Division of Hospital Medicine

Clinical

Independent Inpatient Clinical Service

This service takes care of approximately 25% of all patients admitted to the hospital. The service consists of 8 rounding teams; each team consists of a physician and a nurse practitioner. This service also provides clinical teaching to fourth year medical students during their medicine rotation. All hospitalists rotate through this service. Majority of the patients on a given team are geographically located. As each medicine floor has the capability to provide intermediate (or step-down) care, each team may have some intermediate care patients. Four medical directors (Drs. Kim Pedram, Michelle Brooks, Laura Paletta-Hobbs, and Jatinder Lachar) in concert with nurse managers of the floors support clinical care.

Resident-Run Inpatient Clinical Service

Academic hospitalists rotate through three (out of five) formal general internal medicine teaching teams; each team is staffed by one Internal Medicine resident and two interns or by two PGY2 internal medicine residents without interns (ward managers). Each team also has third year medical students. Almost all patients on each team are geographically located to provide better teamwork and communication.

Consult and Co-management Service

One team provides inpatient general medicine consultation to patients admitted on non-medicine services. This team consists of an academic hospitalist attending, a resident, an intern, and 1-2 medical student(s). Currently, we provide co-management service to a select group of patients on the Orthopedic Service. Dr. Dennis Wixted is the medical director for this service.

MAA Service

We have a unique relationship with our Emergency Medicine colleagues maintained by the presence of the Medical Admitting Attending (MAA). This Hospitalist is stationed in the ED and serves as a liaison between the inpatient medicine teams, Emergency Department, and outside hospital transfers. The MAA receives and assesses patients from ED providers, facilitate their early care, and decide their disposition. Similarly, MAA receives transfer calls from regional hospitals, determines the appropriateness of transfer, and when appropriate accepts patients on behalf of medicine teams.

Procedure Service

he Medicine Procedure consult service was established in July 2016 to further the service, throughput, and academic mission of the Hospital Medicine. This team provides high quality, safe, and efficient bedside procedure services to adult inpatients at VCU Health. A small group of highly skilled and trained hospitalists rotate through this service along with at least one junior resident (PGY-2). The rotation is also offered to IM-Peds residents and Internal Medicine PGY-3 residents as an elective. During their two week rotation, residents train on a simulation based model, provide consultative services, triage and perform supervised bedside procedures, such as central venous lines, lumbar punctures, abdominal paracentesis, and knee arthrocentesis. Residents are also taught the use of ultrasound for bedside procedures. Dr. Manpreet Malik is the medical director for this service.

GME Night Medicine

The GME night medicine service provides teaching and supervision of the internal medicine night float residents. GME night medicine curriculum includes formal midnight report (similar to morning report in structure) as well as informal bedside teaching. In addition, GME night medicine faculty independently covers 8 teaching teams for two nights per week when residents are off. One hospitalist attending staffs this team during the resident covered nights while two hospitalists staff this service when residents are off. Dr. Rajesh Konjeti is the liaison for this service to the residency program.

Support services for other Divisions and the Institution

Hospital Medicine attending also provide coverage to the Palliative Care Medicine and Geriatrics Consult service during evening and nights. In addition, hospitalists are also the responsible physicians for in-hospital codes. Several hospitalists hold senior leadership positions within the institution including Chief Medical Informatics Officer (Dr. Colin Banas), Associate Chief Medical Officer (Dr. Heather Masters), Medical Director, TeleHealth (Dr. Vimal Mishra), Medication Safety Chair (Dr. Melissa Chouinard), and Associate Chair for Quality Department of Medicine (Dr. Sarah Hartigan).