• 24-Hour Solo Coverage for Rural Hospital

• Overview:

• This position involves 24-hour solo coverage at a Critical Access Hospital, typically entailing 12-15 hours of on-site work with the remainder on call. The physician is provided with nearby or on-site sleeping arrangements.

• Key Requirements:

• Hospitalists must be proficient in performing emergency intubations, ventilator management, and central line placements.

• Required Procedures:

• Ventilator Management, Central Lines, Intubations.

• Coverage Details:

• Orientation:

• 7/30

• Shift Coverage:

• 8/1•8/11•

Schedule:

• Start Time:

• Daily shifts commence at 12:00 PM.

• Orientation Arrival Time:

• To Be Determined.

• Typical End Time:

• 12:00 PM daily.

• Clinical Settings:

• Total Beds:

• 25 (Critical Access Hospital)

• Average Daily Census:

• 12 patients (14.5 average daily encounters).

• ICU Capacity:

• 6 designated ICU beds.

• Procedures Required:

• Ventilator Management, Central Lines.

• Nights:

• Anticipate 1-2 admissions per night; transition orders are to be utilized post-10 PM unless the patient requires ICU care—protected sleep hours are between 10 PM to 6 AM.

• Specialty Support:

• Available specialties include General Surgery, Cardiology, Neurology, Dermatology, Obstetrics, and an outpatient pharmacy operating 24/7.

Interventional Radiology is accessible Monday through Friday with physician-to-physician call support from hospitalists. Imaging services and Orthopedics typically manage their patient coverage, and surgical consults will engage with hospitalists as needed. Night and weekend coverage requirements may differ.

• Electronic Medical Records:

• EMR System:

  Cerner

• Administrative Notes:

• Sleeping Amenities:

• On-site or adjacent accommodations for the physician.

• Credentialing Timeline:

• Expedite credentialing as soon as possible.

• Licensing Expedite Availability:

• Consideration for a "telemed" license that may serve as a temporary full license.

• Hospitalist Schedule:

• Shift Structure:

• 24-Hour on-site coverage (typically 12-15 hours in-shift with overnight call responsibilities).

• Admissions and Rounding:

• Shift handoffs occur daily between 12 PM and 3 PM.

• Morning Rounds:

• Typically commence between 7:00 AM and 8:00 AM, depending on facility protocol.

• Informal Evening Rounds:

• Conducting informal rounds between 9:00 PM and 10:00 PM can enhance collaboration with ED and nursing staff, potentially mitigating late-night admissions and allowing for adequate rest.

• Admissions:

• Given the rural setting, it's critical to evaluate patients in the ED prior to admission to avoid unnecessary transfers, especially considering variable ED skillsets. Transition orders are to be used during overnight and busy daytime hours to optimize ED throughput.

• Overnight Admissions:

• Admissions between 11:00 PM and 6:00 AM will require transition orders from ED physicians to reduce documentation burden. Morning rounds should include evaluations of overnight admissions, particularly ICU patients requiring immediate bedside assessment.

• Discharges:

• Awareness of patients scheduled for discharge is crucial prior to rounding; these patients should be identified during interdisciplinary meetings and prepared by case management to ensure readiness for timely discharge.

• Patient Expectations:

• Patients should be informed of their discharge plans the previous day, aiming for an early release, typically by noon, to facilitate efficient care transitions and room turnovers for incoming admissions.

• Certifications Required:

•

Board Certification:

Yes ACLS:

Yes Additional Certification:

Stroke Certification.