title: Communication between residents and attending doctors on call after hours.
abstract: OBJECTIVE
  Off-hours medical care in hospitals is provided by residents, while attendings on call are available for assistance. This study evaluated the gap between residents' expectations and professional guidelines' requirements of attendings on call and what actually occurs during night shifts, while comparing surgical and medical specialties.
  
  
  METHODS
  Two questionnaires based on professional guidelines were filled by residents. The first queried about residents' expectations of attendings on call, and the second asked about communication with the attendings during actual night shifts.
  
  
  RESULTS
  While 91 (100%) of residents expected the attending on call to be available by phone during the shift, only 44 (48%) expected the attending to initiate contact, and only 17 (19%) expected the attending to visit the ward or emergency department (ED) without being requested to do so. In 127 shifts (84%), some form of communication occurred. Residents called their attendings during 105 shifts (70%). However, attendings initiated contact with residents at the beginning or during the shift in only 67 (44%) and 62 (41%) shifts, respectively, and initiated a visit to the ward/ED during the shift in only 41 cases (27%). Surgical attendings initiated contact in these three ways significantly more frequently than medical attendings [21 (28%) versus 46 (61%), 20 (26%) versus 42 (56%) and 4 (5%) versus 37 (50%), respectively; P < 0.001].
  
  
  CONCLUSIONS
  While communication during night shifts between residents and attendings occurs in most shifts, attendings initiate far less contact with residents than is required by the guidelines.
authors.affiliation: Hadassah Medical School, Hebrew University of Jerusalem, Jerusalem, Israel.
authors.forename: Michal A
authors.initials: MA
authors.lastname: Novoselsky Persky
authors.forename: Amos M
authors.initials: AM
authors.lastname: Yinnon
authors.forename: Yossi
authors.initials: Y
authors.lastname: Freier-Dror
authors.forename: Ruth
authors.initials: R
authors.lastname: Henshke-Bar-Meir
mesh_terms: D003142:Communication; D006785:Hospitals, University; D006801:Humans; D007396:Internship and Residency; D008505:Medical Staff, Hospital
keywords: attending doctors; communication; night shifts; off-hours care; residents