171 Ashley Ave.
Charleston, SC 29425
843-792-1414
800-424-MUSC
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July 2006
Update From Our Administrator
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J. Philip Saul, MD
Medical Director
Director, Pediatric Cardiology |
Interns help provide omnipresent care
With a new set of interns entering training this month, it seems appropriate to follow up on last month's article about the role trainees play in caring for our patients. I used to hear it said that one should never buy a car manufactured on a Monday. Similarly, many people fear coming to the hospital in July, when many of the residents, or "house staff," have recently started. A patient or family might ask, "How can we be sure the trainee knows what he or she is doing?"
In the past, one often heard the phrase, "See one, do one, teach one," when it came to medical procedures. That is no longer the case. Due to a variety of factors, including a national emphasis on safety in the hospital, there are now multiple safeguards in place to assure that trainees are competent at performing the care they deliver.
Some programs, such as anesthesia, stagger the starting dates of their trainees by a number of months, so that a large group of inexperienced doctors never enters training at the same time. For most programs, though, including pediatrics, the new trainees all start on July 1.
Consequently, a system of checks and balances has been developed to guarantee that each individual trainee is competent at the care they deliver. The MUSC Children's Hospital requires that a trainee demonstrate competence at even the most minor procedures before being allowed to perform them unsupervised. This is documented through a web-based electronic system called "E-value," which allows a patient's nurse to confirm a trainee's competence before he actually performs the procedure alone.
For most other aspects of care, supervision takes on a more layered approach: an "attending," a fully trained physician responsible for the patient's care, sees the patient, discusses the case with the trainee at least once a day, and is directly involved in all major decisions. If and when inexperienced trainees need assistance, they rely on senior trainees or non-physician specialists, such as nurse practitioners and physicians' assistants, for supervision and advice. Importantly, in every case, close supervision is provided until the trainee is fully competent at that particular level of care.
Yet a family still might ask, "Why have any trainees involved?" The strongly positive side of trainees being in the workplace is that a patient benefits from having a physician assigned to his case continually present in the hospital 365 days per year, 24 hours per day. This omnipresent care is what allows our teaching hospitals to provide the highest level of care to even the sickest patients.
When a well-regulated supervisory process is in place, the result is a health care environment that provides truly excellent care. As medical director, the most important part of my job is to make sure that is, indeed, always the case here in our Children's Hospital.
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