High Quality Consults (How to ask for help like a pro)

Alice Kennedy

Communicate a concise goal with a specific question/request

  • Do you need help diagnosing a patient or thinking about the next step.
  • Are you looking for an expert to help co-manage a specific condition (for example tacro dosing for a transplant patient)
  • Does your patient need a specific procedure?

Know your patient, but share only the most pertinent information in your one liner

  • Always see the patient and inform them about the consult prior to placing the order.
  • Practice a concise one liner to frame the situation over the phone.
  • Communicate the patient's degree of stability so that the consultant can assess the urgency of assessment.

Ensure appropriate timing

  • Please place consults in the morning if at all possible.
  • Consider pending consult orders to sign efficiently during rounds.
  • Most consultants for the day shift arrive at 7AM. If you need an after-hours consult, please prioritize as urgent/STAT as appropriate so that the consultant receives a notification of your request.
  • If requesting a procedure that requires sedation, consider making patient NPO/ holding DVT ppx or sedation.

Anticipate basic information your consultant will need

  • Cardiology: an EKG should generally have been performed and you should have your own interpretation prepped. Do your best to assess the patient's volume status. What is their JVP? Are there crackles on exam? Is there pitting edema?
  • Pulm/MICU: please call from the bedside about urgent problems.
  • Infectious Disease: do your best to do initial history taking/detective work. There is a "staph pager" that goes off whenever anyone in the hospital has Staph aureus, Enterococcus or yeast grows from a blood culture and ID may ask to be consulted in these circumstances.
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