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.

Admitting to ICU-sd during Night Float

During the week, pre-pre call and post call can be capped. Long call can accept admissions but must be open for 2 during the day, 7x/week.

During the weekend/holidays, only admit to the long call resident. Long call can accept admissions but must be open for 2 during the day, 7x/week.

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. Any patient downgraded from ICU-SD who needs to return to ICU-SD within 48hrs will return to the resident taking care of the patient, regardless of call schedule.

  • A transient increase to a cap of 6 is acceptable in this situation to allow for continuity. 

  • If the resident is assigned to clinic at the time of the bounce back, the hospitalist for that team will manage the patient and the resident will assume care at the time of signout of 6:45pm. 

Nonteaching transfers

  • Hospitalists may transfer patients to the nonteaching service (ex. patients pending downgrade/discharge/hospice) to create an open spot for an admission.

  • Hospitalists may move a patient from nonteaching to teaching if there is educational benefit. 

Schedule Breakdown

Mendeloff runs on a Q4 long call schedule.

During the week,

There will be a rolling cap for all 4 resident positions in the ICU-SD unit. This means if a patient is upgraded/downgraded/discharged, this opens up a spot for a new patient. The cap remains at 5 Hospitalist patients for all Mendeloff residents. Please note, this does not include private patients (acute care patients under Dr. Harry Kaplan). 

Mendeloff Long Call

  • Cannot be capped overnight. Must be left open for 2 spots during the call day. This policy will stand 7 days a week, including holidays. 

  • Can accept new patients until 5PM.

  • Holds RR2 4:00 to 6:45PM.

Mendeloff Pre-Pre Call

  • Can be capped overnight.

  • Accepts admissions or transfers until 2PM.

  • Holds RR2 pager from 6:45AM to 4:00PM

Mendeloff Post Call

  • Can be capped overnight.

  • Accepts admissions/transfers until 2PM.

Mendeloff Pre-Call

  • If assigned Sinai Community Care in the afternoon, does not accept new patients.

  • Cannot be capped overnight if no clinic is assigned.

  • If the resident is not assigned clinic:

    • The pre-call resident stays in house until 4PM.

    • The pre-call resident can accept (2) admission/transfers from 6:45AM to 2PM

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.

on weekends…

  • 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 only admits to the long call 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 to long call.

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.