Consultation Guidelines

Principles

1. Attendings are accountable and responsible for all consultative care; housestaff do not provide independent consultative care without supervision.
2. Each surgical service shall respond appropriately to consultation requests at both the housestaff and attending level.
   1. Although a first year resident can educationally participate in the consultative process by fact-finding, the initial consultative advice must be provided by a more senior resident or Attending who personally sees the patient.
3. Except for E.R. patients who are not admitted, all consults will be personally seen by a Surgery Attending within an appropriate time frame not to exceed 48 hours of receipt.
4. All consultation reports will be signed by an Attending with their comment.

Logistics

1. The Department shall have a plan to guide the communication of request for consultation.
   1. Elective consults can be directed to individual Faculty at the discretion of the consult resident.
   2. Non-Elective Consults
      1. Each surgical service shall have a HOUSESTAFF and FACULTY on-call system for non-elective consults to their service and its individual Faculty members.
      2. Such on-call schedules are posted, distributed and maintained by the Page Operator.
      3. The Department will have a mid-level resident (second-third year) in the Hospital AT ALL TIMES to function as the initial consultant to the Emergency Room physicians as their sole function (E.R. Resident). This E.R. Resident does not have any specific INPATIENT bed responsibilities during this assigned tour.
2. Administrative Responsibility
   1. The Department will have a senior resident (fourth-seventh year) in the Hospital AT ALL TIMES to function as the senior administrative officer of the Department as their sole function (S.O.D.). This S.O.D. does not have any specific INPATIENT bed responsibilities during their assigned tour of duty. All non-elective problems regarding these issues should be referred to this individual for resolution.