On Call

  • Overview
You have first call responsibility during the rotation. A copy of the call schedule for your block of service is included under the “schedule” section. Call is taken from HOME. 

Weeknight call begins at 17:00 and ends at 8:00 the following morning.  Weekend call begins at 8:00 a.m. and ends at 8:00 a.m.  For weekend days or holiday, contact the palliative medicine physician on call with you prior to the start of call to ensure that you have arranged a place and time to meet.

 When on call you will cover:

1. Providence Care Hospital Palliative Care Unit patients – You are responsible for the patients in the 10 beds of the Palliative Care Unit and others who are on the weekly list for specific reasons.  On weekend days, you will round on the patients as needed. When called, if you are unsure of how to respond, take the information and indicate that you will call back after contacting the palliative medicine physician on call with you.  

2. Community Palliative Care patients – You are only responsible for community patients being followed by the palliative medicine physicians i.e. on the weekly list. (Note: The list is updated weekly on Fridays but changes can occur daily as the community palliative medicine physicians assess new patients throughout the week.  If the patient is not on the current weekly list but has been seen by the community palliative medicine physician since the list was printed, they are our responsibility.) You need to take the weekly list home for reference when on call.  Most of these patients are eligible for home visits if deemed necessary.  Calls regarding patients not followed by one of the community palliative medicine physicians, even if they are ‘palliative’, should be referred to their family physician. If you are unsure of whether you should provide advice to a patient/family/nurse, take their phone number and indicate that you will call them back after contacting the palliative medicine physician on call with you. For any calls that you receive from the community that may require a home visit (see Policy on Resident Safety During Home Visits) you must contact the palliative medicine physician on call with you to discuss further.  

At times, family physicians will call for advice regarding patients not on the weekly list.  These calls should go directly to the palliative medicine physician on call with you.  If you receive a call from a family physician for advice, take their contact information and advise that the palliative medicine physician will call them back.  

3. Palliative Care Clinic patients – You may be contacted after hours by a patient (family/nurse of a patient) who is being followed in one of the Palliative Medicine clinics.  Check the weekly list to see if there are comments related to the patient.  If not and the situation is not complex (e.g. renewal of medication), it is reasonable to respond to their request.  If the request requires further timely assessment, these patients are not eligible for home visits and need to be encouraged to contact their family physician or attend the emergency department of their local hospital if deemed necessary.  If you are unsure of what to do, take their phone number and indicate that you will call them back after contacting the palliative medicine physician on call with you.

4. Kingston General Hospital patients –  
Complex Palliative Medicine Beds: After hours, the non-take Internal Medicine resident provides first call for the Complex Palliative Medicine Beds. You are responsible for providing turnover to this resident at the end of the day and ensuring that they are aware to call the palliative medicine physician on call with you if they have questions/concerns.  On the weekends you will round on these patients daily.

Consult list
patients: You should respond to calls for patients being followed as consults by the KGH Palliative Care Service for symptom control issues ONLY. Other issues, such as new onset fever or chest pain, should be addressed by the attending team.  On weekends, you will round on the patients identified at handover as needing reassessment.  You are also responsible for new consults. 

 When on call you will need:

• Blank death certificates
• Prescription sheets
• The weekly list of community/palliative care unit/KGH patients being followed by our team (provided Monday at turnover rounds & Friday as an updated list to persons on call for the weekend)
• Your stethoscope
• On-call Notes to record telephone calls or home visits* ( download from website)

* You MUST document ALL telephone calls and community visits to patients using the “On-call Notes”, and give them to Ruili Fang the morning following call or Monday morning if on call Saturday or Sunday.
  • Home Visit Policy (PDF)
  • Pronouncement Information
Completion of Death Certificate (PDF)
KGH Policy re: Coroner (PDF)
When to Call the Coroner (PDF)