Before you arrive...
Depending on your home residency program and R-level, you will be designated a member of a team and have assigned reading.
- Trauma Team "TT": UW and visiting surgery specialties--UW GS1, AN1, Uro1, OTO1, FM1, VS1, CT1, VS1; Madigan EM1, FMR1, ORS1; Virginia Mason GS1; Swedish GS1, Podiatry R2, Family Medicine R1.
- Trauma Docs "TD": UW GSR2, UW PS2, Peds EM Fellow, Madigan EMR3
- Medicine Team: UW IM1, UW FM3, SCH Peds EM Fellow (some duties on TT as well); Madigan FM2.
- Medic One Docs “M1D”: UW IM2
- UWMC ED rotators: UW and visiting surgery specialties: IM1, AN1, Rehab 1, Psych R1, FM1; Madigan EM1 and EM2.
** You must complete the required reading for your role and team before you start - see the right-hand side bar **
You will receive an email about a month in advance of your rotation outlining the below information and giving you additional information about your upcoming rotation.
- ORCA. You must have completed ORCA training prior to your ED Rotation. If you are a UW resident/fellow and have not had ORCA training prior to your HMC ED rotation, let Elizabeth Jarrett (EJ) know immediately. HMC visiting residents: We normally schedule you for ORCA training on the first day of your rotation. If you are reading this information 2 weeks prior to your rotation and have not received ORCA class registration information, please contact EJ ASAP. UWMC ED Madigan EM1s: You will be scheduled for ORCA training at your all-day UWMC ED orientation day in the summer before the academic year begins.
- LMS (“Learning Management System”) modules. You are required to complete two Education learning modules prior to your rotation. You will receive an email about a month prior to your rotation that will also contain deadlines for completion of the modules, which will take about 60 minutes total to complete. Compliance is tracked and program directors are kept informed. If you have completed these modules on a prior ED rotation with us, you need not take them again.
- Medic Ride-Alongs - Optional Experience for HMC Medic One Docs and Trauma Docs only. On or by prior to the first day of your rotation after you have received your schedule, you must arrange a ride-along with the Medic One office. You are asked to call Vicki Anderson at SFD at 206-386-1483 to make arrangements. The proper attire is slacks/khakis or scrubs, white coat, and ID. Do not wear jeans, shorts or tennis shoes/sandals. Your role is observational only. During station time (when not out on calls) ask the medics about their protocols for common calls: trauma / chest pain, dyspnea, seizures, hypoglycemia, cardiac arrest, etc. ** Note: residents rotating in the ED in June and July are excempt from this requirement. **
- Formal orientation. Because of the complexity and nature of ED schedules, the only three roles to be oriented as a group are: At Harborview: The Medic One Docs and Trauma Docs will orient on IM2 switch days; (note: Madigan EM3s and will be contacted and oriented individually by our Assistant Program Director prior to the rotation.) Other roles (medicine team members, trauma team members) will be oriented individually on their first day on service by the attendings/trauma docs, and nursing staff. At UWMC: All rotating residents (except Madigan, who orient as an R1 group in the summer prior to the academic year) will orient on R1 switch day. You will be reminded a month in advance of your rotation about the day and time.
FirstNet Training Modules
HMC ED & UWMC ED use the FirstNet Tracking and Triage computer systems and ORCA EHR systems. You must complete the training modules listed below before your rotation. Directions: If you are asked to log in, enter amc\yourUserName and your UW Medicine password. (You must enter the amc\ before your user name or it does not work); select ED First Net; click FirstNet eLearning.
Evaluations & Chart Completion
- As a matter of GME policy & patient care, we require you to evaluate the faculty with whom you have worked. During the third week of your rotation, we will email you and ask you to evaluate 4-5 faculty with whom you have worked, giving you a three-day window to do so. Completing the evaluations and submitting them within that time frame is part of your professional responsibility and will be tracked and considered in your final evaluation. Your patient chart documentation must be complete before you leave the rotation. Completing them by that time frame is also part of your professional responsibility & will be considered in your final evaluation. Delinquent charting will be reported to your program director.
Emergency Medicine Policy on Dragon Software use in the ED
Dragon is speech recognition software that allows practitioners to document directly into UW Medicine Electronic Health Record (EHR) systems. Using Dragon for direct entry increases efficiency and decreases the time spent dictating or directly typing notes into the EHR.
To create your Dragon user profile, we offer "Dragon on Your Own" in lieu of attending a training class, this is a reference guide that directs users on how to create and setup their Dragon user profile. The DRAGON ON YOUR OWN GETTING STARTED GUIDE can be downloaded from here:
The guide covers the basics of requesting and creating a Dragon user profile; since your access has already been requested and setup, you may start at Step 2 on page 3 of this guide to get started.
The basic Dragon profile setup takes about 30 minutes to complete, but ongoing training takes time. Integration with ORCA Auto Text or Epic SmartPhrases requires additional setup, but can significantly reduce the time it takes to document. The efficiencies gained by using Dragon come from building up vocabulary and commands, and the time invested in improving Dragon’s accuracy with your own voice.
For more information please visit the Dragon web site:
Badging. Badging is required to enter and remain in the ED. UW/SCH residents/fellows may use their own hospital badges. HMC Visiting residents: You must obtain an HMC badge on or before your first day. Badging office location: Same as the parking office area - 8CT-70. UWED visiting residents (Madigan EM1 residents)--You will receive your ID badges at your summer orientation; please save these for the following year. Madigan EM2s: Wear your badge from the prior year or your Madigan Photo ID badge.
Parking: HMC--Harborview parking is located in room 8CT-70 (eighth floor of the Central Tower at Harborview), hours 0700-1630. Visiting Residents qualify for the UW Resident Pay-per-Use cost, which is about $9.00/day. Call the parking office at 206.744.3254 if you have questions. UWMC ED Madigan EM1 and EM2 residents--UWMC parking vouchers/commuter tickets will be mailed in advance to your home program administrator for distribution to you.
Food and drink during shifts: By DOH regulations, food and drink other than water are not allowed anywhere in the ED. This includes doctors' work areas in the ED Fishbowls and in Zone 4. There are break areas in both EDs.
ED attire: Regular clinic clothes or scrubs, your choice. On the Medicine side at HMC and at the UWMC ED, white coats are encouraged because they help patients identify their physician. ** Note - Wear your own scrubs if possible. If you absolutely need to borrow scrubs from us, they are available but you must let Elizabeth know.
Personal belongings during shifts: At HMC, you may use a locker by contacting Elizabeth Jarrett; at UWMC ED, there is a resident room which can be used to locate your belongings.
EM resident conferences and service teaching: You should not attend any of the Thursday EM resident conferences, but there is service teaching daily after morning report @ HMC and daily teaching by the UWMC 10:00AM attending.
Regarding meal reimbursements: Residents [except Madigan visiting residents] will be reimbursed for meals on shifts 12 hours or longer. Residents may choose to eat in the hospital cafeteria or go elsewhere to purchase food. At HMC, residents will be reimbursed at the rate of $7.50 per 12-hour shift. For UW residents, reimbursements will be made monthly onto their Husky Card accounts; visiting residents (except Madigan) will be cut a check at month-end following the end of their rotation. It is therefore important that you log/verify your hours regularly and accurately since reimbursements are based on MedHub duty hour data. ** You must also insure that your home mailing address information is accurate in MedHub as that is where your check will be mailed.*
Credentialing for Visiting Residents: All visiting residents must be credentialed in advance by UWGME. If you have any questions about the process or your status, contact Elizabeth Jarrett at 206.744.8335 or by email .