Advanced Heart Failure
Cardiology Fellow – Advanced Heart Failure/Transplant Service Expectations
ROUNDS: Goal is to oversee, coordinate, and direct the clinical care of ALL the HF patients on the census to gain experience with the depth and breadth of heart failure and hone skills as a “junior attending.”
Contribute knowledge and provide advice from experiences on other cardiology services while simultaneously learning from the expertise of the HF APPs regarding the evaluation and management of advanced heart failure, LVAD, pre- and post-transplant patients.
Be present, be available, and always be ready to assist with emergencies!
Pre-rounding: Review APP email regarding overnight events and help resolve morning issues in coordination with covering APP. You should briefly review electronic charts and pertinent telemetry data before rounds. Assist APP with acute issues before rounds.
If possible, the Fellow is encouraged to attend CICU AM rounds for updates on shared HF patients.
Rounds: Meet at 9 AM in the small conference room in the Cardiology offices for 4-3400 for interdisciplinary rounds. Team-based patient rounds with Attending and Fellow in supervisory role, working cooperatively with APPs to review clinical data and determine plan of care. APPs will place relevant orders. Fellow is expected to assist with (1) coordinating and communicating with consulting services, (2) pacemaker/ICD interrogations, (3) arranging cardiac procedures with the cath or EP labs.
It is expected that the Fellow communicates with the APP team throughout the day to determine if any specific assistance or guidance is needed in enacting care plans.
Additionally, the Fellow will work with the APPs to determine an appropriate time and modality (in-person, telephone, Zoom) for afternoon “Quick Rounds” to follow up on pertinent items from morning rounds (for example, PM labs, I/O goals, hemos, test results, consult notes, etc) and determine next steps in care.
NOTES:
The Fellow is not responsible for writing any Admit or Daily Progress Notes for patients on the HF service.
Fellows are expected to see all new HF consults, off-service, and ICU patients and write notes at an interval determined in conjunction with Attending. That is, not every off-service patient is seen every day. However, it is the responsibility of the Fellow to review patient data on a daily basis and communicate with the primary teams to determine what input is needed from the HF team.
CONFERENCES/HEART FAILURE ACTIVITIES:
- Monday 3:30 PM interdisciplinary VAD meeting in 42800 Hicks Conference Room.
- Tuesday 4:00 PM HF evaluation rounds (Zoom).
- Thursday 8:15 or 8:30 AM interdisciplinary HF/Transplant (“Candidate Selection”) meeting in the Jay Steiner Conference Room. The Fellow is responsible for presenting the HF patients being considered for LVAD or cardiac transplant, with the Attending providing additional details as needed.
- Friday 8:00 AM Pathology conference in G-7415. Zoom option available but Fellow highly encouraged to participate in-person.
- Optional: OR to see VAD implant or heart transplant procurement/surgery, outpatient cardiopulmonary exercise testing, tissue typing lab.