Comments on: Making night float work http://www.medrants.com/archives/3680 Internal medicine, American health care, and especially medical education Sat, 11 Feb 2012 15:15:48 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Patrick B http://www.medrants.com/archives/3680/comment-page-1#comment-521013 Patrick B Tue, 05 Aug 2008 19:53:45 +0000 http://www.medrants.com/?p=3680#comment-521013 I think another very good alternative is Day Float. At our program, we have a day float resident. A hospitalist team admits from 0600-noon, allowing teams to round without interruption. We have a day float resident who rounds with the on-call team, and takes admissions from noon to 1700. Meanwhile, the resident for the on-call team comes in at 1700 and takes turnover from the day float resident. Meanwhile, interns alternate q4 long and short call--short call admits during the day until 8pm, and then the long call takes over. This way, interns rarely "cap", and somebody from the on-call team is involved in every admission. Plus, the next day, the overnight intern leaves by noon, and is able to hand off his/her work to the other intern on the team and the resident. It maximizes continuity, there is only q8 overnight call, nobody has any work hour issues, and there is still time for didactics. I think another very good alternative is Day Float. At our program, we have a day float resident. A hospitalist team admits from 0600-noon, allowing teams to round without interruption. We have a day float resident who rounds with the on-call team, and takes admissions from noon to 1700. Meanwhile, the resident for the on-call team comes in at 1700 and takes turnover from the day float resident. Meanwhile, interns alternate q4 long and short call–short call admits during the day until 8pm, and then the long call takes over. This way, interns rarely “cap”, and somebody from the on-call team is involved in every admission. Plus, the next day, the overnight intern leaves by noon, and is able to hand off his/her work to the other intern on the team and the resident.

It maximizes continuity, there is only q8 overnight call, nobody has any work hour issues, and there is still time for didactics.

]]> By: Theresa http://www.medrants.com/archives/3680/comment-page-1#comment-521012 Theresa Tue, 05 Aug 2008 15:52:59 +0000 http://www.medrants.com/?p=3680#comment-521012 I agree absolutely. My Night Float experience was relatively well-integrated into the overall residency curriculum, and I think it enhanced rather than detracted from my learning experience. However, many Night Float systems are merely tacked onto an already busy curriculum as a work-hours saving device, and these are--I suspect--less educational. I'm going to propose a Modest Solution on my blog at the end of the week. I agree absolutely. My Night Float experience was relatively well-integrated into the overall residency curriculum, and I think it enhanced rather than detracted from my learning experience. However, many Night Float systems are merely tacked onto an already busy curriculum as a work-hours saving device, and these are–I suspect–less educational. I’m going to propose a Modest Solution on my blog at the end of the week.

]]>