E. Supervision Policy

• Moffitt-Long & Mt Zion Medical Center
  UCSF requires that faculty (members of the Attending Medical Staff) actively supervise all residents and ACGME fellows. Supervision is documented in the medical record. Each Medical Center must have a supervision policy. The following pertains to the Parnassus campus.
  • An appropriately credentialed Medical Staff members must:
    • be available to the Housestaff member in person or by telephone
    • direct the care of the patient and provide supervision based on the nature of the patient’s condition, the likelihood of major changes in the management plan, the complexity of care and the experience and judgment of the Housestaff member being supervised.
    • countersign History and Physicals, Operative Reports and Discharge Summaries;
  • Departments must publish call schedules, and these must be prominently available, indicating the responsible faculty member.
  • Housestaff members as individuals must be aware of their limitations. Failure to function within graduated levels of responsibility or to communicate significant patient care issues to the responsible facutly physician may result in the removal of the Housestaff member from patient care activities.
    
    
• San Francisco General Hospital
  SFGH requires that members of the Attending Medical Staff holding UCSF faculty titles (“Attending Faculty”) actively supervise all residents and ACGME fellows (“Housestaff”). The Attending Faculty supervise Housestaff in such a way that Housestaff assume progressively increasing responsibility for patient care according to their level of training, ability and experience. Supervision is reflected in the documentation in the medical record.
  • An appropriately credentialed Medical Staff member must:
    • Be available to the Housestaff member in person or by telephone
    • Direct the care of the patient and provide supervision based on the nature of the patient’s condition, the likelihood of major changes in the management plan, the complexity of care and the experience and judgment of the Housestaff member being supervised.
    • Countersign History and Physicals, Operative Reports and Discharge Summaries.
  • Clinical Service Departments must publish call schedules, and these must be prominently available, indicating the responsible attending to be contacted.
  • Housestaff members as individuals are expected to function within graduated levels of responsibility and to communicate significant patient care issues to the responsible attending faculty physician. Failure to do so may result in the removal of the Housestaff member from patient care activities.
    
    
• Veterans’ Medical Center
  VA policy is that all residents will be supervised by an attending physician. All new patients and any patients with a significant change in status must be presented to an attending physician in a timely fashion. The attending physician must document his/her findings and supervision of the resident in a note. Residents are responsible for communicating to the staff practitioner any significant issues as they related to patient care. This communication must be documented in the medical record. Residents must be aware of their limitations and not attempt to provide clinical services or do procedures for which they are not trained. They must know the graduated level of responsibility described for their level of training and not practice outside that scope of service. Failure to function within graduated levels of responsibility or to communicate significant patient care issues to the responsible staff practitioner may result in the removal of the resident from VA patient care activities. The full policy for Resident Supervision (MCM-22) is available on the VA Intranet under employee resources.