Intern call structure and patient satisfaction.
Our institution has instituted "short-call" and "nightfloat" systems to reduce the number of admissions to the traditional "long-call" housestaff. However, the nightfloat system introduces increased discontinuity to patient care, and interns may spend less time with short-call patients because they are nor required to spend the night on-call. Discontinuity and less time spent with patients may result in decreased patient satisfaction. Over a 6-month period, data were collected on 145 consecutive patients admitted to a teaching Veterans Affairs Medical Center with the primary diagnoses of congestive heart failure and chronic obstructive pulmonary disease. We found that patients admitted to either short-call or nightfloat interns were significantly less satisfied with their care than patients admitted to long-call housestaff, controlling for intern gender, patient age, and patient severity of illness (p = 0.02). Residency program directors need to realize that changes in the structure of teaching environment may have an impact on patient satisfaction.
Griffith
C H
CH
Department of Internal Medicine, Lexington VAMC, KY, USA.
Wilson
J F
JF
Rich
E C
EC
D018806:APACHE; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000628:therapy; D006784:Hospitals, Teaching; D006787:Hospitals, Veterans; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D007629:Kentucky; D007902:Length of Stay; D016014:Linear Models; D008173:Lung Diseases, Obstructive / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009551:Night Care; D010343:Patient Admission / Q000592:standards*; D017060:Patient Satisfaction; D011787:Quality of Health Care / Q000458:organization & administration*; D014940:Work Schedule Tolerance; D016526:Workload