Changes in inpatient staffing following implementation of new residency work hours.

In 2011, the Accreditation Council for Graduate Medical Education added additional resident work-hour restrictions that limited the number of hours residents could work, with increased emphasis on attending supervision. Our objective was to determine how residency programs have responded to residency work hours, specifically assessing residency night float systems and in-house attending physicians. In May 2012, an electronic survey was sent to all US pediatric residency training programs via the Association of Pediatric Program Directors listserv with e-mail reminders to nonresponding programs. We analyzed data to assess the use of resident night float systems, admission caps, and attending physicians in-house at night. Out of 198 programs contacted, 152 programs responded (77% response rate). Residency programs utilizing a night float system increased from 43% to 71% after new work hours were implemented. Overall use of resident admission caps did not change significantly. Twenty-three percent of programs increased the number of attending physicians in-house at night; 57% of those programs increased the number of pediatric hospitalist attendings, whereas 37% increased the number of pediatric intensivists. There is a trend toward increased pediatric hospitalist attending in-house 24/7 coverage. Of programs without 24/7 coverage, 26% plan to add coverage within 5 years. Only 12% of programs have no in-house attending coverage at night. Although programs vary in their response to changes in residency work restrictions, they most commonly utilize night float systems and increased the amount of in-house attending coverage at night, especially pediatric hospitalist attendings. Many programs plan to add 24/7 pediatric hospitalist coverage within 5 years.

Oshimura JM ，Sperring J ，Bauer BD ，Carroll AE ，Rauch DA ... -  《-》

Inpatient staffing within pediatric residency programs: work hour restrictions and the evolving role of the pediatric hospitalist.

In October 2010, the Accreditation Council for Graduate Medical Education (ACGME) mandated new standards that will further restrict resident work hours. There is growing concern surrounding the impact these restrictions will have on the staffing of inpatient services. The objective of this study was to survey the landscape of pediatric resident coverage of noncritical care inpatient teaching services prior to the implementation of these guidelines. In addition, we sought to explore how changes in work hour restrictions might affect the role of pediatric hospitalists in training programs. In January 2010, an institutional review board (IRB)-approved electronic survey was sent to 196 US residency training programs via the Association of Pediatric Program Directors (APPD) listserve. One hundred twenty responses were received representing 5201 pediatric residents. Of the programs that responded, 84% have hospitalists. At programs with hospitalists (n = 97), 24% have pediatric hospitalist attendings in-house at night. Nearly a quarter of responding programs (22%) reported having no attending physicians in-house at night. At the time of our survey, 31% of programs anticipated the addition of 24-hour in-house hospitalist coverage within the next 5 years. When the additional work hour restrictions are implemented, 70% of programs anticipated the need to add additional hospitalist coverage at night. Significant variation exists in how pediatric teaching services provide overnight coverage. While hospitalists are prevalent in pediatric training programs (84% overall, 67% day only), their role in direct patient care during the overnight hours has been limited thus far. New work hour restrictions will promote the need for more hospitalists.

Oshimura J ，Sperring J ，Bauer BD ，Rauch DA ... -  《-》

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

Suryadevara AC ，Zandifar H ，Guyer M ，Kellman RM ... -  《-》

Results of the 2004 survey of the American Association of Academic Chief Residents in Radiology.

Peterson CM ，Gerstle R ，Bhalla S ，Menias CO ，Jost RG ... -  《ACADEMIC RADIOLOGY》

Pediatric residents' perspectives on reducing work hours and lengthening residency: a national survey.

Gordon MB ，Sectish TC ，Elliott MN ，Klein D ，Landrigan CP ，Bogart LM ，Amrock S ，Burke A ，Chiang VW ，Schuster MA ... -  《-》