Graduate Medical Education



Medical Student Rotation Manual


         January 2008
OUR MISSION

We will be the health care providers of choice in the communities we serve by continuously
improving our deli...
VISION FOR SOUTH POINTE HOSPITAL


To be recognized as the leading community health care resource in southern Cuyahoga/
no...
Institutional Commitment
                                     to
                       Graduate Medical Education


The o...
Welcome…
…..to South Pointe Hospital/a Cleveland Clinic hospital. You are about to become an
integral member of the best o...
South Pointe Hospital
         Workforce Diversity and Equal Employment Opportunity


By policy, South Pointe Hospital wil...
Code of Ethics
                                  Of The
                      American Osteopathic Association
           ...
Section 8
A physician shall not hold forth or indicate possession of any degree recognized as the basis
for licensure to p...
FACTS ABOUT SOUTH POINTE HOSPITAL

Background Information:

South Pointe, a 275-bed community teaching hospital, is locate...
VITAL STATISTICS:

Parent Corporation:                               Cleveland Clinic health system
Status:               ...
Departments by Floors:

Building B
 1st floor                                4th floor
       Administration             ...
Policies and Scope of
  Responsibilities




                        12
POLICIES:
SCOPE OF RESPONSIBILITIES:

As a medical student, you will work directly under the supervision of the intern, re...
Evaluations: Please provide your preceptor with your rotation evaluation form from your
school. All evaluations are to be ...
Medical Library: The library is staffed during normal working hours, however students and
employees can access it 24 hours...
PATIENT INFORMATION ACCESS:

MyPractice: You will receive a username and password on your first day of rotation. With
this...
COMPLETING HISTORY AND PHYSICAL GUIDELINES:

History and Physical:
   1. Must be on medical chart within 24 hours of admis...
Names of primary and assistant surgeons
       Anesthesia used

Discharge Summary:
   1. Must be dictated upon discharge o...
Late Entries:

   1. Late entries may be made in the medical record as follows:
         a. Late entries will be labeled a...
DRESS CODE AND ID BADGES:

South Pointe Hospital recognizes the importance of the professional appearance of its staff
in ...
has a bath and shower area. There is a shared lounge across the hall from the sleep rooms,
which contains a TV, DVD/VCR pl...
OHIO EMERGENCY CODES
                Code Name                                          Event
                 Code Red   ...
Employees should refrain from making inquiring phone calls during a “Red Alert”. The
operator will notify you of any perti...
Rotations




            24
ROTATIONS AVAILABLE AT SOUTH POINTE


Rotation                                      Duration    Number of
                ...
Descriptions of Rotations:
Anesthesiology:
This rotation will provide the student with a broad and comprehensive exposure ...
Preceptor:
Richard Garwood, D.O., Rotation Coordinator
Barbara Bakus, D.O.

Cardiology:
This rotation will emphasize the p...
Allen Kline, D.O.

Pulmonology:
This is an elective rotation, which is designed to combine bedside rounds and teaching in ...
Ophthalmology:
The student will be exposed to the presentation of the basic knowledge of examination and
diseases of the e...
Surgery/General:
Through participation in this rotation, the student will increase his/her knowledge base in
preoperative,...
Elective Rotations outside of South Pointe Hospital:

Ambulatory Underserved:
This rotation is scheduled at the Cleveland ...
Additional Information:

Forms
Unapproved abbreviations
Parking map




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Medical Student Rotation Manual

