Use of a 90-Minute Admission Window and Front-Fill System to Reduce Work Compression on a General Medicine Inpatient Teaching Service

Youngjee Choi, Daniel Kim, Hyemi Chong, Christopher Mallow, Jason Bill, Anthony T. Fojo, Melvin Blanchard

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

BACKGROUND: Duty hour limits have shortened intern shifts without concurrent reductions in workload, creating work compression. Multiple admissions during shortened shifts can result in poor training experience and patient care.

OBJECTIVE: To relieve work compression, improve resident satisfaction, and improve duty hour compliance in an academic internal medicine program.

METHODS: In 2014, interns on general ward services were allotted 90 minutes per admission from 3 pm to 7 pm, when the rate of admissions was high. Additional admissions arriving during the protected period were directed to hospitalists. Resident teams received 2 patients admitted by the night float team to start the call day (front-fill).

RESULTS: Of the 51 residents surveyed before and after the implementation of the intervention, 39 (77%) completed both surveys. Respondents reporting an unmanageable workload fell from 14 to 1 (P < .001), and the number of residents reporting that they felt unable to admit patients in a timely manner decreased from 14 to 2 (P < .001). Reports of adequate time with patients increased from 16 to 36 (P < .001), and residents indicating that they had time to learn from patients increased from 19 to 35 (P < .001). Reports of leaving on time after call days rose from 12 to 33 (P < .01), and overall satisfaction increased from 26 to 35 (P = .002). Results were similar when residents were resurveyed 6 months after the intervention.

CONCLUSIONS: Call day modifications improved resident perceptions of their workload and time for resident learning and patient care.

Original languageEnglish (US)
Pages (from-to)245-249
Number of pages5
JournalJournal of graduate medical education
Volume9
Issue number2
DOIs
StatePublished - Apr 1 2017
Externally publishedYes

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Inpatients
Teaching
Workload
Medicine
Patient Care
Hospitalists
Patients' Rooms
Internal Medicine
Compliance
Learning
Surveys and Questionnaires

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Use of a 90-Minute Admission Window and Front-Fill System to Reduce Work Compression on a General Medicine Inpatient Teaching Service. / Choi, Youngjee; Kim, Daniel; Chong, Hyemi; Mallow, Christopher; Bill, Jason; Fojo, Anthony T.; Blanchard, Melvin.

In: Journal of graduate medical education, Vol. 9, No. 2, 01.04.2017, p. 245-249.

Research output: Contribution to journalArticle

Choi, Youngjee ; Kim, Daniel ; Chong, Hyemi ; Mallow, Christopher ; Bill, Jason ; Fojo, Anthony T. ; Blanchard, Melvin. / Use of a 90-Minute Admission Window and Front-Fill System to Reduce Work Compression on a General Medicine Inpatient Teaching Service. In: Journal of graduate medical education. 2017 ; Vol. 9, No. 2. pp. 245-249.
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