title: Resident Supervision and Patient Safety: Do Different Levels of Resident Supervision Affect the Rate of Morbidity and Mortality Cases?
abstract: BACKGROUND
  In our academic emergency department, our senior residents lead their own patient care team, known as the red team (RT). Attending physicians are responsible for managing their own team (AT) and precepting the senior resident's cases.
  
  
  OBJECTIVE
  We hypothesized that the RT would have the same number of morbidity and mortality (M&M) cases and similar numbers of adverse outcomes as the AT. We also hypothesized that there would be no increase in M&M cases during the first quarter of every academic year.
  
  
  METHODS
  We obtained data from M&M cases from 2009-2013, including month and year of patient visit, standard of care code (SoCC), and whether the patient was seen by the RT or an AT. Data were analyzed using a χ(2) test comparing expected outcomes with observed outcomes.
  
  
  RESULTS
  There was a total of 117 M&M cases during the study period with a SoCC ≥ 3; 76 cases were AT and 41 cases were RT. There was no statistically significant difference between expected and observed number of cases. Mean RT and AT SoCCs were 4.03 and 4.23, respectively. There was no statistically significant difference between the two groups for SoCC. Mean SoCC was not significantly different for the first quarter of the year.
  
  
  CONCLUSIONS
  We found that our patient care model did not lead to an increased number of M&M cases and RT cases were not associated with worse outcomes overall. Additionally, there was no increased rate of M&M cases in the beginning of the academic year.
authors.affiliation: Department of Emergency Medicine, Mt. Sinai St. Luke's-Roosevelt Hospital Center, New York, New York.
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Van Leer
authors.affiliation: Department of Emergency Medicine, Mt. Sinai St. Luke's-Roosevelt Hospital Center, New York, New York.
authors.forename: Elyse K
authors.initials: EK
authors.lastname: Lavine
authors.affiliation: Department of Emergency Medicine, Mt. Sinai St. Luke's-Roosevelt Hospital Center, New York, New York.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Rabrich
authors.affiliation: Department of Emergency Medicine, Mt. Sinai St. Luke's-Roosevelt Hospital Center, New York, New York.
authors.forename: Dan E
authors.initials: DE
authors.lastname: Wiener
authors.affiliation: Department of Emergency Medicine, Mt. Sinai St. Luke's-Roosevelt Hospital Center, New York, New York.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Clark
authors.affiliation: Department of Emergency Medicine, Mt. Sinai St. Luke's-Roosevelt Hospital Center, New York, New York.
authors.forename: Tommy Y S
authors.initials: TY
authors.lastname: Wong
mesh_terms: D004503:Education, Medical, Graduate; D004635:Emergency Medicine / Q000193:education*; D017052:Hospital Mortality; D006801:Humans; D007396:Internship and Residency; D009017:Morbidity; D010348:Patient Care Team / Q000458:organization & administration*; D061214:Patient Safety; D011787:Quality of Health Care; D012189:Retrospective Studies; D000078329:Workforce
keywords: morbidity and mortality; patient safety; resident education; resident supervision