  1. 1. Graduate Medical Education Medical Student Rotation Manual January 2008
  2. 2. OUR MISSION We will be the health care providers of choice in the communities we serve by continuously improving our delivery of health services as part of the Cleveland Clinic health system. We will fulfill this mission by personal behaviors that exemplify the values of:  Clinical excellence  A safe environment for all  Ethics and integrity  Individual responsibility  Respect for diversity  Caring for others Our mission will be achieved through the following philosophies:  Enhancing the quality of life, preserving and restoring the health, and alleviating the pain and suffering in the communities we serve.  Promoting excellence and safety through continuous improvement in all our endeavors.  Embracing the contributions of diverse cultures throughout our organization.  Respecting the important role of the private practice of medicine.  Creating a caring, respectful and friendly environment, which allows each individual to do his or her best work, feel personally satisfied and reach his or her fullest potential.  Fostering teamwork and employee empowerment by building open, effective communication and decentralized decision making.  Supporting the role of individual hospitals in medical education.  Partnering with other individuals and organizations similarly committed to improving the health and quality of life in the communities we serve.  Encouraging individuals to take personal and professional responsibility for their activities and roles within the organization.  Supporting the improvement and development of the Cleveland Clinic health system. 2
  3. 3. VISION FOR SOUTH POINTE HOSPITAL To be recognized as the leading community health care resource in southern Cuyahoga/ northern Summit counties, providing the highest quality of care and service in a fully integrated health care campus, which attract and retains the most competent health care professionals. This leadership position will be achieved through the following six key strategies: 1. Enhance clinical and service quality utilizing the principles of total quality improvement. 2. Implement a patient focused care model by building on the success of the support service teams in order to redesign the patient care process. 3. Facilitate the integration of osteopathic and allopathic medical staffs to enhance trust, further physician partnerships, and foster shared governance. Restore the historic and new medical staff alliances to the merged medical campus. 4. Inspire a team of transitional leaders to embody the values of integrity, mutual respect and fairness, creating a climate of trust throughout the transition. This new organization will have the respect for the future, regard for the present and understanding of the past. 5. Identify, prioritize, and respond to the health-related needs of the communities we serve. 6. Enhance and promote the affiliation with Ohio University College of Osteopathic Medicine and create the most advanced osteopathic medical training program in the United States. The pursuit of this mission will be based upon the vision of the Health System, which states: The best place to receive care. The best place to practice medicine. The best place to work. This mission is in concert with the values of the vision statement, which reflect caring, excellence, ethics, integrity, individual responsibility, and the enhancement of the quality of life by which the rightness of our direction will always be measured. 3
  4. 4. Institutional Commitment to Graduate Medical Education The osteopathic teaching programs at South Pointe Hospital date back to our founding as Brentwood Hospital in 1957. We recognize the importance and value of osteopathic graduate medical education programs, which help to train the physicians who will serve future generations through the highest quality care. We affirm South Pointe Hospital’s commitment to Graduate Medical Education. The programs at the Institution will continue to emphasize the development of personal, clinical and professional competency under the careful guidance and supervision of the faculty. The programs will also continue to be monitored to be certain they provide safe and humane care of patients at the same time that our intern and resident physicians progress in responsibility as appropriate for their experience and competency. South Pointe Hospital is dedicated to train the future leaders in osteopathic medicine by providing organized and academically rigorous programs of education that foster physicians’ professional development as skilled, ethical, compassionate, and sensitive clinicians who are capable of meeting the challenges of a changing healthcare environment while assuring the highest possible quality of patient care. Our graduate medical education programs will promote the collaboration and development of a network that includes other local, regional and national institutions and affiliated community health centers. With this commitment, we recognize the necessity for adequate funding, facilities, support staff, and faculty teaching time to be certain that every program under our Institutional sponsorship offers the best possible training environment and opportunities. Reviewed 06/07 4
  5. 5. Welcome… …..to South Pointe Hospital/a Cleveland Clinic hospital. You are about to become an integral member of the best osteopathic facility in this state. Life as a medical student is a challenge and may seem overwhelming at times. The GME department recognizes your needs and has developed the GME Medical Student Rotation Manual to help you navigate your clinical rotations. When you have questions, ask your preceptor and/or refer to this manual. If you are unable to find the answer, feel free to stop by the GME department and ask the staff. We are here to support you during your time at South Pointe Hospital. Brian Kessler, D.O. Chief Academic Officer & Director of Medical Education Nealie Houk, MSHA Department Director, Graduate Medical Education Pauli Jaffe-Bokor Education Specialist Debbie Kenyon Coordinator, Skills Lab Donna Ayres Graduate Medical Education Assistant Lori Langley Department Secretary 5
