Resident-faculty overnight discrepancy rates as a function of number of consecutive nights during a week of night float
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Christine Peterson
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Michael Moore
Abstract
Objectives
In 2018, the ACGME (Accreditation Council for Graduate Medical Education) made a change to the maximum permissible number of consecutive nights a resident trainee can be on “night float,” from six to seven nights. To our knowledge, although investigators have studied overall discrepancy rates and discrepancy rates as a function of shift length or perceived workload of a particular shift, no study has been performed to evaluate resident-faculty discrepancy rates as a quality/performance proxy, to see whether resident performance declines as a function of the number of consecutive nights. Our hypothesis is that we would observe a progressive increase in significant overnight resident – attending discrepancies over the 7 days’ time.
Methods
A total of 8,488 reports were extracted between 4/26/2019 to 8/22/2019 retrospectively. Data was obtained from the voice dictation system report server. Exported query was saved as a .csv file format and analyzed using Python packages. A “discrepancy checker” was created to search all finalized reports for the departmental standard heading of “Final Attending Report,” used to specify any significant changes from the preliminary interpretation.
Results
Model estimates varied on different days however there were no trends or patterns to indicate a deterioration in resident performance throughout the week. There were comparable probabilities throughout the week, with 2.17% on Monday, 2.35% on Thursday and 2.05% on Friday.
Conclusions
Our results reveal no convincing trend in terms of overnight report discrepancies between the preliminary report generated by the night float resident and the final report issued by a faculty the following morning. These results are in support of the ACGME’s recent change in the permissible number of consecutive nights on night float. We did not prove our hypothesis that resident performance on-call in the domain of report accuracy would diminish over seven consecutive nights while on the night float rotation. Our results found that performance remained fairly uniform over the course of the week.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Ethical approval: Per institutional IRB, this study was determined to be exempt.
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© 2020 Walter de Gruyter GmbH, Berlin/Boston
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Artikel in diesem Heft
- Frontmatter
- Editorial
- Chest pain management and biomarkers: the lack of trust in cardiac troponins measurement
- Reviews
- Bringing the clinical laboratory into the strategy to advance diagnostic excellence
- Atrial fibrillation: is there a role for cardiac troponin?
- Opinion Papers
- Towards better metainterpretation: improving the clinician’s interpretation of the radiology report
- The challenges of diagnosing diabetes in childhood
- Guidelines and Recommendations
- Measuring patient experience of diagnostic care and acceptability of testing
- Original Articles
- Clinical assessment of the Roche SARS-CoV-2 rapid antigen test
- Delayed treatment of bacteremia during the COVID-19 pandemic
- Strengths and weaknesses in the diagnostic process of endometriosis from the patients’ perspective: a focus group study
- Identifying trigger concepts to screen emergency department visits for diagnostic errors
- Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors
- Uncertain diagnoses in a children’s hospital: patient characteristics and outcomes
- The effects of rudeness, experience, and perspective-taking on challenging premature closure after pediatric ICU physicians receive hand-off with the wrong diagnosis: a randomized controlled simulation trial
- Resident-faculty overnight discrepancy rates as a function of number of consecutive nights during a week of night float
- CONUT: a tool to assess nutritional status. First application in a primary care population
- Is there a real need for sputum culture for community-acquired pneumonia diagnostics? Results from a retrospective study in Russia
- Differentiating solid breast masses: comparison of the diagnostic efficacy of shear wave elastography and magnetic resonance imaging
- Short Communication
- Chest pain management: use of troponins in internal medicine wards
- Case Report
- Learning from tragedy – The Jessica Barnett story: challenges in the diagnosis of long QT syndrome
- Letters to the Editor
- Usability of non-medicinal swabs for SARS-CoV-2 detection to circumvent supply shortages
- Medical decision making during the COVID-19 epidemic: an opportunity to think how we think
