scholarly journals On-site Night Float by Attending Physicians: A Model to Improve Resident Education and Patient Care

2010 ◽  
Vol 2 (1) ◽  
pp. 57-61 ◽  
Author(s):  
Andrew Paul DeFilippis ◽  
Ildefonso Tellez ◽  
Neil Winawer ◽  
Lorenzo Di Francesco ◽  
Kimberly D. Manning ◽  
...  
Keyword(s):  
Patient Care ◽  
Resident Education ◽  
Treatment Plan ◽  
Diagnostic Procedures ◽  
Institute Of Medicine ◽  
Night Float ◽  
Quality Of Patient Care ◽  
Attending Physician ◽  
The Impact

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. Conclusion 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.

scholarly journals Pediatric Endocrinology in the Time of COVID-19: Considerations for the Rapid Implementation of Telemedicine and Management of Pediatric Endocrine Conditions

2020 ◽  
Vol 93 (6) ◽  
pp. 343-350
Author(s):  
Molly O. Regelmann ◽  
Rushika Conroy ◽  
Evgenia Gourgari ◽  
Anshu Gupta ◽  
Ines Guttmann-Bauman ◽  
...  
Keyword(s):  
Patient Care ◽  
Care Patient ◽  
The Novel ◽  
Patient Privacy ◽  
Pediatric Endocrinology ◽  
Quality Of Patient Care ◽  
Care Outcomes ◽  
Novel Coronavirus ◽  
The Impact

<b><i>Background:</i></b> Pediatric endocrine practices had to rapidly transition to telemedicine care at the onset of the novel coronavirus disease 2019 (COVID-19) pandemic. For many, it was an abrupt introduction to providing virtual healthcare, with concerns related to quality of patient care, patient privacy, productivity, and compensation, as workflows had to change. <b><i>Summary:</i></b> The review summarizes the common adaptations for telemedicine during the pandemic with respect to the practice of pediatric endocrinology and discusses the benefits and potential barriers to telemedicine. <b><i>Key Messages:</i></b> With adjustments to practice, telemedicine has allowed providers to deliver care to their patients during the COVID-19 pandemic. The broader implementation of telemedicine in pediatric endocrinology practice has the potential for expanding patient access. Research assessing the impact of telemedicine on patient care outcomes in those with pediatric endocrinology conditions will be necessary to justify its continued use beyond the COVID-19 pandemic.

scholarly journals Sports Rehabilitation and Interprofessional Collaboration

10.3823/2613 ◽  
2019 ◽  
Vol 12 ◽  
Author(s):  
Nicholas B Washmuth ◽  
James M Sepich ◽  
Abby D McAfee
Keyword(s):  
Patient Care ◽  
Physical Therapist ◽  
Interprofessional Collaboration ◽  
Healthcare Setting ◽  
High Productivity ◽  
Quality Of Patient Care ◽  
The Impact ◽  
Collaborative Efforts ◽  
Successful Collaboration

Background: The demand for interprofessional collaboration continues to grow due to changing priorities of the health care system.  The benefits of interprofessional collaboration are well documented; however, the methods of collaboration are often unclear and often difficult to put into practice.  While there is a growing number of studies on the impact of interprofessional collaboration in settings such as inpatient, intensive care units, and acute care, there are limited documented cases regarding the interprofessional management of a physical therapy patient in the outpatient orthopedic private practice setting.   Purpose: The purpose of this paper is to describe the reflections of a physical therapist and an athletic trainer in their experience with interprofessional collaboration, describe the barriers they have experienced that make interprofessional collaboration challenging, and to offer solutions to these barriers.  The barriers discussed in the paper include limited knowledge of and respect for other professionals’ skill set, high-productivity work environments, medical hierarchy, overlapping bodies of knowledge, discrepancy between professional reasoning, territorial behavior, and ineffective communication.  Discussion: It appears that contextual factors, such as community in which the professionals practice, the healthcare setting, and the practice environment, have a far less important impact to successful collaboration than the professionals’ attitudes and investment in the collaborative efforts.  Conclusion: Collaboration between a PT and an AT can lead to power struggles and suboptimal patient care if these barriers are not overcome and collaboration may be necessary to provide the highest quality of patient care.

scholarly journals A Systematic Review of the Impact of Physicians’ Occupational Well-Being on the Quality of Patient Care

2015 ◽  
Vol 22 (6) ◽  
pp. 683-698 ◽  
Author(s):  
Renée A. Scheepers ◽  
Benjamin C. M. Boerebach ◽  
Onyebuchi A. Arah ◽  
Maas Jan Heineman ◽  
Kiki M. J. M. H. Lombarts
Keyword(s):  
Systematic Review ◽  
Patient Care ◽  
Well Being ◽  
Quality Of Patient Care ◽  
The Impact

scholarly journals Perceived Quality Improvements Using Daily Allocation of Surgical Residents to the Operating Room and Outpatient Clinics

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Keith Wirth ◽  
Patricia Leung ◽  
Prasanth Patcha ◽  
Aliu Sanni
Keyword(s):  
Patient Care ◽  
Resident Education ◽  
Educational Experience ◽  
Surgical Residents ◽  
Quality Of Patient Care ◽  
Tertiary Center ◽  
Significant Difference ◽  
Busy Clinical Setting ◽  
Balancing Efficiency