  6. 6. South Pointe Hospital Workforce Diversity and Equal Employment Opportunity By policy, South Pointe Hospital will not discriminate against any employee or applicant for employment. We will act to assure that we treat applicants and employees equally, without regard to their race, color, religion, age, sex, sexual orientation, disability, national origin or status as a veteran. South Pointe forbids the use of racial, ethnic or sexual slurring or harassment in the work environment. We will enact disciplinary action for violations. Our commitment to workforce diversity and equal employment shall include, but not limited to: employment, placement, promotion, demotion or transfer, recruitment and recruitment advertising, referrals and referral sources, termination, training, education and tuition assistance, social and recreational programs, wages and other forms of compensation and job requirements. As an employee, we expect you to conduct your activities in a manner consistent with this policy. This includes extending fair treatment in all matters to patients, visitors, physicians and fellow employees. 6
  7. 7. Code of Ethics Of The American Osteopathic Association (Revised 1996) Section 1 The physician shall keep in confidence whatever he/she may learn about a patient in the discharge of professional duties. Information shall be divulged by the physician when required by law or authorized by the patient. Section 2 The physician shall give a candid account of the patient’s condition to the patient or to those responsible for the patient’s care. Section 3 A physician-patient relationship must be founded on mutual trust, cooperation and respect. The patient, therefore, must have complete freedom to choose his/her physician. The physician must have complete freedom to choose patients who he/she will serve. However, the physician should not refuse to accept patients because of the patient’s race, creed, color, sex, national origin or handicap. In emergencies, a physician should make his/her services available. Section 4 A physician in never justified in abandoning a patient. The physician shall give due notice to a patient or to those responsible for the patient’s care when he/she withdraws from the case so that another physician may be engaged. Section 5 A physician shall practice in accordance with the body of systematized and scientific knowledge related to the healing arts. A physician shall maintain competence in such systemized and scientific knowledge through study and clinical application Section 6 The osteopathic physician has an obligation to society to maintain in high standards and, therefore, to continuously regulate themelf. A substantial part of such regulations is due to the efforts and influence of the recognized local, state, and national associations representing the osteopathic profession. A physician should maintain membership in and actively support such associations and abide by their rules and regulations. Section 7 Under the law, a physician may advertise, but no physician shall advertise or solicit patients directly or indirectly through the use of materials or activities that are false or misleading. 7
  8. 8. Section 8 A physician shall not hold forth or indicate possession of any degree recognized as the basis for licensure to practice the healing arts unless he is actually licensed on the basis of that degree in the state in which he practices. A physician shall designate his osteopathic school or practice in all professional uses of his name. Indications of specialty practice, membership in professional societies and related matters shall be governed by rules promulgated by the American Osteopathic Association. Section 9 A physician shall obtain consultation whenever requested to do so by the patient. A physician should not hesitate to seek consultation whenever he/she believes it advisable. Section 10 Any dispute between or among physicians involving ethical or organizational matters in controversy should first be referred to the appropriated arbitrating bodies of the profession. Section 11 Any dispute between or among physicians regarding the diagnosis and treatment of a patient, the attending physician has the responsibility for final decision, consistent with any applicable osteopathic hospital rules or regulations Section 12 Any fee charged by a physician shall compensate the physician for services actually rendered. There shall be no division of professional fees for referrals of patients. Section 13 A physician shall respect the law. When necessary, a physician shall attempt to help to formulate a law by all proper means in order to improve patient care and public health. Section 14 In addition to adhering to the foregoing ethical standards, a physician should, whenever possible participate in community activities and services. Section 15 It is considered sexual misconduct for a physician to have sexual contact with any current patient whom the physician has interviewed and/or upon whom a medical or surgical procedure has been performed. Section 16 Sexual harassment by a physician is considered unethical. Sexual harassment is defined as physical or verbal intimidation of a sexual nature involving a colleague or subordinate in the workplace or academic setting when such conduct creates an unreasonable, intimidating, hostile or offensives workplace or academic setting. 8
  9. 9. FACTS ABOUT SOUTH POINTE HOSPITAL Background Information: South Pointe, a 275-bed community teaching hospital, is located in the heart of Cleveland’s southeastern suburbs. The merger of Meridia Suburban and Brentwood hospitals formed the present hospital. In 1997, the hospital became part of the Cleveland Clinic health system. The medical staff is a blend of osteopathic and allopathic philosophies of medicine. Service highlights include:  Full continuum of medical and surgical services  Emergency medicine  Cardiology  Gastroenterology  Surgery  Pain management  Orthopedics  Vascular services  Behavioral medicine  Palliative care  Osteopathic manipulative medicine We are dedicated to meet the needs of the communities that we serve through programs such as Community Advisory Council, Community Health Resources Center, Healthwise Connection program and specialty screening programs. South Pointe also offers vital services such as weekly low-cost dinners for area seniors, along with free blood pressure screening in the emergency department. Our approach to serving the community includes combining the talents of highly qualified physicians, nurses and ancillary staff to continuously improve the quality of care to our patients and their families. Our goal is to meet and exceed the expectations of those we serve. Affiliated with Ohio University College of Osteopathic Medicine, South Pointe is the third largest osteopathic teaching hospital in Ohio. Our Graduate Medical Education department trains medical students, interns, residents and fellows from across the country. The hospital is fully accredited by both the Joint Commission of Accreditation of Healthcare Organizations and the Healthcare Facilities Accreditation Program. South Pointe Hospital has been awarded the Northcoast 99 “Best Places to Work in Northeastern Ohio” for over several years. 9
