Weekly Update

December 27, 2021

Reminder from Residency Leadership: Continue to Wear PPE

Reminder to everyone that they should be wearing PPE (masks + N95 + eye shield) at all times in all clinical areas.  During breaks and morning reports, please continue to wear a face mask at all times.  This is to protect yourselves and each other and prevent us from depleting our sick call pool.

If you have not received your Covid Booster shot yet, please consider doing this as soon as possible.  Please reach out to the chiefs or Manish if you are having difficulty finding an appointment.

 
Please join us in congratulating Dr. Christie Lech on her appointment as Assistant Program Director of the NewYork-Presbyterian Emergency Medicine Program. The bi-campus Weill Cornell and Columbia Emergency Medicine residency program is led by Dr. Manish Garg, Program Director, and the Associate/Assistant Program Directors, Osman Sayan (Columbia), Anne Katz (Cornell), Trudi Cloyd (Columbia), and Adria Simon (Columbia).
 
As assistant program director, Dr. Lech will oversee didactic and clinical education, resident scholarly and professional development, resident evaluation and selection, resident advocacy, and patient management. Dr. Lech will be assuming the role from Dr. Mark Curato, who will be taking on a new role on the Weill Cornell Medicine Emergency Medicine Undergraduate Medical Education (UME) leadership team. We would like to extend a sincere thank you to Dr. Mark Curato for his wonderful service as Assistant Program Director. and congratulate him on his new role.
 
Dr. Christie Lech received her undergraduate degree from CUNY Honors College at Queens College, and earned her medical degree from New York Medical College. Dr. Lech completed her residency at Mount Sinai Hospital, where she was Chief Resident. During her time there, she continued her medical school research into looking at barriers into HIV testing in emergency departments both locally and abroad.
 
After her residency, Dr. Lech joined the NYU Langone Department of Emergency Medicine at Bellevue Hospital. For three years, she served as the assistant residency director and then as the interim residency program director. While there, she completed her master’s in health professions education (MHPE). Her thesis focused on the design, implementation and evaluation of a novel debriefing program in the emergency department. 

Reminder:  Hospital and Stroke Training Due December 31 – Please complete ASAP if not already done so

Remember to complete the SabaCloud training by December 31.  All residents must also complete the required stroke modules, also due December 31.

From the Residency Leadership: Interview Season

Dear EM family,
 
Faculty and residents, if free we ask that you try and make it anytime from 9am to 11:15am (east coast interview days) on 
 
January:
18th, 24th
 
Faculty and residents, if free we ask that you try and make it anytime from 11:45am to 2:00pm (non-east coast interview days) on
 
December: 
20th, 21st
January:
10th, 11th
 
Here is the zoom link for every interview day:
 

Interview Day Zoom: 

https://weillcornell.zoom.us/j/8641139634

Meeting ID: 864 113 9634

Passcode: 741852

One of the most positive pieces of feedback we receive from applicants is an acknowledgment of how many faculty and residents show up on interview day.  So even if you can be present for 15 minutes, it would be greatly appreciated.  Your shared experience, advocacy, and passion for EM truly demonstrate the essence of our remarkable NYP Columbia and Cornell residency.
 
Thank you for your care and commitment,
 
With gratitude,
The EM Residency Program Leadership

Reminder: Documenting Disposition Notes

A reminder that all patients being discharged should have a progress note documented and to use the “.resdispo” smartphrase as a template.  This is important for documenting what was done in the ER and that the patient was reassessed.  This should be done for all patients at both campuses.

Furthermore, all admitted patients must have a resident hanoff note. 

Campus Announcements

ED OB Fast Track – Update from Cornell Leadership:

Good morning —
 
Effective today, we will pilot a new “ED OB Fast Track” workflow, which aims to expedite Obstetric patients’ transfer out of WCMC ED to Cohen Hospital, immediately after
    (a) ED Triage
    (b) ED Provider decision whether ED OB Activation is warranted, including Medical Screening Exam documentation
 
Which patients get Expedited Transfer?: 
Any NYP/WCMC ED patient between 16 weeks pregnant to 6 weeks post-partum, who does not fit ED OB Activation criteria.
 
What’s different for ED Providers?*: 
Immediate binary decision for:  ED OB Activation vs. Expedited Transfer to Cohen
  • When ED Triage APP/Attending present, binary decision made at triage.  
  • At all times, ED Admin Attending and appropriate Area Attending will be notified via Epic Chat from ED Triage.  When no ED Provider in triage, binary decision made at bedside.
  • Expedited Transfers require an MSE Note, which include a brief history, brief physical, and brief assessment and plan that patient is clinically stable for transfer to Cohen Hospital
  • Expedited Transfers require same Epic clicks on “Dispo” Tab for Cohen Transfer
  • ED Provider does NOT call Transfer Center/EMS.  OB PA’s will continue to own this responsibility.
  • Expedited Transfers will NOT require OB Team to come to ED.  Patient will see OB Team at Cohen Hospital
  • NO changes to ED OB Activation workflow. 
  •     – ED OB Activations will continued to be roomed in A2. 
  •     – ED Providers/Nursing will activate via ED Clerk’s Telecom call (5-5555)
 
Given the increasing numbers of COVID-19 patients in our ED and the need for isolation rooms, special thanks to leadership from Cohen Hospital, NYP EMS, and Emergency Department leadership. 

Covid Updates from Cornell Leadership:

In anticipation of rising ED arrivals for COVID-like Illness (CLI), we want to socialize the following WCMC ED Operational workflows:
  • SAFE exam room has moved from C10 to B3, effective immediately.  As during peak pandemic times, SAFE Exams will be triaged to B Bay.  This will add capacity for CLI patients in C Bay and maintain SAFE exam standards. 
  • Patients with CLI, who fill ESI 4-5 criteria, will continue to be triaged to a patient room in D Bay.  Standard isolation and cleaning processes must be taken. 
    • C Bay will continue to be triaged patients with CLI who require longer workups and during hours when D Bay is closed or at capacity for appropriate isolation. 
  • Pulse Oximeters will continue to be stocked in D1 and with Social Work/Care Coordination — current inventory is sufficient; MRN’s recorded for each pulse ox given out.   
  • Continue using Epic Orders under “Common Follow-Ups” (photo below), when appropriate: 
    • ED COVID Discharge, which populates options for COVID Discharge Instructions and Pulse Oximeter.

No Conference this week!

Shout outs to Kamler and Nolan for a difficult resuscitation this weekend involving prenatal twins (22 weekers!).  Performed CPR, intubated both, and dealt with both the OB and NICU teams extremely well.  Great teamwork and leadership in really tough cases.

Chief on Call

Chris Hennessy, M.D.  
EM Chiefs’ Cell:  917-410-1056
  • Please call and do not text/ email so we can address issues promptly.
  • If you do not hear back within 10 minutes, then call any of the other chiefs