Effects of a night-float system on resident activities and parent satisfaction.
Night-float systems have recently been proposed as a way to reduce resident stress resulting from irregular sleep patterns. We prospectively evaluated the effects of a night-float system in which designated residents relieved on-call senior residents and interns of routine admissions of patients in medically stable condition during the late-night period (11 PM to 7 AM). Senior residents (3.7 vs 2.4 hours) and interns (3.7 vs 3.2 hours) reported sleeping more under the night-float system than under the traditional system. The night-float system did not affect residents' overall ratings of call nights. Educators who reviewed medical records agreed with residents' decisions about patients' appropriateness for admission using the night-float system in 95 (81%) of 117 cases. When educators disagreed with residents, the most common reasons were the patient's potential educational value or medical instability. The night-float system did not affect interns' ratings of the educational value of late-night admissions or parents' ratings of satisfaction with medical care. We conclude that the night-float system can increase resident sleep with little cost to parent satisfaction, but standards for selective use may be needed to avoid compromising patient care and resident education.
Lieu
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TA
Division of General Pediatrics, University of Pennsylvania, Philadelphia.
Forrest
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CB
Blum
N J
NJ
Cornfeld
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D
Polin
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RA
D003258:Consumer Behavior; D004636:Emergency Service, Hospital; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D010290:Parents; D010343:Patient Admission; D011368:Professional-Family Relations; D011446:Prospective Studies; D012890:Sleep; D013997:Time Factors