title: On-site Night Float by Attending Physicians: A Model to Improve Resident Education and Patient Care.
abstract: BACKGROUND
  In 2003, the Accreditation Council for Graduate Medical Education instituted common duty hour limits, and in 2008 the Institute of Medicine recommended additional limits on continuous duty hours. Using a night-float system is an accepted approach for adhering to duty hour mandates.
  
  
  OBJECTIVE
  To determine the effect of an on-site night-float attending physician on resident education and patient care.
  
  
  METHODS
  Night-float residents and daytime ward residents were surveyed at the end of their rotation about the impact of an on-site night-float attending physician on education and quality of patient care. Responses were provided on a 5-point Likert scale ranging from 1, strongly agree, to 5, strongly disagree.
  
  
  RESULTS
  Overall, 92 of the 140 distributed surveys were completed (66% response rate). Night-float residents found the night-float attending physician to be helpful with cross-cover issues (mean  =  2.00), initial history and physical examination (mean  =  1.56), choosing appropriate diagnostic tests (mean  =  1.79), developing a treatment plan (mean  =  1.74), and improving overall patient care (mean  =  1.91). Daytime ward residents were very satisfied with the quality of the admission workups (mean  =  1.78), tests and diagnostic procedures (mean  =  1.76), and initial treatment plan (mean  =  1.62) provided by the night-float service.
  
  
  CONCLUSIONS
  A night-float system that includes on-site attending physician supervision can provide a valuable opportunity for resident education and may help improve the quality of patient care.
authors: Andrew Paul
authors: AP
authors: Defilippis
authors: Ildefonso
authors: I
authors: Tellez
authors: Neil
authors: N
authors: Winawer
authors: Lorenzo
authors: L
authors: Di Francesco
authors: Kimberly D
authors: KD
authors: Manning
authors: Sunil
authors: S
authors: Kripalani