title: The effect of a resident night team on cesarean delivery.
abstract: We tested the hypothesis that the implementation of a resident night team would change the rate of, the indications for, and the time of day of cesarean delivery. A retrospective chart review was performed on patients who underwent cesarean birth during two time periods. Charts of 1722 patients who had a cesarean delivery between January 1, 1990 through June 30, 1991 (control group) and January 1, 1992 through June 30, 1993 (study group after implementation of a resident night team) were abstracted. All patients were cared for only by resident physicians and all patients delivered during a workweek defined as Sunday 1700 through Friday 0700. Each workday was divided into three shifts (0001-0700; 0701-1700; and 1701-2400) for analysis. After implementation of the night team, the cesarean rate increased (p < 0.002), the proportion of planned repeat cesarean deliveries decreased, the proportion of cesareans for malpresentation decreased (p < 0.005), and the proportion of cesareans for arrest of labor increased (p < 0.0001). These changes were not associated with a change in the temporal distribution for any indication among the three shifts. The implementation of a resident night team did not change the time of day distribution of cesarean delivery for any of six indications.
authors.affiliation: Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Busowski
authors.forename: R A
authors.initials: RA
authors.lastname: Chez
authors.forename: V M
authors.initials: VM
authors.lastname: Goldfain
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000458:organization & administration; D009551:Night Care / Q000379:methods* / Q000458:organization & administration; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies