Structure

  • 2 “solid oncology” teams (A & B), each composed of 1 resident and 1 intern.
  • Team A is on call every Monday and Thursday
  • Team B is on call every Tuesday and Friday
  • Only solid oncology (including multiple myeloma and lymphoma) patients are admitted
  • Teams take turn rounding, starting around 8AM. If rounds are routinely running past 10:30AM, please alert the chief residents
  • Team cap: 10 patients

Admitting 

  • 7AM: call team (intern and resident) will begin admitting patients
  • Solid Oncology patients can be admitted from 7 AM to 7:30 PM on call days, with up to 2 of those new admits after 5pm (only 1 of which after 6:30pm).
  • Admission caps: Up to 7 new patients, no more than 5 patients requiring an H&P (ICU transfers and overnight holdovers do not require fresh H&Ps, but progress notes)
  • The call team will take up to two Solid Oncology patients who were admitted by the hospitalist teams overnight (cold handoffs). These two patients will be added to the on-call oncology team’s Epic list by 9100, and the on-call resident should then page the FCP for these patients at 7am to receive sign out.These hand-offs must be completed by 7:30am so these patients can be presented on rounds that day.
  • When patients transfer from hospitalist to housestaff, please cancel the “consult to hospitalist oncology” order, and also change the service name from “Hospitalist Solid Tumor” to “Hematology/Oncology House-staff Solid Tumor”.
  • Patients with a new mass consistent with a malignancy but has not yet undergone formal tissue biopsy and are here for malignancy work up can be accepted to hem-onc housestaff solid tumor and hospitalist solid tumor service.
  • All admissions should all go through 9100. Please epic secure chat 9100 at the beginning of each call day to let them know how many patients you are open to take.
  • On your call day, you should ALWAYS cover the Solid Admitting pager, 4662. When you are capped or not on call, you should sign the pager over to 9100.
  • Patients may be accepted from the ORAC (Oncology Rapid Assessment Clinic, in the old Mitchell ED, next the COVID clinic). Please ensure these patients have beds assigned prior to seeing them. Once you confirm they have a bed, you can go see the patient in ORAC.

Cross Cover

  • On days HONC is admitting, the admitting team will cover the non-call team patients when the non-call team work is done
  • On days HONC is not admitting (W, Sa, Su), both HONC teams sign out to the call cardiology team when their work is done
  • All onc patients should be in CCD. If there are any patients in Mitchell, Gens DF will take cross cover on those patients as the cardiology team on call cannot leave CCD

Nightfloat

  • HONC patients are covered overnight by the cardiology NF team. Any patients in Mitchell will be covered by the gens NF team
  • HONC teams should pick up signout no later than 7AM every morning

End of Service Sign Out

  • Signout emails at the end of your service should always be sent to both the oncoming team member you are signing out to and the intern/resident remaining on service when you leave.

Bone Marrow Biopsies or Intrathecal Delivery

  • If you need to order a bone marrow biopsy or intrathecal chemo, this can be accomplished by asking the APPs on the BMT service. They have someone assigned to help with procedures (p30002). Ask your attending what studies they want from the biopsy and the APPs (or your attending!) can help you with how to order them.
  • It is your responsibility to make sure the patient is consented for a bone marrow biopsy prior to the team doing the Bx. Your attending can help you with the consent process (ideally done during rounds).
    • Call 21314 and ask to schedule a bone marrow biopsy – they can tell you what time slots are available
    • Discuss with BMT team what time would work best for them from available options
    • Call heme lab back and sign the pt up (they need name, MRN, room number)
    • Figure out with your attending whether the pt needs premeds – usually Ativan and or pain med, but not always necessary
    • Also discuss with your attending how long they should be off anticoagulation; if you need guidance, ask the BMT team for help as well

    There might be other things that the APPs would like you to do, so please ask how you can help them in doing the biopsy!

Inpatient Chemotherapy Orders

  • For chemotherapy orders: If a patient with an existing diagnosis requires inpatient chemo and follows at UCMC, please contact the outpatient attending as they will be primarily ordering inpatient chemotherapy if needed. You can email the attending or page if urgent.
  • If the outpatient team is unavailable or cannot order the chemo or the patient does not have an established outpatient onc team, then you can page hematology consults p5330 for assistance.
  • The primary Onc service attending may be able to help consent and put in chemo orders with the pharmacists help (attending-dependent). However, if you need help from an onc fellow for chemo consents or orders, please consult hematology consults p5330, not the chemotherapy fellow.

If you are called about off-service patients, you can direct them to:

  • BMT – Transplant fellow Hem/Onc – p6201
  • Chemo patients/Hospitalists patients with HONC consult needing chemo – p6203
  • Leukemia – p5385
  • Heme/onc consult fellow: p5330

Updated 6/2025