Section of Neurology On-Call Handover Policy

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This page sets out the transition protocol for physicians in the Neurology section to transition between their slots on the Neurology Call Schedule.

Start times for receiving pages

Day neurologist: 0800 hrs Night neurologist: 1700 hrs

Transition Protocol

Sign-over

  • Be available! - by phone, in-person, or use PHIA-secure email account (not available for some neurologists. (WRHA/ E-Health does not permit texting personal health information)
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I thought all Manitoba physicians can now access a WRHA secure email account. Emailing Tom for additional info.

  • In traffic, use car Bluetooth link if available to inform caller when able to stop car and discuss details.

‘Stroke 25s’ occurring during the transition period

Stroke 25s arriving after 17:00 are the responsibility of the Night neurologist unless other arrangements are agreed upon via direct communication. Similarly, Stroke 25s arriving after 08:00 are the responsibility of the Day neurologist unless other arrangements are agreed upon via direct communication. For example, if the Night neurologist is going to be delayed in arriving for a Stroke 25 called after 17:00, then (s)he could call the Day neurologist and the Day neurologist could agree to start seeing the patient, although there would be no obligation to do so.

End-of-afternoon housekeeping

  • At the end of the afternoon the Day Neurologist should confirm that any unfinished ward consults or other issues can wait until the next day. Alternatively she/he may choose to finish consults and/or other issues after 1700hrs.
  • The goal is to keep the Night Neurologist free from in-patient issues other than critical in-patient follow-up and unexpected emergencies.
  • The goal is for the Day Neurologist to leave no later than 1800 hrs.

Stroke pagers

  • There are three stroke pagers.
    • The Day Neurologist will keep a pager throughout his/her call-period.
    • Night Neurologists will get a pager from GF543 and return it the next day.
    • The GF5 secretary will check for returned pagers daily Monday-Friday. If pagers are not returned the responsible neurologist will be contacted.
    • Template:Discusison is the GF5 secretary one of the people on this wiki so we can link this to her/him?

Neurology Mobile Phone

  • Transfer the phone, in-person, to on-call Neurologist ...or leave it on the charger in room GF540
  • Charge the spare battery
  • Do not take the phone home or leave in your office unless returning promptly in the morning.

Handover patients: - Who Bills?

If a consult is started by one neurologist and finished by another, the neurologist who sees the patient in-person for history and physical exam, and produces the primary consult note, should bill for the consult.

For example:

  • The Night Neurologist would not bill for a consult if she/he is only following up on the imaging and/or other results on a patient initially seen and documented by the Day Neurologist, and then discharged or admitted.
  • The Night neurologist would not bill for a patient only discussed by phone with the resident overnight when there is an expectation that the patient will require review with the Day neurologist in the morning.

Handover patients – Who arranges follow-up?

  • If a patient requires referral to a specific clinic, such as Stroke, M.S., or Epilepsy etc., the neurologist present at the time of discharge from the ER and completion of the neurology service review will ensure the referrals are made, if not already done.
  • If a patient requires general neurological follow-up, the billing neurologist is responsible to either see the patient in his/her clinic or make other follow-up arrangements.
  • In cases where it is determined that follow-up is required only after tests are reviewed by the non-billing (follow-up) neurologist, the non-billing neurologist should inform the billing neurologist (usually on a non-urgent basis) to make the arrangements.
  • It is important that Day and Night neurologists communicate and clarify follow-up responsibilities of any hand-over patients to make sure they are not lost in the system.

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