title: Oncology house physician model: a response to changes in pediatric resident coverage.
abstract: BACKGROUND
  Given decreasing resident duty hours, subspecialty hospitalist models have emerged to help compensate for the restructured presence of residents. We sought to examine the impact of our pediatric oncology hospitalist model on the oncology unit staff.
  
  
  METHODS
  The survey was developed after a literature review of subspecialty hospitalist models. The final surveys were designed using a 5-point Likert scale. Descriptive statistics were used to compile baseline demographic characteristics of respondents and overall responses to survey questions.
  
  
  RESULTS
  Respondents agreed that house physicians provide better continuity of care (96.8%), are more comfortable with the experience level of the physician (98.4%), and are better able to answer questions (92%). Respondents also agreed that house physicians serve as backup for system-related and patient-related questions and found security knowing an experienced provider was on the floor (87.5%). Responses to open-ended questions indicated that the house physician model has impacted fellow education.
  
  
  CONCLUSIONS
  Our oncology house physician model helps account for decreased residency duty hours. This can serve as a model for other institutions requiring subspecialty inpatient coverage, given resident work hour restrictions. Adjustments in the clinical education of hematology/oncology fellows need to be considered in the setting of competent, consistent, and experienced front-line providers.
authors.affiliation: *Division of Oncology, The Children's Hospital of Philadelphia †Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA.
authors.forename: Alicia
authors.initials: A
authors.lastname: Rapson
authors.forename: Leslie
authors.initials: L
authors.lastname: Kersun
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D016026:Bone Marrow Transplantation; D002648:Child; D003266:Continuity of Patient Care / Q000458:organization & administration; D019538:Health Care Surveys; D006754:Hospital Restructuring / Q000458:organization & administration; D020445:Hospitalists / Q000458:organization & administration*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008495:Medical Oncology / Q000458:organization & administration*; D008505:Medical Staff, Hospital / Q000458:organization & administration*; D017146:Models, Organizational; D064686:Nutritionists / Q000458:organization & administration; D009859:Oncology Nursing / Q000458:organization & administration; D064701:Pediatric Nurse Practitioners / Q000458:organization & administration; D010372:Pediatrics / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D010595:Pharmacists / Q000458:organization & administration; D011570:Psychiatry / Q000458:organization & administration