Resident Inpatient Service (RIS)
The Resident Inpatient Service (RIS) includes five teams on the inpatient services that include an attending physician, a senior resident, two interns (first year residents), third and fourth year medical students, and often a pharmacist. The UCSF resident physicians are doctors who have graduated from top medical schools around the country and practice under the supervision of an experienced attending physician to provide the highest standard of care.
These RIS teams are responsible for admitting patients to the inpatient medicine services according to an on-call schedule. The teams provide comprehensive patient care including: diagnosis and treatment of acute medical conditions; coordination with specialist consultation services; interprofessional collaboration with nursing, social work, and rehabilitation services.
For questions regarding our Resident Inpatient Service (RIS) please contact Dr. Larissa Thomas at [email protected].
Faculty Inpatient Service (FIS)
The Faculty Inpatient Service (FIS) is a direct care hospitalist service at Zuckerberg San Francisco General Hospital (ZSFG) staffed by UCSF internal medicine physicians within the Division of Hospital Medicine (DHM). FIS delivers care for approximately a third of all patients admitted to the Medicine Service. In addition, FIS provides co-management support to the Orthopedic Surgical Service as well as general medical consultations for all other clinical services throughout ZSFG.
The Faculty Inpatient Service is covered by five hospitalists over three shifts. The day shift consists of two physicians providing direct patient care and one physician providing consultative and co-management support from 7 am to 5 pm. The swing shift consists of one physician that is responsible for triaging, admitting new patients, cross-covering existing patients and providing in-house attending support for the residency program from 1 pm to 10 pm. Lastly, the night shift consists of one nocturnist, who is responsible for distributing the overnight admissions between the Faculty and Resident Inpatient Services, in addition to the aforementioned duties delineated under the swing shift from 9 pm to 9 am.
The core tenets of the service include providing high value care to our underserved patient population, establishing strong interdisciplinary relationships, and creating quality improvement initiatives to enhance the environment we practice in and the experience we share as healthcare providers. Finally, we aim to learn and educate ourselves and others regarding the social determinants of health and how we can better support our patients within the safety net of the city of San Francisco.
Palliative Care Service
The Palliative Care Program at Zuckerberg San Francisco General (ZSFG) aims to meet the needs of seriously ill patients and families through a range of hospital- and clinic-based services, and is able to extend care into patients’ homes through telehealth services and partnerships with home health providers. Through this range of services and our interdisciplinary, holistic approach, we aim to support patients and families from the time that someone is diagnosed with a serious illness, throughout the entire course of treatment.
Our services include:
- Consultation for hospitalized patients, through the Supportive and Palliative Care Service
- Clinic and telehealth services through the Plus Service
- Patient and programmatic support by volunteers
Medicine Consult and Orthopedic Comanagement Service (MCS)
The Medicine Consult and Orthopedic Comanagement Service (MCS) is an inpatient consultative service housed within the Division of Hospital Medicine at Zuckerberg San Francisco General Hospital. The MCS assists with evaluation and treatment of complex medical problems in hospitalized patients at our level one trauma center and safety-net institution. Our mission is to provide high quality consultative and ecomanagement services with compassion and respect.
The MCS is available for our patients and colleagues at ZSFG 24 hours every day. All consultations are performed by a hospitalist attending physician, sometimes with the assistance of a senior UCSF internal medicine resident. Throughout the year, third and fourth year UCSF medical students may rotate on the service on an elective basis. The MCS also provides a didactic curriculum on principals of consultative care, comanagement skills, and perioperative evaluation and medication management for trainees.
Common reasons to obtain a medical consultation include:
- Acute medical problems (e.g. respiratory distress, chest pain, electrolyte disorders, venous thromboembolism)
- Complications of chronic medical problems (e.g. cardiopulmonary disease, liver disease, diabetes mellitus, anticoagulation)
- Comanagement of select patients on the inpatient Orthopedic Service.
- Request to transfer a patient from an outside institution to the ZSFG medicine service.
- Request to transfer a ZSFG inpatient to the internal medicine service.
To obtain a consultation, please call the medicine consult pager at 415-443-7246. For orthopedic comanagement requests, please call the comanagement pager at 415-443-1247. For questions or feedback pertaining to our consultative services or to obtain didactic materials, please contact Dr. Larry Haber at [email protected].
Acute Care for Elders
The Acute Care for Elders (ACE) Unit at ZSFG prevents many of the hazards associated with hospitalization that older adults face. Frequently, despite treating the primary reason for admission correctly, older adults leave the hospital less able to care themselves than before their illness. The ACE unit is a system of acute hospital care starting from admission, designed to maintain or achieve independence and avoid preventable adverse events. The ACE team uses an interprofessional model of care consisting of the bedside nurse, geriatrician, a clinical nurse specialist, an occupational therapist, a pharmacist, a social worker, and a dietitian. The ACE team provides recommendations for comprehensive care for patients on all medical and surgical services at ZSFG. The major components of ACE unit care are:
- Prepared environment (communal dining and private rooftop garden)
- Patient-centered care: care that is aligned with a patient’s goals for themselves with a focus on maintaining independence and early identification and addressing risk factors for dependence (functional, cognitive, social)
- Daily ACE team rounds with review of the acute illness and chronic medical conditions and medications in the context of a patient’s functional, cognitive, and social conditions.
- Early and regular mobility and discharge planning
The ACE unit has achieved excellent functional and cognitive outcomes for patients cared there.
Patients are admitted to the ACE directly from the Emergency Department and in select cases, in transfer from other units.