The coverage policy has been developed to allow for continuous patient care without any disruptions due to emergency situations. The protocol for coverage has several features to allow for adequate coverage in all situations. Fellows requiring coverage on an immediate basis must themselves be involved in an emergent, unforeseeable incident that could not have been otherwise prevented. These events will require the requesting fellow to contact the chief fellow either in person or via phone and discuss the specifics of the coverage options. When the decision has been made by the chief fellow to grant coverage, the name of the available coverage fellow will be provided. For situations where the requesting fellow is incapable of contacting the coverage fellow, the chief fellow will assist. Otherwise, it is then the responsibility of the fellow who is requesting coverage to contact the coverage fellow either in person or via phone and discuss the specifics of the coverage requirements. Also, it is the responsibility of the fellow requiring coverage to provide full details regarding pertinent patient care issues either over the phone or via email to the covering fellow.
The pool of fellows available to cover will depend on the time of day coverage is required and the rotations from where fellows can be withdrawn. A hierarchial system has been developed to determine the order of coverage. The order of coverage will be first, the nuclear fellow, second, the echo fellow (if there are two echo fellows), and third, the elective fellow. Fellows maybe pulled from these services Monday-Friday from 8am to 5pm when coverage is required.
The next pool of coverage will be provided by the back-up fellow. This is a pre-determined schedule developed in advance and it will rotate a F2 starting every Monday (regardless of holiday /long weekends) through Sunday. This coverage pool exists for nights (after 5pm) and weekends (starting 5pm on Friday until 8am on Monday). Coverage requested for non emergent reasons will require to be paid back to the fellow providing coverage.
Third year fellows are allowed to take a one week vacation without having to find coverage during the UIHC consult service if the division is provided notice 60 days in advance. For these specific situations, the chief fellow will first utilize the back-up fellow, if available and not involved in an ongoing research project and then follow the aforementioned hierarchy to provide adequate coverage. Fellows will not be allowed to take a vacation or go to any conferences without 60 day advance notice signed by the staff attending on that particular service. For fellows requiring coverage for conferences not already provided, the back-up fellow and the hierarchy system will be used. For medical emergencies that require week-long coverage on services, the responsibility may be split between two or three fellows (for example, echo, nuclear fellow etc) and this will be at the discretion of the chief fellow.
For the rare circumstance where coverage is required on nights or weekends and the back-up fellow is ill, coverage will have to be provided by the hierarchial model described above.
Finally, to keep the coverage system equitable for all those involved, all coverage’s will be documented on a spreadsheet for future reference. Most importantly, the pay-back system will be tracked for all coverage issues except for vacation and conference coverage.
The above policies are meant to serve as guidelines to be as fair as possible to all fellows. Minor adjustments in the enforcement of the above policies will be at the discretion of the chief fellow, fellowship program coordinator and fellowship program director. Issues of concern with regard to this policy may be periodically reviewed and refined to suit the needs of the fellowship program.