  10. 10. VITAL STATISTICS: Parent Corporation: Cleveland Clinic health system Status: Tax Exempt Date Founded 1957 Hospital: South Pointe Hospital 20000 Harvard Road Warrensville Hts., Ohio 44122 Satellite Sites: Sagamore Hills Medical Center Fleet Medical Center 863 W. Aurora Road 6511 Fleet Avenue Sagamore Hills, Ohio 44067 Cleveland, Ohio 44105 Twinsburg Medical Center Twinsburg Urgent Care 2365 Edison Boulevard 2676 East Aurora Road Twinsburg, Ohio 44087 Twinsburg, Ohio 44087 Operating Budget (2007): $139 million Number of Employees: 1389 Number of Physicians: 410 Number of Nurses: RNs 414 LPNs 63 Number of Volunteers: 178 Outpatient registration (2006): 118,620 Emergency Department Visits (2006): 44,335 Inpatient Surgeries (2006): 3,174 Outpatient Surgeries (2006): 8,409 Total Acute/Non-Acute Discharges (2006): 9,994 Co-Chiefs of Medical Staff: Charles Webb, M.D. Wayne Sevier, D.O. Administration:  David Kilarski President  William Young Chief Operating Officer  Kathleen Crawford, R.N. Vice President of Professional Services  John Bruyere Vice President of Support Services  Sue Collier, R.N. Vice President of Nursing 10
  11. 11. Departments by Floors: Building B 1st floor 4th floor  Administration  House staff call rooms  GME Department  Quality Management  Medical Staff Office  Social Services  Doctors Lounge 5th floor  Laboratory  Step Down Unit  Chapel 6th floor  Mail Room  43 Medical beds th  Marketing 7 floor  Human Resources Department  44 Surgical beds th  Gift Shop 8 floor  Board Room  Respiratory Therapy Department  Security Department  Inpatient Rehabilitation  Medical Records Department  PAT Department  Student lockers  Center for Corporate Health  Pharmacy Department th  Multi-specialty Resident Clinic 9 floor 2nd floor  Dialysis Department  PACU  Observation  Ambulatory Surgery Ground Floor  Surgery Department  Radiology  Digestive Health Center  CT/MRI  Cardiology Department  Ultrasound  2N Classrooms  Nutrition Department  HRD Department  Cafeteria rd 3 floor  Linen Services  44 Medical Beds  Emergency Department Building A 1st floor 3rd floor  Congestive Heart Clinic  Support Service Office  Anticoagulation Clinic  Pain Management Center  Community Health Resource  Wellness Coordinator Office Center  Volunteer Office  Cafeteria  Engineering Office  Cancer Care Center  Hospice Center  Outpatient Pharmacy 4th floor  PBX Operators  Rehabilitation Center  Women/Children Center 5th floor  Laboratory  Subacute Care Center  Gift Shop 6th floor nd 2 floor  Behavioral Medicine Care Unit  Outpatient Behavioral Medicine  Pulmonary Rehabilitation  Outpatient Rehabilitation 11 Therapies
  12. 12. Policies and Scope of Responsibilities 12
  13. 13. POLICIES: SCOPE OF RESPONSIBILITIES: As a medical student, you will work directly under the supervision of the intern, resident and attending physician. You may, in the presence of your supervisor, take part in the care of the patients assigned to you. Your attending physician will countersign all entries in the patient record. History & Physicals: You are responsible for the H&Ps assigned to you including the osteopathic structural exam. Your preceptor will provide constructive feedback after reviewing your work. (See H&P Procedure) Procedures: You may, under direct supervision, perform a procedure in the presence of an attending physician. Limitations: Under NO circumstances should you, as a medical student, write orders or act as a scribe for any physician. Rounds: Your direct supervisor will give you the schedule to make rounds on each service. You are expected to be prompt and prepared to discuss the patient status and any reports that may have been done prior. This is the time to ask questions. DO NOT be afraid to speak up if there is something you are not clear on. Morning Report: Each service has a morning report, where the “on-call” house staff will report on the events of each patient during the night. This is also where the chief resident will make assignments for the day. There is usually an educational component during this time. This conference is MANDATORY if you are on a service with morning report. BE ON TIME and be prepared. Skills Lab: The schedule for the Skills Lab is provided in the GME Monthly Department Schedule. An attending physician teaches each lab with assistance of a senior resident. Attendance is MANDATORY if you are on service in the hospital. (see Didactic section for description) Didactics: Each service has a didactic schedule of their own, which you will be provided the first day on service. A daily House Staff Conference is provided at noon in the West Wing. GME provides a wide range of speakers on many topics. This is an opportunity to eat lunch and learn. The schedule is in the GME monthly Department Schedule. This is a MANDATORY conference if you are in the building. Check the bulletin board in the GME office hallway for revisions in the schedule throughout the month. Work hours: Your day will begin at 6:30/7:00am (depending on service). The day will end when your work is complete, usually by approximately 5pm. Variations of these hours are at the discretion of the attending physician and/or intern or resident. 13
  14. 14. Evaluations: Please provide your preceptor with your rotation evaluation form from your school. All evaluations are to be returned to the GME department. We will make a copy for your file and send the original to your Clerkship Office. Prior to completion of your rotation, you will be expected to complete a rotation evaluation of your experience here at South Pointe. This information is critical for us to improve our programs constantly. Final evaluations to your schools will be sent upon receipt of the rotation evaluation and all items provided to you during your rotation, i.e. beepers, books, badges, etc. Attendance: All medical students are required to be at assigned areas at assigned times. If you request a rotation and your school has an official holiday during the rotation, you must notify our rotation office at the time of application. The policy applies to mandatory and elective vacation time. If there is an illness, the medical student has the responsibility to notify the Graduate Medical Education department (216.491.7464) and their immediate supervisor in a timely manner. Absences will be kept in your file. If this is an extended period, you must notify your school. In case of bereavement, your school needs to be notified immediately to apply for a leave of absence. If you are a CORE based student, you will notify the CORE office. Mail: You may have mail sent to you in care of the Graduate Medical Education Department at South Pointe Hospital, 20000 Harvard Road, Warrensville Hts., Ohio 44122. The mail may be picked up at the secretary’s desk in the department. It is your responsibility to check periodically if you are expecting mail items. Meals: Meals are provided to all Medical Students on rotations at South Pointe Hospital. Each resident is given meals in the cafeteria. The limit is: $3.00 for breakfast, $5.00 for lunch. If there is lunch provided by a Pharmaceutical representative for lunch, it is highly recommended that lunch not be gotten in the cafeteria. This is a benefit for students only; NO family members may take part. Only a reasonable quantity of food for one person may be purchased at one meal. Pagers: Individual student pagers will be assigned for Internal Medicine, and Surgery (including Orthopedics) rotations. Pagers will be issued on the first day of your rotation. You will sign an agreement accepting responsibility for any damage and charges for a lost pager. The pager must be on at all times. Batteries may be obtained from the GME department. If you have a problem with your pager, you must go to the Telecommunications department (1st floor building A) for repair. ID Badges: You will be issued a Medical Student ID badge on your first day of rotation. This badge must be worn at all times, while in the hospital. This badge is worn above the waist, so you may be identified as a student. You may wear your school ID badge under the South Pointe badge. The hospital ID badge will be needed to obtain access to secure areas in the hospital, such as the library. Deposit: A $20.00 deposit will be requested on the first day of rotation, during the South Pointe orientation. This will be held and returned to you upon return of your badge, beeper and any other materials that are issued to you during your rotation. 14
  15. 15. Medical Library: The library is staffed during normal working hours, however students and employees can access it 24 hours/day. A badge is required to enter the library at all times. Students should register with the librarian to activate their library account, which allows students to access online journals and resources from home as well as check out library materials. Schools will be notified regarding any material that has not been returned in a timely matter. The library staff can help students with online research, literature requests, and obtain copies of materials from other libraries. During your rotation at South Pointe you may ask for home access to the Medical Library databases. A registration form may be completed and taken to the Medical Library, they will give you a quick class on how to use the system. NOTES: 15
  16. 16. PATIENT INFORMATION ACCESS: MyPractice: You will receive a username and password on your first day of rotation. With this you will be able to access Patient lists, laboratory results, radiology results, and pharmacy information. You will sign a “confidentiality agreement” to receive this data. Each time you rotate at South Pointe this will be your username and password. Please keep this in a secure area. DO NOT use others’ usernames and passwords. This is a HIPAA violation. Confidentiality: All rotating students must sign a Confidentiality and Non-Disclosure Agreement. This agreement will allow the student to receive a user name and password for computer access for the above applications. See attached form. 16
  17. 17. COMPLETING HISTORY AND PHYSICAL GUIDELINES: History and Physical: 1. Must be on medical chart within 24 hours of admission or completed within 7 days prior to the admit date. 2. Must be on medical record prior to performing surgery procedure. 3. If hand written in the progress notes, must be labeled as such. 4. For patients re-admitted within 30 days for the same condition, an interval note may be handwritten in the progress notes, but must be labeled as such. A copy of the previous H&P must be placed in the chart. 5. Osteopathic structural exams must be completed within 24 hours as part of the H&P for all patients admitted under the service of an osteopathic physician. A complete history must contain:  Chief complaint  History of present illness  Family history  Psych/social history  Past medical history  Review of systems A complete physical must contain:  Vital signs  Head and neck  Ear, nose and throat  Chest  Heart  Abdomen  Genitalia/Pelvic/Rectal  Extremities  Neurological assessment A conclusion and impression along with a plan of the hospital course must be in the H&P for completion. Operative Report: 1. Must be dictated immediately after surgery. 2. An operative progress note must be documented in the medical record immediately following an operative procedure. A complete operative report shall contain Description of findings Technical procedures used Specimen removed Pre- and post- operative diagnosis 17
  18. 18. Names of primary and assistant surgeons Anesthesia used Discharge Summary: 1. Must be dictated upon discharge or death. 2. A final progress note, to include discharge instructions, may be substituted for the discharge summary in the case of patients with problems of a minor nature who require less than a 48-hour period of hospitalization. A final progress note may NOT be substituted for death summary. 3. For extended stays, interim discharge summaries may be dictated to include the care given for a specific period. A complete discharge summary shall contain: Reason for hospitalization Significant findings Diagnoses/procedures performed Treatment rendered Condition of patient upon discharge/cause of death (avoid using vague terms such as “improved” for the condition of discharge) Specific instructions given to patient and or family to include Physical activity Medications Diet Follow-up care Physician Progress Notes: 1. Should be written at least daily or more frequently based on condition of the patient. 2. Must be dated, timed and authenticated. 3. Trainees/medical students must identify the attending physician for whom the progress note is being written. Abbreviations: 1. Abbreviations are strongly discouraged. 2. Abbreviations may be used in the medical record, EXCEPT in documentation of the final diagnosis and procedures. 3. See attached “unapproved abbreviation list”. Corrections in the Medical Record: 1. May be made only by the individual writing or dictating the entry a. The supervising physician may correct the documentation of a trainee 2. A single line must be drawn through the error. 3. The error must be initialed and dated by this individual. 4. The correct entry written, if necessary. 18
