Pediatric Resident’s Perception of Night Float System Compared to 24 Hours System, a Prospective Study 

Abstract

Background:This study aims to evaluate the pediatric residents’ perceptions of the Night Float (NF) on-call system and its impact on their well-being, education and patient safety and compare it with the previous traditional 24-hour on-call system. Methods: This is a prospective study conducted in two pediatric residents training centers who applied the NF on call system as a pilot project. The senior residents (PGY-3 & PGY-4) enrolled in the two training centers were invited to participate in this study before changing the on-call system and 6 months after starting the new NF on-call system. A self-administered online questionnaire was distributed to them. A five-point Likert-type scale was used to rank the residents’ responses (1 means strongly disagree & 5 means strongly agree), covering three main domains; residents’ well-being, ability to deliver health care, and their medical education experience. Pre- and post-intervention scores were presented as means and compared using the t-test for paired samples.Results: A total of 42 residents participated in the survey. Of these, 24 (57.1%) were females. All participants were senior residents; 25 (59.6%) were third year residents while 17 (40.4%) were fourth year residents. Participants felt that most aspects of the three domains were improved by the introduction of the NF system. The NF system was perceived to have less adverse health effect on the residents (Mean 2.37±1.01), compared to the 24 hours on-call system (Mean 4.19±0.60), P ˂0.001. The NF system was perceived to have less exposure to personal harm, less negative impact on the quality of care, better work efficiency, reduced potential for medical error, more successful teaching and fewer disruptions to other rotations compared to the 24 hours on-call system, (P ˂0.001).Conclusion: The senior residents’ perception about the 24-hour on-call system has shown a negative impact on the residents’ well-being and education of residents and patient safety compared to an on-call system with more restrictive duty hours. The perception of the restricted duty hours was perceived to be less harmful, more useful from pedagogic aspect and has positive impact on the quality of delivered health care services.