Introduction. Balancing efficiency and quality in resident education and clinical care is challenging, particularly in a large tertiary center with resident work hour restrictions. This study investigates the use of daily allocation of surgical residents to operative cases and clinics with the goal of improving patient care, resident education, and coverage. Methods. Surgical residents were allocated to cases and clinic activities a day ahead, with a central email generated and sent to all surgical staff the day prior to the procedures and duties. A ten-item questionnaire was administered to the staff on the surgery service before and after this intervention, evaluating perceptions of educational experience, patient care, and coverage of operative cases, clinic, and floor duty. Results. A total of 28 staff members participated. No significant difference was found in the perception of stress at work, coverage of OR cases, or clinic attendance after the intervention. However, a statistically significant increase () was noted in the perception of resident’s educational experience in the clinic (39% vs. 94%), appropriate case distribution (54% vs. 94%), and quality of patient care (50% vs. 100%). Conclusions. Daily allocation of surgical residents to operative cases and clinic activities improves perceptions of resident educational experience and quality of patient care in a busy clinical setting.

scholarly journals The impact of clinicians' personality and their interpersonal behaviors on the quality of patient care: a systematic review

2014 ◽  
Vol 26 (4) ◽  
pp. 426-481 ◽  
Author(s):  
Benjamin C.M. Boerebach ◽  
Renée A. Scheepers ◽  
Renée M. van der Leeuw ◽  
Maas Jan Heineman ◽  
Onyebuchi A. Arah ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Care ◽  
Interpersonal Behaviors ◽  
Quality Of Patient Care ◽  
The Impact

scholarly journals A Night Float System in Nephrology Fellowship: A Mixed Methods Evaluation

Kidney360 ◽  
2020 ◽  
Vol 1 (7) ◽  
pp. 631-639
Author(s):  
Jennifer B. Plotkin ◽  
Eric J. Xu ◽  
Derek M. Fine ◽  
Daphne H. Knicely ◽  
C. John Sperati ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Patient Care ◽  
Night Float ◽  
Mixed Methods Evaluation ◽  
Included Patient ◽  
Quality Of Patient Care ◽  
Positive Effect ◽  
Neutral Effect

BackgroundJohns Hopkins was an early adopter of an in-house nephrology fellowship night float to improve work-life balance. Our study aimed to elucidate attitudes to guide fellowship structuring.MethodsWe performed a mixed-methods study surveying Johns Hopkins fellows, alumni, and faculty and conducting one focus group of current fellows. Surveys were developed through literature review, queried on a five-point Likert scale, and analyzed with t and ANOVA tests. The focus group transcript was analyzed by two independent reviewers.ResultsSurvey response rates were 14 (100%) fellows, 32 (91%) alumni, and 17 (94%) faculty. All groups felt quality of patient care was good to excellent with no significant differences among groups (range of means [SD], 4.1 [0.7]–4.6 [0.7]; P=0.12), although fellows had a statistically significantly more positive view than faculty on autonomy (4.6 [0.5] versus 4.1 [0.3]; P=0.006). Fellows perceived a positive effect across all domains of night float on the day team experience (range, 4.2 [0.8]–4.6 [0.6]; P<0.001 compared with neutral effect). Focus group themes included patient care, care continuity, professional development, wellness, and structural components. One fellow said, “…my bias is that every program would switch to a night float system if they could.” All groups were satisfied with night float with 4.7 [0.5], 4.2 [0.8], and 4.0 [0.9] for fellows, faculty, and alumni, respectively; fellows were most enthusiastic (P=0.03). All three groups preferred night float, and fellows did so unanimously.ConclusionsNight float was well liked and enhanced the perceived daytime fellow experience. Alumni and faculty were positive about night float, although less so, possibly due to concerns for adequate preparation to handle overnight calls after graduation. Night float implementation at other nephrology programs should be considered based on program resources; such changes should be assessed by similar methods.

scholarly journals The Effect of Restricting Residents' Duty Hours on Patient Safety, Resident Well-Being, and Resident Education: An Updated Systematic Review

2015 ◽  
Vol 7 (3) ◽  
pp. 349-363 ◽  
Author(s):  
Lauren Bolster ◽  
Liam Rourke
Keyword(s):  
Systematic Review ◽  
Patient Care ◽  
Resident Education ◽  
Negative Impact ◽  
Well Being ◽  
Duty Hours ◽  
Night Float ◽  
Protected Time ◽  
Resident Wellness ◽  
The Impact

ABSTRACT Background Despite 25 years of implementation and a sizable amount of research, the impact of resident duty hour restrictions on patients and residents still is unclear. Advocates interpret the research as necessitating immediate change; opponents draw competing conclusions. Objective This study updates a systematic review of the literature on duty hour restrictions conducted 1 year prior to the implementation of the Accreditation Council for Graduate Medical Education's 2011 regulations. Methods The review draws on reports catalogued in MEDLINE and PreMEDLINE from 2010 to 2013. Interventions that dealt with the duty hour restrictions included night float, shortened shifts, and protected time for sleep. Outcomes were patient care, resident well-being, and resident education. Studies were excluded if they were not conducted in patient care settings. Results Twenty-seven studies met the inclusion criteria. Most frequently, the studies concluded that the restrictions had no impact on patient care (50%) or resident wellness (47%), and had a negative impact on resident education (64%). Night float was the most frequent means of implementing duty hour restrictions, yet it yielded the highest proportion of unfavorable findings. Conclusions This updated review, including 27 recent applicable studies, demonstrates that focusing on duty hours alone has not resulted in improvements in patient care or resident well-being. The added duty hour restrictions implemented in 2011 appear to have had an unintended negative impact on resident education. New approaches to the issue of physician fatigue and its relationship to patient care and resident education are needed.

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