  19. 19. Late Entries: 1. Late entries may be made in the medical record as follows: a. Late entries will be labeled as such. b. Late entries will be dated with the date the entry is made. c. Late entries will be authenticated. 19
  20. 20. DRESS CODE AND ID BADGES: South Pointe Hospital recognizes the importance of the professional appearance of its staff in maintaining an atmosphere conducive with the delivery of quality health care. To promote this atmosphere, all employees including medical students, are expected to dress in a manner appropriate to the jobs they perform. Some general guidelines include: 1. The Cleveland Clinic ID badge must be worn at all times while on any Cleveland Clinic campus. The badge must be worn above the waist in compliance with Cleveland Clinic /South Pointe Hospital policy. Medical School badges must be worn beneath the Cleveland Clinic badge. 2. Shirts, suits, dresses, tailored pants, slacks (ankle length), blouses, skirts, sweaters, blazers, sports coats and turtlenecks should be clean, neat and non-wrinkled. Dresses and skirts must be of sufficient length. Men are encouraged to wear ties unless they pose a safety hazard. 3. Hosiery should be neutral in tones. 4. Shoes should be appropriate for the work being performed. Acceptable styles include oxfords, dress flats, loafers or moderately heeled dress shoes. Sandals, shoes worn without socks or hosiery are inappropriate attire. 5. Business casual attire may include khakis with a polo shirt (no vendor logo). Jeans or denim material are not acceptable 6. Lab coats are expected to be kept clean, pressed and in good repair and worn at all times. 7. Good personal hygiene is expected. Do not wear overpowering perfume or aftershave. 8. Scrubs are to be worn ONLY on surgical services. They are not to be worn home or into the hospital from outside. New scrubs must be worn daily. Surgical head and footgear is not to be worn outside of the operating room area. Failure to adhere to these standards of dress and grooming may result in corrective action and notification to your school. SMOKE FREE ENVIRONMENT: In an effort to provide a healthy environment for all employees, patients and visitors at South Pointe Hospital, all Cleveland Clinic hospitals are smoke free environments. Smoking bans on all Cleveland Clinic properties are strictly enforced. HOUSING GUIDELINES: The GME department provides housing for those students’ completing electives and living more than 50 miles from the rotation site (i.e. South Pointe Hospital.) The housing rooms are located in building A on the South Pointe campus. There are suites for male and female, each containing 6 beds. Each person will have one single bed, desk and closet. Each suite 20
  21. 21. has a bath and shower area. There is a shared lounge across the hall from the sleep rooms, which contains a TV, DVD/VCR player, refrigerator and microwave.  Students must provide their own linens (both sheets and towels).  Environmental Services will clean and empty the trash on a daily basis.  It is the student’s responsibility to maintain these areas as if they were their own.  Do NOT store food or beverages in the sleeping areas; please use the lounge area refrigerator.  No alcoholic beverages are permitted at any time.  Keep clothes and other personal belongings off the floors.  Be aware that some of the rotating students work various hours, so please respect them and be quiet when in the sleep areas. The GME staff will routinely inspect both the sleep area and lounge area. If we find the area unkempt, we will notify the student(s) responsible and their respective COM. Future housing will not be approved for those unable to follow the guidelines. If you request housing and find you no longer need the bed, please notify our Graduate Medical Education Assistant at 216.491.7464 as soon as possible. We usually have a waiting list for this convenience. SAFETY AND SECURITY: Our security department is a proactive and well-trained group of individuals. They provide a variety of services. All members of the security department are Hospital Certified by the International Association of Health Care Security and Safety. Listed below are a few services that you may find a need for during your time at South Pointe.  Alarm monitoring  Incident investigation  Lost and found  Regular patrols  Securing doors  Evacuation assistance/Fire drills  Motor vehicle assistance  Enforce restraining orders  Site security surveys Security may be reached at extension 45588 or by calling the operator. Emergency Pages: For all calls of an emergency nature, dial “88” instead of dialing “0” to reach the switchboard operator. This procedure can be used on any emergency calls requiring immediate attention. 21
  22. 22. OHIO EMERGENCY CODES Code Name Event Code Red Fire Code Adam Infant/Child Abduction Code Black Bomb/Bomb Threat Code Gray Severe Weather Code Orange Hazardous Material Spill Release Code Blue Medical Emergency/Adult Code Pink Medical Emergency/Child Code Yellow Disaster Code Violet Violent Patient/Visitor Code Silver Person with Weapon/Hostage Situation Code Brown Missing Adult Patient FIRE PROCEDURES A plan of action to fight fires is outlined below for the guidance of all hospital personnel. IF A FIRE OCCUS WHEN YOU ARE IN YOUR WORKING AREA 1. Remove anyone from immediate danger (not to be confused with evacuation). 2. Go to the nearest fire alarm station and pull the handle. 3. Dial 88 to notify the PBX operator of the location of the fire. 4. Close all doors and windows. 5. Obtain fire extinguisher from the wall and try to extinguish the fire. 6. DO NOT a. Turn off lights b. Use the elevators or telephones unless directed to do so by the Fire Department. IF THE FIRE IS NOT IN YOUR AREA 1. Report to your normal workstation, and follow procedure outlined above. 2. Do not use elevator to reach your normal work area. 3. You may be requested to respond to another work area. 4. If you are off duty, DO NOT LEAVE THE BUILDING. Remain in your work area. Elevators should be used ONLY for patient evacuation and transfer of fire equipment. All elevator use must be approved by the Fire Department South Pointe Hospital’s Safety Committee has developed a fire plan wherein each hospital employee has an assigned role. The effective execution of this role by each employee is vital to the success of this plan in the event of a fire. Each department manger will be responsible for the training of those employees within his/her department with the contents of the South Pointe Fire Manual. 22
