COTTAGE HEALTH SYSTEM POLICY

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SUBJECT:

 RADIOLOGY RESIDENT PHYSICIAN SUPERVISION POLICY

 

DEPT: MEDICAL EDUCATION
POLICY #: 8240.07

 

GOAL

To define responsibility for supervision of radiology residents.

 

In the clinical learning environment, each patient must have an identifiable, appropriately credentialed and privileged attending physician who is ultimately responsible for that patient's care.  This information should be available to residents, faculty members and patients.  Residents and faculty members should inform patients of their respective roles in each patient's care.

 

The program must demonstrate that the appropriate level of supervision is in place for all residents who care for patients.  Supervision may be exercised through a variety of methods.  Some activities require the physical presence of the supervising faculty member.  For many aspects of patient care, the supervising physician may be a more advanced resident.  Other portions of care provided by the resident can be adequately supervised by the immediate availability of the supervising faculty member or resident physician either in the institution or by means of telephone or electronic modality.  In some circumstances, supervision may include post-hoc review of resident-delivered care with feedback as to the appropriateness of that care. 

 

POLICY

Residents involved in patient care are responsible ultimately to the supervising physician with immediate supervision potentially under the auspices of a more senior radiology resident.

 

1.  

Levels of Supervision

To ensure oversight of resident supervision and graded authority and responsibility, the program must use the following classifications of supervision:

   

a. 

Direct Supervision

The supervising physician is physically present with the resident.

    b. Indirect Supervision
      i.   with direct supervision immediately available:  the supervising physician is physically within the hospital or site of care and is immediately available to provide direct supervision
      ii.   with direct supervision available:  the supervising physician is not present within the hospital or other site of care, but is immediately available by means of telephone and/or electronic modalities, and is available to provide direct supervision.
    c.

Oversight

The supervising physician is available to provide review of procedure/encounter with feedback provided after the care is delivered.

2.

  The privilege of progressive authority and responsibility, conditional independence and a supervisory role in patient care delegated to each resident must be assigned by the program director and faculty members.
    a.   The Program Director must evaluate each resident?s abilities based on specific criteria. When available, evaluation should be guided by specific national standards-based criteria. 
    b.   Faculty members functioning as supervising physicians should delegate portions of care to residents, based on the needs of the patient and skills of the residents.  
    c.   Senior residents should serve in a supervisory role of junior residents in recognition of their progress toward independence, based on the needs of each patient and the skills of the individual resident. Residents in their first, second and third year of radiology residency are considered to be at the intermediate level.  Residents in their fourth year of radiology residency are considered to be in their final year of training. 
3.   There are set guidelines for circumstances and events in which residents must communicate with the appropriate supervising faculty members. 
    a.   Each resident must know the limits of his/her scope of authority and the circumstances under which he/she is permitted to act with conditional independence.
      i. A resident must immediately report to the supervising physician when the resident deems that a case or circumstance is beyond his/her scope of medical knowledge or experience.
4.   Faculty supervision assignments should be of sufficient duration to access the knowledge and skills of the resident on that rotation and delegate to him/her the appropriate level of patient authority and responsibility.

 
PROCEDURE

  1. The radiology residency program provides a schedule which assigns qualified faculty physicians to supervise at all times and in all settings in which residents provide any type of patient care.  The type of supervision to be provided is delineated in the Diagnostic Radiology Residency Curriculum.
  2. The minimum amount/type of supervision required in each situation is determined by the definition of the type of supervision specified, but is tailored specifically to the demonstrated skills, knowledge and ability of the individual resident.  In all cases, the faculty member functioning as supervising physician may delegate portions of the patient's care to the resident, based on the needs of the patient and the skills of the resident.
  3. Progressive authority and responsibility, conditional independence and a supervisory role in patient care is delegated to the resident by the Program Director and faculty members.
    1. First year residents are supervised either directly or indirectly with immediate direct supervision available.
    2. Senior residents serve in a supervisory role of junior residents in recognition of their progress toward independence.
  4. Each resident must know the limits of his/her scope of authority and the circumstances under which he/she is permitted to act with conditional independence.  In the event that a resident determines that a particular case or circumstance is beyond his/her scope of educational knowledge/experience he/she must communicate with the appropriate supervising faculty member. 
  5. Clinical Responsibilities:  The clinical responsibilities for each resident must be based on PGY-level, patient safety, resident education, severity and complexity of patient illness/condition and available support services.
  6. Teamwork:  Residents must care for patients in an environment that maximizes effective communication.  This must include the opportunity to work as a member of effective interprofessional teams that are appropriate to the delivery of care in radiology.
5/12

 


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COTTAGE HEALTH SYSTEM POLICY


RECOMMENDED BY: B. Chow, MD DATE: 5/11

ORIGINAL POLICY EFFECTIVE DATE: 9/99

APPROVED BY: E. Wroblewski, MD DATE: 5/11

DATE REVISED:
DATE REVIEWED: