Department of
Internal Medicine at Highland Hospital
A member of Alameda Health System

MASH Triage Rotation

PGY2  MASH  rotation—Medicine Admitting and Systems-based Healthcare

The general internist should be competent to evaluate and appropriately triage patients with medical disease.  Consultative and triage work by nature tests a physician’s abilities to communicate and work in a team based fashion with other medical, emergency department, and surgical specialties.  Experience in working with transitions of care is also part of patient care and systems based practice.

This rotation provides a focused resident experience in a systems- based approach to patient care including:

  1. Emergency Department triage and consultation for patients identified as needing admission, or who would benefit from early assessment by an internal medicine physician.
  2. Using evidence based criteria for hospital admission and level of care.
  3. Clinical decision-making during the patient’s transition from outpatient [emergency department, clinics] to inpatient care, including use of stable admit [holding] orders.
  4. Clinical management of patients whose clinical criteria qualify them for observation status [short-term acute care].
  5. Management and coordination of care for medical patients who will be discharged from the ED who need specialized follow-up care.

Description of the Rotation:

6 days a week the resident will be based in the emergency department from 4:00 pm until 1:00 am.  Hours will vary on weekends.  Until 5-6 pm, MASH resident  will be triaging admits and writing skeleton orders, then signing out to long call team so they can finish the full evaluation and orders.  After 6 pm, MASH will have day-float duties, which combines triage and full admission duties.  Supervision is by the long call and evening attendings and by 3rd year backup resident.

Teaching Methods:

  1. Participate in the admission process for internal medicine patients in the Highland Emergency Department.
  2. Case presentations to the supervising attending and admitting team.
  3. Case presentations at morning report during ambulatory week.