  23. 23. Employees should refrain from making inquiring phone calls during a “Red Alert”. The operator will notify you of any pertinent information over the public address system Parking: All students are required to park in appropriate employee parking. Enclosed is a map of the hospital parking areas. You are NOT, under any circumstances, to park in the Physician parking area. Your car will be towed at your expense if you park in any undesignated area. See attached South Pointe Hospital parking map. 23
  24. 24. Rotations 24
  25. 25. ROTATIONS AVAILABLE AT SOUTH POINTE Rotation Duration Number of Students Anesthesiology 2 weeks 1 Emergency Medicine 2-4 weeks 4 Family Medicine (Fleet Clinic) 2-4 weeks 2 Cardiology 2-4 weeks 2 Intensive Care Unit 2-4 weeks 1 Gastroenterology 2-4 weeks 1 General Medicine 2-4 weeks 4 Pulmonology 2-4 weeks 1 Lab Medicine 1 week 1 Nephrology 2-4 weeks 1 OMT 2-4 weeks 1 Ophthalmology 1-2 weeks 1 Orthopedics 2-4 weeks 2 Radiology 1-2 weeks 1 Surgery/General 2-4 weeks 3 Surgery/Vascular (must complete Gen Surg) 2-4 weeks 1 Surgery/Plastic (must be MSIV) 2-4 weeks 1 Other Rotations arranged with our GME Dept. Ambulatory Underserved (Free Clinic) 2-6 weeks 2 Family Medicine (various SP Physician) 2-4 weeks 4 Pediatrics (ER Peds at Hillcrest Hospital 2-4 weeks 2 Forensics (Cuyahoga Cty Coroner Office) 2-4 weeks 1 Psychiatry (various physicians) 2-4 weeks 1 25
  26. 26. Descriptions of Rotations: Anesthesiology: This rotation will provide the student with a broad and comprehensive exposure to anesthesiology. Each student will be involved with all aspects of the pre, intra and postoperative care of the patients under the supervision of a resident or attending physician. The student must apply for this rotation on the South Pointe Hospital GME web page. The application will be sent to the Dr. Kane who will interview each student before acceptance to the rotation. Between June and January, Dr. Kane will only take fourth year students who are applying for residency. Preceptors: Dennis Kane, D.O., Rotation Coordinator Michael McClain, D.O. Patrick O’Brien, D.O. Todd Csorba, D.O. Emergency Medicine: This rotation is an exciting introduction to a busy community hospital emergency department. The student will be assigned incoming patients where their diagnostic skills will help them evaluate their patients, and learn to diagnose and treat the acutely ill. Students will also have the opportunity to manage several patients simultaneously. There will also be exposure to trauma during this rotation. The student will be assigned to various shifts and be scheduled at Sagamore Hills Emergency Center to receive a different experience. Preceptors: Levente G. Batizy, D.O. Jamil Alarafi, D.O. Daniel Dickriede, D.O. Armand Eusanio, D.O., Rotation Coordinator Arnold Feltoon, M.D. Jonathan Klein, M.D. Michael Kelley, D.O., Program Director Daniel Kranitz, D.O. Michael Schmitt, M.D. Family Medicine: Fleet Clinic This rotation is completed in our Fleet Medical Center, a clinic located in Cleveland’s Slavic Village area. Our Family Medicine resident staff this clinic. The student will receive a well- rounded understanding of the day-to-day operations of an “inner city clinic.” Students will be given the opportunity to evaluate patients and carry out appropriate treatment under the guidance of the residents and physician faculty. Each student will be assigned a topic to present at the end of his or her rotation. The Family Medicine residents and preceptors meet each Wednesday at South Ponte for their didactic programs. These consist of various outside speakers, journal club, case presentations and skills labs. 26
  27. 27. Preceptor: Richard Garwood, D.O., Rotation Coordinator Barbara Bakus, D.O. Cardiology: This rotation will emphasize the physical diagnostic skills, diagnostic and therapeutic cardiac procedures as related to the cardiac care of the patient. Students will work up assigned patients and attend rounds. This is considered an Internal Medicine rotation, thus the student will be required to attend IM Morning Report. The student will be assigned a case presentation for the end of his/her rotation period. Preceptor: Mark Pace, D.O., Rotation Coordinator Intensive Care Unit: This rotation provides the student with experience in ventilator management as well as hemodynamic monitoring. Students will be involved in the initial work up and evaluation of each patient admitted to the ICU. The student will be required to make rounds with the ICU physician daily or more frequently as needed. Preceptors: Andrew Liu, D.O. , Rotation Coordinator Gastroenterology: This is an elective rotation within the internal medicine department. The student will learn and be given the opportunity to formulate diagnosis by assimilating clinical findings, lab results and procedures. The student will be expected to perform along with the residents and attending physicians in daily rounds. This being an Internal Medicine rotation, the student will need to attend IM Morning Report and present a case presentation at the end of the rotation. Preceptor: Paul Turowski, D.O., Rotation Coordinator General Medicine: The general internal medicine experience will expand the student’s knowledge and competency in internal medicine by working as a team with the interns and residents in managing hospitalized patients. Students will oversee the management of three to four patients under the supervision of the interns, residents, and attending physician. The student will be expected to take part in rounds, educational conferences, and lectures. The student will be given a topic for presentation at the end of his/her rotation. Preceptors: Jane D’Isa Smith, D.O., Rotation Coordinator Elizabeth Habjan, D.O. Brian Pollock, D.O. Carrie Bassett, D.O. 27
