Sinai Stroke:
The Stroke Service cares for patients in two levels of acuity: a stroke step-down unit and stroke patients on the regular medical-surgical unit. The Stroke Team consists of a Stroke Attending, with fellowship training in Vascular Neurology, a Vascular Neurology Fellow, a PGY-4 neurology resident, one PGY-2 resident and 1-2 physicians assistants (PAs). Medical students include 2-3 Mount Sinai students in their third year of medical school and occasional medical students visiting from both US and foreign medical schools.
The senior resident is the primary delegator of responsibilities and facilitator of multi-level education. He/she responsible for overseeing the service and guiding day-to-day patient care decisions. They work with the various consult teams and the stroke fellow and attending to admit any acute or sub-acute stroke patients. They discuss with the stroke fellow and the NSICU about any stroke downgrades to the floor (the stroke fellow will do the initial consult in the NSICU and decide when is a safe time for downgrade). We encourage the senior residents and stroke fellows to foster collaborative processes within the stroke service and between ED and inpatient consult teams.
The PGY-2 and the PAs are responsible for carrying out the daily patient care responsibilities such as writing progress notes, writing orders, gathering data for work and teaching rounds and maintaining Sign-outs. On new patients, the PGY-2 or PA writes an admission note, admission orders, and an Epic Signout.