What is it?

Mendeloff is a junior hospitalist team that is localized to the ICU Step Down unit [6th floor South Tower]. There is a Mendeloff A and a Mendeloff B, each comprised of two PGY2/PGY3 residents and one hospitalist attending. Each resident an carry up to 5 hospitalist patients (Cap of 10 hospitalist patients for the whole team) and 1 private attending patient (except Drs. Kaplan and Fine - no cap), which can be redistributed amongst the team members. Private attendings are concierge internists who admit patients under their care in the hospital. The patients admitted under private attendings are admitted and cared for normally, however are staffed with the private attendings instead of the hospitalists.

Beginning 9-9-24, there will be formal interdisciplinary rounds in the ICU-Stepdown Unit. Please see a summary of the format to be followed HERE.

Admitting to IMC during Night Float

During the week, admit to the on-call residents and post-call residents. Both the on call and post call residents can be capped overnight.

During the weekend/holidays, only admit to the on call resident. The on call resident can be capped overnight.

Add all patients to the respective Mendeloff list.

Admissions occur on a rolling basis - if there are downgrades to acute care, that opens up spots for admissions and the nocturnists should be notified.

IMC Bounce Backs

An IMC bounce back is defined as a patient who needs to return to IMC within 48hrs of being downgraded. Starting Wednesday 5/25/22, if a patient is a bounce back within 48hrs back to IMC, it will go to the resident originally taking care of the patient in IMC regardless of call day schedule.

  • Residents can take up to one bounce back in addition to their 5 standing hospitalist patients. This will allow a transient cap of 6 patients.

  • Mendeloff residents will write a brief progress note on the date of bounce back [not an H&P].

  • Residents can only take bounce backs until 12PM as to not interfere with SCC schedules

  • If there is a bounce back after 12pm or if there is more than one bounce back for one resident, it will either go to Mendeloff Long Call [cap remains at 5] or go to nonteaching.

  • No bounce back policy for weekends or holidays.

  • Bounce backs that occur overnight should be staffed with the nocturnist and given to the original Mendeloff resident within the parameters as above. NF MAO/Rapid will write a brief progress note [not an admission note].

Schedule Breakdown

Mendeloff runs on a Q4 call schedule.

During the week,

  • Post-Call: Takes overnight admissions/transfers and daytime admissions/transfers till 2pm.

  • Long Call: Takes overnight admissions/transfers and daytime admissions/transfers till 5pm (typically after both pre-pre-call and post-call residents are capped). Covers RR2 pager from 4-7pm.

  • Pre-Pre-Call: Takes up to two transfers till 2pm. Covers RR2 pager from 6:45am-4pm.

  • Pre-Call: No admissions or transfers. Attends SCC in the afternoon. Signs out to long call resident prior to noon conference if assigned clinic.

  • When there is a mandatory day off: the total cap for the whole team remains at 20. The patient list carried by the resident who has the day off will be distributed amongst the remaining 3 Mendeloff residents. The team is responsible for redistributing patients amongst themselves.

On weekends, 

Private Patients

The ED will page MAO and state there is a patient to be admitted under the private patient. MAO should relay the contact information to Mendeloff Long Call.

  • If the patient requires IMC level care, the patient must be under the care of the hospitalist and should go through the Hospitalist gatekeeper.

  • Check if the on call Mendeloff resident is open [cap is 1 patient].

    • If the patient is cared for Dr. Fine or Dr. Kaplan, there is no cap and this patient must be admitted under Mendeloff by the on call resident. 

      • The next day, the private patients can be redistributed amongst all Mendeloff residents.

  • Long Call: Takes overnight admissions/transfers and daytime admissions/transfers till 5pm. Covers RR2 pager for entirety of shift. Cross-covers co-resident’s patients on their respective team (Mendeloff A or B), but does not admit/transfer to their list.

  • Weekend In House: Takes no admissions or transfers. Cross-covers co-resident’s patients on their respective team (Mendeloff A or B). Signs out at 4pm.

On holidays,

  • Long Call: takes admissions/transfers as per usual (overnight admissions/transfers and daytime admissions/transfers till 5pm). Covers RR2 pager from 2-7pm.

  • Post-Call: No admissions or transfers. If work is completed, can sign out to Long Call Resident at 2pm.

  • Pre-Pre-Call: No admissions or transfers. Covers RR2 pager from 6:45am-2pm. If work is completed, can sign out to Long Call Resident at 2pm.

  • Pre-Call: No admissions or transfers. SCC is closed on holidays, so no afternoon clinic. If work is completed, can sign out to Long Call Resident at 2pm.