title: Improving resident work environment: evaluation of a novel cooperative program.
abstract: BACKGROUND
  Improving the resident work environment is a major concern for surgery faculty. This study evaluated the ability of a cooperative program with nurses and interns to decrease the number of nonurgent pages and consistently generate a 4-hour block of time at night without nonurgent pages.
  
  
  METHODS
  Multiple discussions with interns and with nurses on 2 nursing floors identified ways to improve nurse/resident communication. These included use of a notebook by nurses to record nonurgent issues and having on-call interns check with the night nurses after night shift report. For the week before and after institution of the program, interns logged each page received. Pretest and posttest data were compared by use of t testing.
  
  
  RESULTS
  Interns logged fewer pages after intervention compared with preintervention (P <.01). In addition, the interns had a 4-hour block of time on call nights without pages more frequently during the posttest period (100% vs 25%, P <.01). The percent of necessary calls increased from 50% to 70% during day shifts (P <.01).
  
  
  CONCLUSIONS
  A cooperative program that focused on decreasing nonurgent pages and maximizing efficient communication led to a decrease in the number of nonurgent pages received by interns and increased the number of call nights in which a 4-hour block of sleep or study time was generated, thereby improving residents' work environment.
authors.affiliation: Department of Surgery, Stanford Hospital, Stanford, CA 94305, USA.
authors.forename: Myriam J
authors.initials: MJ
authors.lastname: Curet
authors.forename: Timothy R
authors.initials: TR
authors.lastname: McAdams
mesh_terms: D005246:Feedback; D006272:Health Facility Environment / Q000592:standards*; D006747:Hospital Communication Systems; D006801:Humans; D007396:Internship and Residency; D009726:Nurses; D012892:Sleep Deprivation / Q000517:prevention & control