Locum Hospitalist

24-Hour Solo Coverage for Rural Hospital

Overview

This position involves 24-hour solo coverage at a Critical Access Hospital, typically entailing 12-15 hours of on-site work with the remainder on call. The physician is provided with nearby or on-site sleeping arrangements.

Key Requirements

• Hospitalists must be proficient in performing emergency intubations, ventilator management, and central line placements.

Required Procedures

Ventilator Management, Central Lines, Intubations.

Coverage Details

Orientation

Shift Coverage

8/1 - 8/11

Schedule

Start Time

Daily shifts commence at 12:00 PM.

Orientation Arrival Time

Typical End Time

12:00 PM daily.

Clinical Settings

Total Beds

25 (Critical Access Hospital)

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Average Daily Census

12 patients (14.5 average daily encounters).

ICU Capacity

Procedures Required

Ventilator Management, Central Lines.

Nights

Anticipate 1-2 admissions per night; transition orders are to be utilized post-10 PM unless the patient requires ICU care—protected sleep hours are between 10 PM to 6 AM.

Specialty Support

• Available specialties include General Surgery, Cardiology, Neurology, Dermatology, Obstetrics, and an outpatient pharmacy operating 24/7.

• Interventional Radiology is accessible Monday through Friday with physician-to-physician call support from hospitalists.

• Imaging services and Orthopedics typically manage their patient coverage, and surgical consults will engage with hospitalists as needed.

• Night and weekend coverage requirements may differ.

Electronic Medical Records

• EMR System: Cerner

Administrative Notes

Sleeping Amenities

On-site or adjacent accommodations for the physician.

Credentialing Timeline

Expedite credentialing as soon as possible.

Licensing Expedite Availability

Consideration for a “telemed” license that may serve as a temporary full license.

Hospitalist Schedule

Shift Structure

Admissions and Rounding

Shift handoffs occur daily between 12 PM and 3 PM.

Morning Rounds

• Typically commence between 7:00 AM and 8:00 AM, depending on facility protocol.

Informal Evening Rounds

• Conducting informal rounds between 9:00 PM and 10:00 PM can enhance collaboration with ED and nursing staff, potentially mitigating late-night admissions and allowing for adequate rest.

Admissions

• Given the rural setting, it’s critical to evaluate patients in the ED prior to admission to avoid unnecessary transfers, especially considering variable ED skillsets.

• Transition orders are to be used during overnight and busy daytime hours to optimize ED throughput.

Overnight Admissions

• Admissions between 11:00 PM and 6:00 AM will require transition orders from ED physicians to reduce documentation burden. Morning rounds should include evaluations of overnight admissions, particularly ICU patients requiring immediate bedside assessment.

Discharges

• Awareness of patients scheduled for discharge is crucial prior to rounding; these patients should be identified during interdisciplinary meetings and prepared by case management to ensure readiness for timely discharge.

Patient Expectations

• Patients should be informed of their discharge plans the previous day, aiming for an early release, typically by noon, to facilitate efficient care transitions and room turnovers for incoming admissions.

Certifications Required

• Board Certification: Yes

• ACLS: Yes

• Additional Certification: Stroke Certification.