ArticleBMC medical education2025
A quality improvement initiative aimed at reducing service strain and improving physician wellness in internal medicine.
Article in BMC medical education, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHospital strain has been shown to negatively impact physician wellness, educational experience, and patient care. To address rising service demands, a non-academic hospitalist service was implemented to reduce daily clinical teaching unit (CTU) census by approximately 30%. Secondary aims were to evaluate physician and trainee wellness on CTU as well as assess unintended adverse patient outcomes.
methodsA two-phase intervention was implemented at one of two academic hospital campuses in January and April 2023. Mean daily census, mortality, 30-day readmissions, and length of stay (LOS) were obtained from an administrative database for the pre-study (October to December 2022) and study (January to December 2023) periods. The Mini-Z physician wellness survey was administered in March, June and December 2023. Data were analyzed by quarters using descriptive statistics as well as parametric and non-parametric testing, and a reflexive thematic analysis was undertaken.
resultsA CTU census trough of 71.3 was briefly attained in the second quarter of 2023 but increased to 78.6 in the fourth quarter of 2023, while remaining below pre-intervention levels. The proportion of attendings and residents reporting burnout was significantly different at the intervention (65.2%, n = 15/23) versus non-intervention site (94.1%, n = 16/17) in Q4 2023 (p = 0.033). Burnout was positively correlated with daily CTU census across both sites (r = 0.906). There were no differences in proportion of in-hospital mortality (p = 0.854), 30-day readmissions (p = 0.262), or LOS (p = 0.977) between the pre- and post-implementation periods. Qualitative analysis identified the hospitalist program as beneficial, but inadequate to address workload, education challenges, and patient safety concerns.
conclusionThe addition of a non-academic hospitalist service reduced CTU census numbers and improved burnout, but the improvement in service strain was limited by rising admissions. Multifaceted approaches to wellness are needed, but this study supports ongoing endeavors aimed at reducing clinical workload to optimize the clinical teaching environment.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.