Mission Bay Service
Quinn Cheng, MD
of Mission Bay Service
Mission Bay is the new UCSF hospital. It is primarily a women's and children's hospital, housing all of pediatrics and OB/Gyn. In addition, several adult surgical services (mostly oncology related) moved to Mission Bay from Mount Zion and Moffitt-Long.
Our Prime Directive of the hospitalist's role is to Always Try to Help. There are no medicine patients at Mission Bay, and the hospitalist will never be the attending of record at MB. Instead, the hospitalist's job is help ensure adult patients receive excellent medical care while they are undergoing surgical, gynecologic, or obstetric care. More specifically, our primary roles include:
Perform medicine consultation
Facilitate consultation by medical specialists
Assist the (pediatric) Emergency Department with adult patients
Respond to Code Blue & assist Rapid Response Team as needed
The hospitalist will consult on medical problems in adult patients. This includes performing preoperative medical evaluations and assessing and managing chronic and acute medical problems in the perioperative period.
Facilitate subspecialty consultation:
As with Mount Zion, few medical specialists are stationed on-site at MB. The hospitalist will be the point of contact for requests for consultation from medical subspecialties, as well as Neurology and Psychiatry. In some cases, the hospitalist may be able to perform the consultation in lieu of the subspecialist. In other cases, the hospitalist will triage and facilitate the specialist's involvement, acting as the liaison between the consultant and primary team. In addition to coming to MB to see the patient in person, specialists also have the option of doing an eConsult (a documented, structured "curbside") or using Tele-health technology to interview and examine patients remotely using a video link.
Emergency Department evaluation and management:
The MB ED is staffed by pediatric emergency medicine providers who may have limited experience with adult patients. The ED will try to minimize the number of adult visits, but recent Mission Bay surgical patients may be referred there. For these patients, the ED will ask the hospitalist to perform the initial evaluation and management with the input from the patient's surgical service. However, patients who cannot be quickly admitted upstairs or discharged should be transported to Parnassus.
The hospitalist will be part of the Code Team (led by the ICU attending or on-call anesthesiologist). The hospitalist is not expected to intubate patients, but needs to be certified in ACLS. The Rapid Response Team may occasionally ask the hospitalist for assistance as well.