Changes in inpatient staffing following implementation of new residency work hours

Jennifer M. Oshimura, Jeffrey Sperring, Benjamin D. Bauer, Aaron E. Carroll, Daniel A. Rauch

Research output: Contribution to journalArticle

12 Scopus citations


Background: 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. Objective: 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. Design: 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. Results: 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. Conclusions: 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. Journal of Hospital Medicine 2014;9:640-645.

Original languageEnglish (US)
Pages (from-to)640-645
Number of pages6
JournalJournal of hospital medicine
Issue number10
StatePublished - Oct 1 2014

ASJC Scopus subject areas

  • Leadership and Management
  • Internal Medicine
  • Fundamentals and skills
  • Health Policy
  • Care Planning
  • Assessment and Diagnosis

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