative, and communicative working relationships with members of interdisciplinary health care teams.
R2.6 Design evidence-based therapeutic regimens.
- Specify therapeutic goals for a patient incorporating the principles of evidence-based medicine that integrate patient-specific data, disease and medication-specific information, ethics, and quality-of-life considerations.
- Design a patient-centered regimen that meets the evidence-based therapeutic goals established for a patient; integrates patient-specific information, disease and drug information, ethical issues and quality-of-life issues; and considers pharmacoeconomic principles.
R2.8 Recommend or communicate regimens and monitoring plans.
- Recommend or communicate a patient-centered, evidence-based therapeutic regimen and corresponding monitoring plan to other members of the interdisciplinary team and patients in a way that is systematic, logical, accurate, timely, and secures consensus from the team and patient.
R2.10 Evaluate patients' progress and redesign regimens and monitoring plans.
- Accurately assess the patient's progress toward the therapeutic goal(s).
- Redesign a patient-centered, evidence-based therapeutic plan as necessary based on evaluation of monitoring data and therapeutic outcomes.
E7.4 Manage time effectively to fulfill practice responsibilities.
- Use time management skills effectively to fulfill practice responsibilities.
Activities Evaluated:
| Rotation Activity | RLS Goal | Teaching Method |
| Daily rounding and patient-specific recommendations with both the general and immunocompromised ID consult teams consisting of the ID attending, ID Fellow and occasionally a medical Resident. The resident must establish a professional role with the team. The average number of patients on each service is 6-8 patients. | R2.1 | M, C, F |
| The resident will learn how to assess the patients' needs for individualized therapy based on available patient information that is synthesized in an appropriate and comprehensive way using multiple information sources: electronic sources-PharmNet, PowerChart,TheraDoc, and from the paper chart. | R2.6 | I, M, C, F |
| The resident will develop their critical thinking skills through the daily preparation and discussions about current evidence, patient care, and therapeutic plan development and monitoring. | R2.6 | M, C, F |
| The resident will develop clear therapeutic plans and monitoring plans that they will recommend to the team and follow-up on in patient daily work-up and discussions with the team. | R2.8, R2.10 | M, C, F |
| The resident assesses alternative therapy and monitoring choices and discusses these for each patient on rounds and preceptor discussions. | R2.8, R2.10 | M, C, F |
| The resident is expected to establish priorities and manage their time effectively to deal with patient care requirements, responsibilities to the team and preceptor, read literature, develop their own skills in linking knowledge to patient care. | E7.4 | M, C, F |
Readings and Preparatory Work:
The resident is expected to identify their own search strategy to retrieve relevant readings and literature with general guidance and supplementation from the preceptor.
Presentation Description:
Daily presentations of patient care reviews/recommendations, disease and drug topics, and operational/stewardship issues.
Typical Daily/Weekly/Monthly Activities:
Daily presentations of patient care reviews/recommendations, disease and drug reviews, and operational/stewardship issues.
Residents are expected to work to care for patients, read, and discuss patients for as long as it takes to ensure best patient care.
Evaluation:
The resident will receive regular oral feedback regarding their thought processes and recommendations and follow-up. The resident will receive a short midpoint evaluation of their strengths and weaknesses at midpoint and a final summative evaluation that will be recorded in ResiTrak at the end of the rotation.
