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Association between ordering patterns and shift‐based care in general pediatrics inpatients
Author(s) -
Vukkadala Neelaysh,
Auerbach Andrew,
Maselli Judith H.,
Rosenbluth Glenn
Publication year - 2016
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.2507
Subject(s) - medicine , graduate medical education , hospital medicine , accreditation , emergency medicine , pediatrics , retrospective cohort study , patient safety , family medicine , limiting , health care , medical education , mechanical engineering , engineering , economics , economic growth
Duty‐hour restrictions have forced changes in care models for inpatient services, including an increase in shift work. In this study we aimed to determine whether a shift model compliant with 2011 Accreditation Council for Graduate Medical Education duty‐hour standards was associated with more active patient care management. Residents caring for pediatric patients changed from a schedule with extended duty shifts and cross‐coverage to one based on day/night shifts, limiting interns to 16 consecutive duty hours. We conducted a retrospective review of orders written under each model. After the intervention, there was a significant increase in the mean number of orders written within the first 12 hours (pre: 0.58 orders vs post: 1.12, P = 0.009) and 24 hours (pre: 1.52 vs post: 2.38, P = 0.004) following admission (not including admission orders), but we did not detect a significantly higher percentage of orders written at night. This shift‐based coverage system was associated with a greater number of orders written early in the hospitalization, indicating more active management of clinical problems. Journal of Hospital Medicine 2016;11:210–214. © 2015 Society of Hospital Medicine