Reducing Resident Physician Workload to Improve Well Being

Area of Science:

• Medical Education
• Healthcare Management
• Internal Medicine

Background:

• Resident physician well-being is often negatively impacted by long work hours and high patient admission volumes.
• The evening admitting shift (short call) at this institution was linked to increased resident stress and reduced well-being.
• A novel intermediate swing shift was implemented to alleviate these pressures.

Purpose of the Study:

• To evaluate the impact of a new swing shift on the departure times of short call physicians.
• To assess changes in the median number of patient admissions handled by short call, swing shift, and night shift residents.
• To determine the effect of the swing shift on resident well-being and patient care.

Main Methods:

• A prospective survey study comparing resident experiences before and after swing shift implementation.
• Internal Medicine and combined Medicine/Psychiatry residents were surveyed regarding shift duration and admission numbers.
• Data on median departure times and admission counts were analyzed.

Main Results:

• Short call physicians' median departure time improved from 8:30-9:00 PM to 7:00-7:30 PM post-implementation.
• The median number of admissions decreased for short call physicians (from 4 to 2) and night shift physicians (from 8 to 5).
• Swing shift physicians admitted a median of 5 patients between 4:00 PM and midnight.

Conclusions:

• The addition of a swing shift significantly improved the timeliness of short call resident departures.
• Reduced admission burdens for short call and night shift residents likely enhance overall resident well-being.
• The swing shift effectively managed admitting duties while preserving patient care continuity.