Pediatric Orthopaedic Practitioners Society POPS

Message from POPS member Colleen Ditro

Posted over 2 years ago by Suzanne Hilt

Hi I wanted to ask the membership about inpatient management. We are have a ortho retreat next week so I need some info quickly. Who manages your patients on the inpatient side of things? One solo NP/PA or do the practitioners in the clinic round and manage while in clinic?

Thanks Colleen


Susan Laham over 2 years ago

We have 5 docs, 5 PAs, and 2 residents. The residents manage our non-operative kids. Operative kids are followed by whomever assisted (PA v. resident). On the weekends the doc/PA team that is on call manages everyone.

Chuck Wyatt over 2 years ago

I'm at TSRH Sports Medicine. We have 2 Pedi Sports Surgeons and 2 APP's teamed up. We have trainee resident/fellow approx 9 months/year at the moment. Generally one of the two teams are on campus in the OR and we cover eachother's inpatients for the purpose of discharging them when we don't have a trainee. When we do have one the trainee covers the inpatient as far as discharging them. As for inpatient management and answering nursing staff questions and coordination of care that is handled by the teams APP exclusively regardless of what that APP is doing on that day OR vs clinic. Weekend's and holidays are covered by the in-house trainee.
Colleen good question, nice to know what others are doing around the country. Good topic for a round table discussion for future meetings. I think membership benefits from these types of discussions.

Anne Stuedemann over 2 years ago

Hi my friend! At CMH we have 3 full-time inpatient NPs/PA. I work Mon-Fri 8 hour days and my partners work 12 hour days. So we typically have 2 people working the floor during the day and have inpatient NP/PA coverage from 6am-6pm Mon-Friday. Before 6am and after 6pm the residents manage the floor. During the day the inpatient NP/PA team manages all floor issues (admits, discharges, complex care coordination and orders, consult communication, multi-disciplinary communication, surgery planning, follow-ups, PICU transfers, etc). The on-call resident still initially sees the new inpatient consults. This plan works out great for our hospital b/c it allows for continuity of care for our inpatient kiddos and each surgeon's preferences can be carried out with our care planning.

Cherlyn Caneda over 2 years ago

Hello I am from Shriners Honolulu. 4 months out of the year we loose our orthopaedic resident. We have only 3 full time physicians and 3+ part time physicians. There are 3 NP's (inpatient NP, outpatient NP, and another NP that cover our outreach clinics/OR first assist coverage). In general hierarchy of coverage when someone is on vacation 1 Inpatient/surgical H&Ps, 2nd Outpatient Clinic. This allows for continuity of care for the patients. However professionally only covering inpatient can contribute to increased burnout for that particular provider, as such recommend everyone cross train or rotate the inpatient coverage.

Leslie Rhodes over 2 years ago

Hi Colleen! This is a great question and I agree with Chuck, I think this discussion board is a great benefit as a POPS member! Our roles/responsibilities have changed drastically over the years. We have 5 surgeons at LeBonheur in Memphis. Currently, we only have 2 NPs and because of that we cover inpatient only except for on Wednesdays which is the busiest day of the week (clinic and OR), so one covers floor and the other covers clinic and we alternate weeks. We split the week and work 12 hour shifts, overlapping on Wednesday. We have 2 PGY5, 2 PGY3 and 1 PGY1 residents and one fellow who operate and see patients in our clinics. We run very similarly to the way that Anne and her team run at CMH.

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