ArticleJournal of graduate medical education2012
The impact of the number of admissions to the inpatient medical teaching team on patient safety outcomes.
Article in Journal of graduate medical education, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of evidence-based practices for clinical education and health care delivery in the clinical teaching unit.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2022Pooled it
- Did government subsidy program improve quality of care for children with complex chronic conditions in children's hospitals? A quasi-experimental study in South Korea.Clinical and experimental pediatrics · 2026Article
- 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
- A quality improvement initiative aimed at reducing service strain and improving physician wellness in internal medicine.BMC medical education · 2025Article
- Physician turnover and its association with mortality after non-cardiac surgery: a retrospective cohort analysis of patients in South Korea.Surgery today · 2019Article
- 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
- A "reverse july effect": association between timing of admission, medical team workload, and 30-day readmission rate.Journal of graduate medical education · 2014Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe clinical work in academic internal medicine inpatient units is done by teaching teams. To date, few studies have investigated how team workload affects patient safety outcomes.
objectiveWe examined the association between the number of patients seen by a teaching team, 30-day readmission, and 60-day mortality.
methodsIn this retrospective observational study we defined each team as "less busy" (total monthly admissions ≤49, the median for all teams) or "more busy" (total monthly admissions >49). We compared patients in both groups' demographic characteristics, comorbidities (Charlson score), severity of illness (the Laboratory-based Acute Physiology Score [LAPS]), and length of stay using t tests, χ(2) tests, and rank sum tests, as appropriate. Logistic regression models were constructed to determine whether there was an association between assignment to a busy team and readmission and mortality.
resultsOf 12 119 admissions examined, 6398 (52.8%) were assigned to the less busy teams and 5721 (47.2%) were assigned to busy teams. Mean length of stay was not statistically different between the groups (5.2 vs 5.3 days; P = .08). After adjustment for demographic and clinical characteristics (LAPS and Charlson score), care by a busy team was associated with greater 30-day readmission rate (odds ratio, 1.21; 95% confidence interval [CI], 1.10-1.34) but not with increased risk of mortality (odds ratio, 1.05; 95% CI, 0.88-1.27). There was a significant linear association between the number of monthly admissions to teams and the readmission rate.
conclusionsAdmission to a busier teaching team is associated with a 21% increase in the odds of 30-day readmission. Sixty-day mortality was not affected by the number of monthly admissions to the teaching team.
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Registered trials
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