Association of 1- versus 2-week faculty rotations for resident teaching services on patient outcomes, learning...

Hospitalists increasingly staff inpatient teaching services, and many prefer shorter time-on-service to align with direct patient care schedules and balance competing demands. The impact of 1- versus 2-week attending rotation duration on patient outcomes, faculty burnout, and learning environment is unknown.

Compare differences in patient outcomes, faculty burnout and learning environment perspectives when faculty rotate for 1- versus 2-weeks on inpatient general medicine teaching services.

A retrospective cohort study compared outcomes associated with 1- versus 2-week attending rotations on medicine teaching services at an academic medical center. The primary outcome was hospital length of stay (LOS). Secondary outcomes included readmission within 14 days, return to the emergency department (ED) within 14 days, and death during hospitalization or within 30 days. Surveys were collected from faculty about satisfaction, burnout, and professional fulfillment, and from residents about learning environment satisfaction.

Of 1351 patient hospitalizations, 701 patients were cared for by faculty rounding for 1 week, and 650 by faculty rounding for 2 weeks. Median LOS was similar between the 1- and 2-week groups (94 h [interquartile range [IQR], 46,166] vs. 95 h [IQR, 49,164]; p = .83). There were no differences in readmission, return to ED, or mortality. Faculty and resident satisfaction were similar between groups, except faculty rounding for 1 week had a mean higher satisfaction with their accessibility/availability (4.73 [SD, 0.58] vs. 4.35 [SD, 0.70]; p = .03). There was no difference in professional fulfillment or burnout.

Hospitalist rotation duration of 1 versus 2 weeks on teaching services was not associated with differences in patient outcomes, overall satisfaction, or faculty professional fulfillment or burnout. This suggests that scheduling flexibility can be considered for teaching services.