Nocturnist - SFV

 

The Nocturnist Hospitalist shall accept Regal Medical Group (RMG) patients admitted through the Emergency Department, directly admitted from a physician’s office, or transferred from another healthcare facility during the Hospitalist’s scheduled coverage periods, 24 hours per day, 7 days per week, 365 days per year.

 

RMG shall ensure that all patients transferred from another facility are medically stable for transfer. If a physician escort is required, as determined by the Medical Director, RMG shall provide such escort.

 

The Nocturnist Hospitalist shall ensure that teaching and mentoring responsibilities, including supervision of residents, nurse practitioners, or other trainees, do not delay the evaluation, treatment, management, or discharge of RMG patients.

 

Response Time

• The Nocturnist shall return RMG pages, calls, or other urgent communications within twenty (20) minutes during the scheduled coverage period.
• In the rare event that emergent patient care responsibilities prevent a timely response, the Nocturnist shall arrange for appropriate support staff to notify RMG of the delay and provide an estimated response time when possible.
• RMG agrees to make reasonable efforts to limit routine communications to essential clinical or operational matters and to keep such interactions as brief as practicable.

 

 

Daily Patient Management – Nocturnist

• Evaluate all newly admitted RMG patients and enter appropriate management orders within one (1) to two (2) hours of admission.
• Conduct timely assessments and ongoing management of all assigned RMG inpatients during the scheduled overnight coverage period, including weekends and holidays.
• Complete all clinically indicated orders, documentation, and care plan updates before the end of the scheduled shift and communicate any pending issues to the daytime Hospitalist during sign-out.
• Participate in a thorough handoff to the incoming daytime Hospitalist, including patient status, overnight events, pending test results, anticipated discharge needs, and recommended management plans to facilitate continuity of care and avoid delays in treatment or discharge.
• Ensure that urgent clinical issues, admissions, transfers, and consultations are addressed promptly throughout the overnight coverage period.

 

 

Overnight Communication and Sign-Out

• The Nocturnist shall participate in scheduled telephonic communications with RMG case management, the Medical Director, or designated representatives as required during the coverage period. The Nocturnist shall be prepared to provide concise clinical updates regarding newly admitted patients, significant overnight events, transfers, critical care issues, and anticipated discharge or disposition needs.
• The Nocturnist shall provide a thorough and complete sign-out to the incoming daytime Hospitalist at the end of each shift. The handoff shall include patient status, overnight clinical events, pending diagnostic studies, consultant recommendations, anticipated discharge needs, transfer requirements, and any other information necessary to ensure continuity of care.
• The Nocturnist shall clearly communicate any clinical milestones, discharge criteria, repatriation requirements, or pending actions that may affect patient disposition, so that patient care, transfers, and discharges are not delayed during the subsequent shift.
• The Nocturnist shall document significant overnight events, management decisions, and recommendations in the medical record to facilitate effective communication and continuity of care.

 

Consultation and Testing

• The Nocturnist shall exercise independent clinical judgment and utilize their full scope of expertise prior to requesting specialty consultations. When a consultation is requested, the Nocturnist shall clearly communicate the specific clinical question or issue requiring specialist input.
• Specialty consultations shall be requested from RMG-contracted specialists whenever feasible and clinically appropriate. Direct physician-to-physician communication is encouraged for urgent consultations, critical findings, transfers, or significant changes in patient status.
• The Nocturnist shall order diagnostic tests, consultations, and procedures based on clinical necessity and when the anticipated results are expected to influence patient management.
• For newly admitted or transferred patients, the Nocturnist shall review available laboratory and imaging studies and avoid unnecessary duplication of testing when recent results are adequate to initiate or continue clinical management.
• The Nocturnist shall coordinate with consulting physicians regarding urgent overnight issu