Table 1.

Frameworks for calling consultation

Framework	Components
5 Cs26,27	• Contact: introduction between consultant and consulting physicians • Communicate: give a concise story and ask focused questions • Core question: specific question with a reasonable timeframe • Collaboration: discussion with changes in diagnostics or management • Closing the loop: ensure both parties are on the same page
PIQUED28	• Prepare: review necessary information for calling the consult • Identify: identify involved parties (patient, trainee, attending physician, consultant) • Question: ask focused question • Urgency: clarify urgency • Educational modifications: let consultant know about your experience or lack thereof, and ask questions that invite teaching • Debrief: elicit and provide feedback on the case
CONSULT25	• Contact courteously: introduce yourself and team • Orient: provide patient’s name, MRN, and location • Narrow question: pose a focused question about diagnosis or treatment • Story: provide a succinct story including pertinent history of present illness, hospital course, and work-up • Urgency: specify whether emergent, very urgent, urgent, or routine • Later: make a follow-up plan and provide contact information • Thank you: show appreciation
MGH framework15	• Step 1: Supervising resident assists the intern in coming up with a specific consult question • Step 2: Interns are encouraged to invite teaching during initial consultation • Step 3: Interns are encouraged to ask questions about the case to facilitate teaching when discussing recommendations with fellow • Step 4: Interns share a teaching point they learned from the fellow on rounds