Day float: an alternative to the night float coverage system for residency programs.

Area of Science:

• Medical Education
• Surgical Residency Programs
• Healthcare Administration

Background:

• The Accreditation Council for Graduate Medical Education (ACGME) mandated an 80-hour work week, necessitating changes in residency program structures.
• Otolaryngology programs commonly adopted home call or night float systems to comply with work hour regulations.
• The department's responsibility for maxillofacial trauma and backup airway calls presented challenges for implementing a traditional home call system.

Purpose of the Study:

• To evaluate the effectiveness and resident perception of a newly implemented day float call system in an otolaryngology residency program.
• To compare resident experiences with the day float system against traditional night float and home call models.

Main Methods:

• A literature review on existing call coverage systems was conducted.
• A novel day float system, involving a 24-hour call period with subsequent home rest, was implemented and described.
• A nine-question survey was administered to otolaryngology residents to gather feedback on their experiences with night float, day float, or both systems.

Main Results:

• Survey responses indicated a strong preference for the day float system among residents.
• This preference was consistent across different training levels and prior experience with various call systems.
• The day float system was favored over the night float coverage model.

Conclusions:

• The day float call system is highly favored by residents in this otolaryngology program.
• This system offers benefits such as an "attending-like" 24-hour call experience, improved continuity of care, and better work-life balance.
• The day float model facilitates attendance at educational activities and allows for more family time, while eliminating prolonged periods without clinical engagement.