Day Float: An Alternative to the Night Float Coverage System for Residency Programs

Suryadevara, Amar C.; Zandifar, Hootan; Guyer, Marci; Kellman, Robert M.

doi:10.1097/mlg.0b013e31816bf52f

Cited by 12 publications

(12 citation statements)

References 13 publications

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“…Other studies used interviews [ 39 ], single-blind intervention [ 55 ], randomized crossover [ 56 ], impact evaluation [ 57 ], program evaluation [ 58 ], prospective self-controlled trial [ 59 ], data review [ 60 ], and retrospective cohort design [ 61 ]. Together these studies assessed organizational measures, including relationships among staff [ 39 , 40 , 62 ], work satisfaction [ 43 , 44 , 58 ], continuity of care [ 39 , 40 , 48 , 50 ], workflow [ 49 , 51 , 56 ], compliance [ 38 , 42 , 45 , 46 , 49 , 51 , 52 , 54 , 57 , 58 , 60 ], workload [ 40 , 41 , 43 , 52 - 54 , 59 , 60 ], and cost [ 51 , 61 ]. Interventions included using new technologies to improve handovers and communication [ 42 , 49 , 56 ], changing staff mixes [ 39 - 41 , 43 , 51 , 53 , 58 , 61 ], and implementing new shift structures [ 38 , 44 - 48 , 50 - 52 , 54 , 55 , 57 - 60 ], each of which had varying effects on the above-stated organizational measures.…”

Section: Resultsmentioning

confidence: 99%

“…Many hospitals have altered shift schedules as a result of duty hour reforms. One hospital in the United States using a day float system found that this change was viewed positively by residents and provided enhanced continuity of care for patients [ 48 ]. A variety of the shift models used in the United States, the United Kingdom, and Australia were also associated with improved compliance with the duty hour reform requirements [ 38 , 45 , 47 , 50 - 52 , 54 , 55 , 58 ].…”

Section: Resultsmentioning

confidence: 99%

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Organizational interventions in response to duty hour reforms

2014

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BackgroundChanges in resident duty hours in Europe and North America have had a major impact on the internal organizational dynamics of health care organizations. This paper examines, and assesses the impact of, organizational interventions that were a direct response to these duty hour reforms.MethodsThe academic literature was searched through the SCOPUS database using the search terms “resident duty hours” and “European Working Time Directive,” together with terms related to organizational factors. The search was limited to English-language literature published between January 2003 and January 2012. Studies were included if they reported an organizational intervention and measured an organizational outcome.ResultsTwenty-five articles were included from the United States (n = 18), the United Kingdom (n = 5), Hong Kong (n = 1), and Australia (n = 1). They all described single-site projects; the majority used post-intervention surveys (n = 15) and audit techniques (n = 4). The studies assessed organizational measures, including relationships among staff, work satisfaction, continuity of care, workflow, compliance, workload, and cost. Interventions included using new technologies to improve handovers and communications, changing staff mixes, and introducing new shift structures, all of which had varying effects on the organizational measures listed previously.ConclusionsLittle research has assessed the organizational impact of duty hour reforms; however, the literature reviewed demonstrates that many organizations are using new technologies, new personnel, and revised and innovative shift structures to compensate for reduced resident coverage and to decrease the risk of limited continuity of care. Future research in this area should focus on both micro (e.g., use of technology, shift changes, staff mix) and macro (e.g., culture, leadership support) organizational aspects to aid in our understanding of how best to respond to these duty hour reforms.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Organizational interventions in response to duty hour reforms

2014

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“…Some programs use call-free systems in which patient care is shared by dedicated day and night teams, 12 whereas others use a day float system in which residents leave the hospital at the conclusion of their 24-hr call cycle and their clinical duties are covered by the day float resident. 18 No studies have compared outcomes between these variations.…”

Section: Discussionmentioning

confidence: 98%

Resident Perceptions of the Educational Value of Night Float Rotations

Luks

Smith

Robins

et al. 2010

Teaching and Learning in Medicine

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“…Work-hour limitations were accommodated by using a variety of systems, such as home call, a night-float system, a day-float system, and hiring physician extenders [10,13,14]. Although systems have been devised to maximize resident education, optimize patient care, and maintain resident operative volume, no clear relationship between types of changes and case volume has been established [10,14].…”

Section: Discussionmentioning

confidence: 99%