ArticleMayo Clinic proceedings2012
Service census caps and unit-based admissions: resident workload, conference attendance, duty hour compliance, and patient safety.
Article in Mayo Clinic proceedings, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Well, How Did We Get Here? The Current State of Pediatric Endocrinology.Journal of pediatrics. Clinical practice · 2026Article
- Safety in Numbers: A Scoping Review of Patient Census and Patient Outcomes.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Article
- Effectiveness of organization-directed interventions on healthcare professionals' well-being: a systematic review.EClinicalMedicine · 2025Article
- Artificial intelligence based assessment of clinical reasoning documentation: an observational study of the impact of the clinical learning environment on resident documentation quality.BMC medical education · 2025Observational
- High-Volume, High-Acuity, and High-Impact Learning: Tips and Tricks for Infectious Diseases Training Programs.Open forum infectious diseases · 2024Article
- Endured and prevailed: a phenomenological study of doctors' first year of clinical practice.BMC medical education · 2023Article
- Veterinarian burnout demographics and organizational impacts: a narrative review.Frontiers in veterinary science · 2023Review
- Preferences to improve rounding efficiency amongst hospitalists: a survey analysis.Journal of community hospital internal medicine perspectives · 2021Article
- The Association of Geographic Dispersion with Outcomes among Hospitalized Pulmonary Service Patients.Annals of the American Thoracic Society · 2020Article
- A Day in the Life of an Internal Medicine Resident - A Time Study: What Is Changed from First to Third Year?Advances in medical education and practice · 2020Article
- Resident Survey on Gastroenterology Training in Canada.Journal of the Canadian Association of Gastroenterology · 2019Article
- Overcoming the barriers of teaching physical examination at the bedside: more than just curriculum design.BMC medical education · 2018Article
- The 2017 ACGME Common Work Hour Standards: Promoting Physician Learning and Professional Development in a Safe, Humane Environment.Journal of graduate medical education · 2017Article
- Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation.BMC medical education · 2017Article
- Implementation of 2011 Duty Hours Regulations through a Workload Reduction Strategy and Impact on Residency Training.Journal of general internal medicine · 2016Article
- The Importance of Fostering Ownership During Medical Training.The American journal of bioethics : AJOB · 2016Review
- Predicting and communicating risk of clinical deterioration: an observational cohort study of internal medicine residents.Journal of general internal medicine · 2015Observational
- Safety in numbers: lack of evidence to indicate the number of physicians needed to provide safe acute medical care.Clinical medicine (London, England) · 2014Article
- Educational Conference Scheduling, Patient Discharge Time, and Resident Satisfaction.Journal of graduate medical education · 2014Article
- The impact of the number of admissions to the inpatient medical teaching team on patient safety outcomes.Journal of graduate medical education · 2012Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the effect of census caps and unit-based admissions on resident workload, conference attendance, duty hour compliance, and patient safety. PARTICIPANTS AND
methodsWe implemented a census cap of 14 patients on 6 Mayo Clinic internal medicine resident hospital services and a unit-based admissions process in which patients and care teams were consolidated within hospital units. All 280 residents and 15,926 patient admissions to resident and nonresident services 1 year before the intervention (September 1, 2006, through August 31, 2007) and 1 year after the intervention (May 1, 2008, through April 30, 2009) were included. Residents' workload, conference attendance, and duty hours were tracked electronically. Patient safety variables including Rapid Response Team and cardiopulmonary resuscitation events, intensive care unit transfers, Patient Safety Indicators, and 30-day readmissions were compared preintervention and postintervention.
resultsAfter the intervention, residents' mean (SE) ratings of workload appropriateness improved (3.10 [0.08] vs 3.87 [0.08] on a 5-point scale; P<.001), as did conference attendance (1523 [56. 8%] vs 1700 [63.5%] conferences attended; P<.001). Duty hour violations for working more than 30 consecutive hours and not having 10 hours off between duty periods decreased from 77 of 9490 possible violations (0.81%) to 27 (0.28%) and from 70 (0.74%) to 14 (0.15%) violations, respectively (both, P<.001). Thirty-day readmissions to resident services decreased (1010 [18.14%] vs 682 [15. 37%]; P<.001). All other patient safety measures remained unchanged. After adjustment for illness severity, there were no significant differences in patient outcomes between resident and nonresident services.
conclusionCensus caps and unit-based admissions were associated with improvements in resident workload, conference attendance, duty hour compliance, and readmission rates while patient outcomes were maintained.
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