McGahan BG, Hatef J, Shaikhouni A, Leonard J, Grossbach AJ, Lonser RR, Powers CJ. Resident Night Float or
24-hour Call Hospital Coverage: Impact on Training, Patient Outcome, and Length of Stay.
J Surg Educ 2022;
79:732-739. [PMID:
34866033 DOI:
10.1016/j.jsurg.2021.11.008]
[Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/15/2021] [Accepted: 11/10/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE
The impact of neurosurgical resident hospital coverage system, performed via a night float (12-hour shifts overnight) or a 24-hour call, on neurological surgery resident training and patient care is unknown.
DESIGN
Retrospective review comparing night float and 24-hour call coverage on trainee surgical experience, elective time, annual program surveys, patient outcomes, and length of stay.
SETTING
The Ohio State Wexner Medical Center Neurosurgery residency program, Columbus, Ohio.
PARTICIPANTS
The neurosurgical residents from 2016 to 2019.
RESULTS
Monthly cases performed by junior residents significantly increased after transitioning to a 24-hour call schedule (18 versus 30, p < 0.001). There were no differences for total cases among program graduates during this time (p = 0.7). Trainee elective time significantly increased after switching to 24-hour call coverage (18 versus 24 months after the transition; p = 0.004). Risk-adjusted mortality and length of stay indices were not different (0.5 versus 0.3, p = 0.1; 0.9 versus 0.9; p = 0.3). Program surveys had minimal change after the transition to 24-hour call.
CONCLUSIONS
Transitioning from a night float to a 24-hour call coverage system led to improved junior resident case volume and elective time without detrimental effect on patient-related outcomes.
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