Drip System for Admissions to Resident Teams: Impact on Workload and Education

Area of Science:

• Pediatric Hospital Medicine
• Healthcare Operations Management
• Medical Education Systems

Background:

• The traditional bolus system for patient admissions led to uneven patient distribution among resident teams.
• This maldistribution necessitated extra faculty involvement for patient care, impacting overall efficiency.

Purpose of the Study:

• To evaluate the impact of transitioning from a bolus to a drip system on resident team workload.
• To assess changes in resident education and faculty utilization following the system change.

Main Methods:

• A retrospective analysis compared data from the bolus system (May 2014-June 2015) with the drip system (May 2016-June 2017).
• Key metrics included daily team census, attending physician schedules, noon conference attendance, in-service examination scores, and duty hour violations.

Main Results:

• The drip system significantly reduced interteam patient variation (6.2 to 3.9 patients) and decreased days with large variations (143 to 25).
• Fewer days involved resident teams at or above capacity (26 to 11) or requiring additional faculty support (61 to 9).
• Resident education metrics, including conference attendance and examination scores, remained unaffected.

Conclusions:

• Transitioning to a continuous daily rotation (drip model) for inpatient admissions promotes equitable workload distribution.
• This operational change enhances physician resource efficiency without compromising resident education quality.