  28. 28. Allen Kline, D.O. Pulmonology: This is an elective rotation, which is designed to combine bedside rounds and teaching in the pulmonary laboratory. Students will learn to correlate pulmonary function tests with clinical findings. The student will participate in fibroptic bronchoscopy and will gain knowledge in diseases such as COPD, pneumonia, pulmonary fibrosis, asthma, ARDs, and other pulmonary conditions. IM Morning Report is required for this rotation, with an assigned presentation. Preceptors: Andrew Liu, D.O. Laboratory Medicine: This elective gives the student the opportunity to understand how lab tests are ordered and used most effectively in evaluating the patients. The student will observe day-to-day operations of the lab, such as clinical chemistry, hematology, microbiology, blood bank and immunology. The student will become familiar with the various tests available and develop appropriate test ordering skills. The educational format will include review of test profiles, analysis of other laboratory data and clinical case studies with emphasis on cost effective laboratory utilization. Preceptor: Chi Hoon Lee, M.D., Rotation Coordinator Nephrology: This rotation provides the student with the opportunity to learn the basic principles of evaluation and management of clinical renal syndromes and hypertension. An emphasis will be placed on the recognition, evaluation and treatment of acid-based and fluid electrolyte disorders. Preceptors: Haifa Hanna, M.D. Andrew Lazar, M.D. Osteopathic Manipulative Treatment: The student will be exposed to the history and theory of Osteopathic Manipulative Medicine. The rotation will include methods for conducting a structure exam, interpretation based on objective criteria and techniques to treat somatic dysfunction. Evaluation of students is required on a regular basis in order to attain competency. The student will be required to attend each OMT conference and assist the preceptor as a table trainer. Preceptor: Katrina Rakowsky, D.O., Rotation Coordinator 28
  29. 29. Ophthalmology: The student will be exposed to the presentation of the basic knowledge of examination and diseases of the eye. The student will gain basic information regarding treatment and triage of diseases and injuries of the eye. Preceptors: Michael Millstein, M.D., Rotation Coordinator Philip Goldberg, M.D. Orthopedic Surgery: The objective of this rotation is to give the student the opportunity to gain a better understanding of the structure and function of the musculoskeletal system. The student will take part in consultations, rounds, surgical procedures and post op care. The student will also have the opportunity to participate in the trauma cases in the ED. The student will be given daily assignments at the Ortho Morning Report. Preceptor: David Krahe, D.O., Rotation Coordinator Robert Hampton, D.O. Richard Masin, D.O. Audley Mackel, M.D. Curtis Smith, M.D. Psychiatry: This rotation is designed to provide students with a broad knowledge base and experience in the assessment and treatment of psychiatric patients. The student will work with the attending physician in the in-patient treatment center at South Pointe and be given the opportunity to evaluate patients in their offices. Preceptors: Mark Zedar, D.O. Gary Wilkes, M.D. Adel Zaraa, M.D. Radiology: During this rotation the student will be able to expand their knowledge with respect to radiographic procedures, anatomy and physiology of organ systems and pathologic processes as shown on the diagnostic radiology studies. The student will expand their knowledge in selecting procedures most appropriate in the diagnoses of their patients. Preceptors: Jeffrey Unger, M.D. Michael Martinez, M.D., Rotation Coordinator Kerry Sullivan, D.O. Young Kim, M.D. 29
  30. 30. Surgery/General: Through participation in this rotation, the student will increase his/her knowledge base in preoperative, intra-operative, and postoperative care. They will be under the direct supervision of the residents and attending physicians. They will learn operative techniques, anatomy, physiology, and pathology. The student will also have an opportunity to expand their manual skills, while assisting in surgery. The staff meets for morning report for daily assignments. Students are expected to complete a presentation at the end of their rotation. Preceptors: Roger Classen, D.O., Rotation Coordinator Rick Gemma, DO Craig Eyman, D.O. Carl Jackson, M.D. Thomas Santoscoy, M.D. Naveed Ahmed, M.D. Shukri ElKhairi, M.D. Surgery/Vascular After completion of a General Surgery rotation the student may elect to do a Vascular Surgery rotation. Besides assisting in surgery, the student will also partake in daily rounds, consults, and time spent in the surgeon’s office. This rotation will expand on the previous learned surgical skills, giving the student an opportunity to work one on one with our vascular surgeon and fellow. Preceptor: Jeffrey Stanley, D.O., Rotation Coordinator Surgery/Plastic and Reconstructive Surgery: This is a fourth year elective and the student must have successfully completed a General Surgery rotation. The training in this area will include repair, replacement and reconstruction of defects in form and function. Emphasis will be placed on one or another phase of plastic and reconstructive surgery, such as skin and soft tissue tumors, hand surgery and aesthetic surgery. Preceptors: Mark Foglietti, D.O., Rotation Coordinator Brock Generalovich, D.O. 30
  31. 31. Elective Rotations outside of South Pointe Hospital: Ambulatory Underserved: This rotation is scheduled at the Cleveland Free Clinic. This is a “walk in clinic”. The student will see a wide range of patient complaints; i.e. sore throats, gyn conditions, pediatrics, drug abuse, etc. The student will be given the opportunity to work up the patient and present to the staff physician. Open discussion of patient conditions and treatments are encouraged. Preceptor: Stephen Weirich, M.D., Rotation Coordinator Family Medicine: FM Physician Offices This rotation introduces the student to the private family medicine practitioner’s office. They will be assigned to one of the many Family Medicine staff who allow students to work hand in hand with them in the practice of Family Medicine. The student will learn to evaluate patients and treat them in an office environment. Preceptors: Ioanna Giatis, D.O. Gregory Yager, D.O. Manual Saridakis, D.O. Michael Saridakis, D.O. Terrance Scanlon, D.O. Pediatrics: Emergency Medicine Pediatrics at Hillcrest Hospital The Pediatric section of the Emergency Department at Hillcrest Hospital sees hundreds of pediatric patients per day. Besides the usual, such as colds and flu the students will be introduced to fast paced pediatric emergency problems, such as fevers, rash, abdominal pain, pneumonia and trauma. Preceptor: Mark Rodkey, M.D., Rotation Coordinator Forensics Medicine: This rotation is based at the Cuyahoga County Coroner’s Office. Besides evaluating the cause of death in many cases, they also work with the police in reconstructing crime scenes. Preceptor: Cuyahoga County Coroner Office Staff 31
  32. 32. Additional Information: Forms Unapproved abbreviations Parking map 32

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