POLICY LIMITING THE NUMBER OF PATIENTS UNDER THE CARE OF A RESIDENT:

Sinai-Grace Hospital has a large number of medical patients.

The teaching medical service has 8 teams responsible for about 128 patients on an ongoing basis, with an average of about 16 patients per team (8 patients per PGY-1 – Two PGY-1 per team and one PGY-1 or one PGY-2).

The teaching Cardiology/Telemetry has 4 teams responsible for about 32 patients on an ongoing basis, with an average of about 8 patients per team (8 patients per PGY-1 and one PGY-2 or one PGY-3 combined).

The ICU has 4 teams responsible for about 32 patients on an ongoing basis, with an average of about 6 patients per team (6 patients per PGY-1 and one PGY-2 or PGY-3 combined).

The PGY-1 is responsible for admitting and managing no more than 5 new patients/2 transfers from other medical services on call and do not manage more than 12 patients at any time during their floor or cardiology/telemetry rotation.

PGY-2/3 are responsible for admitting and managing no more than 10 new patients/4 transfers from other medical services on call and do not manage more than 24 patients at any time during their floor or cardiology/telemetry rotation.

Once the on-call team caps (medical or cardiology/telemetry) with their admissions, all patients are admitted to the Physician Assistant Service (Non-teaching).

The ICU team has back up from a Board certified Internist who is available in-house to help the ICU residents with excess number of patients and/or to cross cover patients when they are busy with new admissions.

In order to provide best and timely care to the patients, the Hospital has 18 Physician Assistants (PA) on the medical service and 8 Physician Assistants on the cardiology/telemetry service. The PAs are on call 24/7 and are responsible for about 120 patients on the non-teaching services.