Upon employment, the Employer will provide three (3) white coats to each House Officer for their use for the duration of their training program. These white coats will be personalized with the House Officer's name embroidered, or affixed in another manner, for personal identification. A worn out or damaged coat may be exchanged by the Employee on a one-for-one basis as needed. The house officer's Department is responsible for implementing a process for the facilitation of the cleaning of white coats. This process must exclude the House Officer personally being responsible for delivering and picking-up their white coat from Laundry Services.

Effective FY25 an alternative jacket can be made available for programs that do not utilize white coats on all rotations. The alternative jackets must be approved by the Department Chair and Program Director to be worn during clinical rotations. Each program will establish a standard to be used for all incoming House Officers. Upon a program's request, a House Officer shall be required to facilitate the identification of the alternative jacket for program approval, collection of sizes, ordering, and distribution to the eligible House Officers within their program. House Officer input should be solicited when identifying alternative jacket options. The alternative jackets shall not require name embroidery, laundering by the Employer, or replacement. The total cost of the white coat(s) and/or alternative jacket provided shall not exceed the current cost through the University's prime vendor of 3 white coats for an individual House Officer. Should the purchase of alternative jackets exceed the allowable amount, the Department is responsible for the cost difference.

The Employer has the authority and obligation to make available high quality medical and dental care for patients and to provide and maintain a suitable environment for the practice of medicine for the Employees covered by this Agreement. In this regard, the Employer agrees to make reasonable efforts to continue to improve that care and environment.

The Employees covered by this Agreement have the responsibility and obligation to provide high quality medical and dental care for patients within the resources and environment made available by the Employer.

In implementation of the above, the parties agree as follows: High-quality medical and dental care requires the combined, coordinated and inter-disciplinary efforts and services of a variety of personnel and the specific identification and assignment of tasks required for proper patient care to certain categories of personnel, to the exclusion of other categories, is not practical nor in the best interest of good patient care.

It is understood, however, that House Officers are not normally required or expected to function as clerks, messengers, transporters or custodians. However, House Officers may occasionally be required to perform these functions when no other employees responsible for these services are available.

In no event shall a House Officer be required to perform such functions on a regular and recurring basis for substantial periods of time. The question of whether an individual House Officer is being required to function to this extent as a clerk, messenger, transporter or custodian may be the proper subject of the Grievance and Arbitration Procedure.

In addition and when a House Officer is required or decides, on the basis of direct assignment or in the exercise of professional judgment and in the best interest of good patient care, to perform the principal duties of hospital-related job classifications, whether professional or non-professional, but the House Officer believes the task should be performed by another category of personnel because the time involved in the performance of the task prevents the House Officer from delivering other important medical care on a timely basis, the following procedure should be utilized by the House Officer.

Following completion of the task, immediately contact the House Officer's Program Director, or designee, who will make a decision on the appropriateness of the direct assignment or the House Officer's exercise of professional judgment, or, at the option of the House Officer, make contact with the HOA administrator and they will contact the Administrative Liaison for the University. Prior to contacting the Administrative Liaison, either the House Officer or the HOA will fill out the House Office Improper Work Duty Assignment Claim (attached as Appendix A). The Administrative Liaison will promptly investigate the situation and respond in writing to the House Officer and the Association. A copy of the response will be forwarded to the House Officer's Program Director. If the issue is determined to involve administration of the contract, then the Contract Administrator for the University will be notified and will investigate accordingly.

The Employer will continue to provide for the safety of Employees during the periods of employment. In the event that an Employee or the Association has a grievance concerning this provision, the grievance procedure should be utilized as soon as possible.

The Employer will place equipment and supplies in a consistent manner in each "clean room". Shelves will be labeled and an index available identifying the location of the equipment and supplies available in each "clean room."

The University is committed to providing state-of-the-art safety equipment in the Operating Rooms and Emergency Department. Education will be provided annually to House Officers on the availability and use of equipment through departmental teaching programs. House Officers commit to using the safety equipment provided.

The University will post protocols for needle sticks and other body substance exposures on the Nursing units, the operating rooms, the Emergency Department, angiography suites, and in other applicable areas.

The University will provide available safety and security information and training, as requested by the Association or as deemed appropriate by the University. Hospital Security Services will offer personal safety and violence management training, as requested by the Association.

Recognizing that the improvement of patient care, work environment, and education often involve complex interactions, the appropriate committee(s) and the Labor-Management Committee (LMC) are the proper, but non-exclusive, forums for consideration of these matters.

The University recognizes that its physicians provide care for patients having some of the most difficult medical problems in the State. The University recognizes that the bulk of this care is delivered by the House Officers, along with the attending staff, who are licensed physicians. The University also recognizes that the quality of patient care is directly related to the supportive and ancillary services.

Supportive and ancillary services are those services commonly provided by hospitals, which free physicians from non-physician tasks and permit them to devote the bulk of their time to providing patient care.

The Employer agrees to provide timely phlebotomy service 24 hours a day every day. This service shall include, but not be limited to, blood cultures and all other laboratory draws in all units including all ICU's. However, in extraordinary circumstances only, the regular blood drawing service will not be required to draw blood. For purposes of this section, House Officers are not considered part of the regular blood drawing service. Extraordinary circumstances are defined to be, and limited to, life threatening situations in which a patient is "coding" or "about to code". Whether extraordinary circumstances exist will be determined by a House Officer's assessment of the patient's condition.

The Employer also agrees to provide timely IV services, which shall include, but not be limited to placement and maintenance of IV catheters. This service shall be provided 24 hours a day every day in all units including all ICU's.

The Employer agrees that no less than the current level of IV service will be maintained on an around-the-clock basis during the term of this agreement.

Reporting problems/concerns with designated ancillary services: Incidents will be reported on standard forms to the Association. As trends are recorded, the Association liaison will be appraised of the trend, and appropriate actions will be taken to address the problem.