Hospitalists | DUTIES

St. Louis Children's Hospital

General Pediatric Inpatient Unit - We provide general pediatric attending level coverage on inpatient floors for all otherwise unassigned patients. This includes supervision of medical students and a resident house staff team. Teaching is done both at the bedside as well as in didactic sessions.

Ambulatory Procedure Center (APC) - The APC operates weekdays Monday through Friday to perform invasive procedures and diagnostic studies that require sedations for both inpatients and outpatients at St. Louis Children's Hospital. The center facilitates a wide range of procedures, including but not limited to bronchoscopy, endoscopy, sedation for radiologic procedures, PICC line placement, and ophthalmologic procedures. The hospitalist role in the APC is to oversee nurse administered sedations for radiologic procedures. In addition, the hospitalists provide deep sedation for some of the procedures. The hospitalists receive extensive training in advanced airway skills with the anesthesiology staff in order to perform this service. Teaching is also provided to the Pediatric house staff, as sedation training is part of a required rotation.

Pediatric Intensive Care Unit - Our responsibility for the PICU is to provide coverage at the fellow level during several evening/overnight and weekend days throughout the month. We cover the general medical side of the unit, while another fellow covers the cardiac division. We work directly with the PICU attending staff, nurse practitioners, and house staff. We assist in supervising the on-call residents and medical students in patient management, admissions and discharges, and all procedures. At all times, there is an ICU attending available on call.

Center for After Hours Referral Emergency Services (C.A.R.E.S.) - The C.A.R.E.S. unit offers community pediatricians as well as hospital-based subspecialists an eight bed unit for private referrals during evenings and weekends. It is staffed by one hospitalist attending, one-two medical technicians, one-two registered nurses, and a unit secretary. All patients seen in the C.A.R.E.S. unit must have been referred in for further evaluation. The goal of the center is to provide more directed and tailored care to patients who have already either seen or spoken to their regular physician.

Emergency Unit (E.U.) - The role of the hospitalists in the E.U. is to provide care at the second attending level in the presence of a primary pediatric emergency attending. We provide coverage in two separate shifts, from 9 a.m. until 5:30 p.m. and from 5:30 p.m. until 12:30 a.m. 7 days a week. Duties include the supervision of medical students and residents as well as direct patient care.

Transport - The Saint Louis Children's Transport Team has a physician on every trip. Our group provides coverage from 7 a.m. until 6 p.m. Monday through Friday. During evening and weekends, residents and fellows have the opportunity to go out on transports. Most trips are compiled of the physician, a transport registered nurse, and an emergency medical technician. Trips are made by ground, helicopter, and fixed wing. About half of the transports are neonatal and half are pediatric. Travel includes hospitals in Missouri and Illinois as well as other neighboring states.

PAWS Sedation Service (Pediatric Ambulatory Wound Service) - The PAWS clinic operates seven days a week to perform follow-up care to surgical inpatients and outpatients. Care primarily involves burn dressing and debridements, abscess packing and management, and wound vac dressing changes. The hospitalist role in the PAWS clinic is to oversee and provide procedural sedations for the various procedures. Sedations range from light to deep depending on the procedure to be performed. The hospitalists receive extensive training in advanced airway skills with the anesthesiology staff in order to perform this service. Teaching is also provided to the Pediatric house staff, as sedation training is part of a required rotation.

BJC West County

Newborn Services - an on-site pediatric hospitalist 24 hours a day, 7 days a week to provide a variety of services for newborns born at BJWC. We attend all cesarean section deliveries, complicated deliveries, and provide emergent care and support to newborns in need after birth. Pediatric hospitalists provide daily newborn care and education to those families whose pediatrician is not on staff or who have not yet chosen a pediatrician. We also work with the neonatologists in the Special Cares Nursery, helping to care for those infants who are ill or are born prematurely.

Emergency Pediatric Center - Emergency care is available 24 hours a day, 7 days a week in the Pediatric Unit located on the 1st floor of BJWC. On-site pediatric hospitalists work with pediatric nurses to provide urgent and emergent care to children and their families.

Pediatric Inpatient Unit - There are 8 observation beds located in the Pediatric Unit for those children who need further care or observation. The pediatric hospitalists frequently work with patient's own pediatrician to coordinate care for the child and their family.

Barnes Jewish Hospital - 9400 Nursery

Newborn Services - The 9400 Assesment Nursery is the well-baby nursery for Barnes-Jewish hospital. A small core group of hospitalists provide service in 2 week blocks for this primary teaching service. Clinical responsibilities include daily rounds with the resident team and assessing each newborn. Teaching responsibilities include teaching sessions with the well-baby and special care nursery teams several times per week. We also provide teaching, instruction, and certification in neonatal resuscitation to the residents and medical students through the Neonatal Resuscitation Program. The 9400 clinical working group meets once per month to address clinical issues and to develop evidence based clinical guidelines.