Title | Discrepancies in After-Hours Communication Attitudes between Pediatric Residents and Supervising Physicians. |
Publication Type | Journal Article |
Year of Publication | 2015 |
Authors | Palakshappa D, Carter LP, Saleeby CMEl |
Journal | J Pediatr |
Volume | 167 |
Issue | 6 |
Pagination | 1429-1435.e2 |
Date Published | 2015 Dec |
ISSN | 1097-6833 |
Abstract | OBJECTIVE: To examine differences in expectations when a resident should contact a supervising physician in several hospital-based, after-hours clinical circumstances. STUDY DESIGN: We developed 34 scenarios collectively considered the most common or serious issues encountered by on-call residents, and incorporated them into a survey of pediatric residents, fellows, and attendings. For each scenario, participants were asked whether the resident should talk to the attending/fellow immediately or delay communication until the next day. ORs comparing attendings/fellows and residents were calculated, and subgroup analyses were performed examining differences among the study populations. RESULTS: A total of 112 participants completed the survey (91% response rate). In 17 of the 34 scenarios (50%), more attendings/fellows than residents asked for immediate communication (OR >1; P < .05). Most discrepant scenarios were in uncertain areas in which residents may feel comfortable managing the issue without supervisory input or, alternatively, fail to recognize an evolving matter or a deteriorating clinical status. In subgroup analyses, residents were homogeneous in their responses; however, responses of fellows and junior faculty differed from those of senior faculty in 7 of the 34 scenarios, with senior attendings more likely desiring immediate communication. CONCLUSION: We found differences in expectations of when a pediatric resident should contact a supervising physician after hours not only between residents and attendings/fellows, but among attendings themselves. These differences could lead to medical errors, miscommunication, and inconsistent supervision for overnight residents. |
DOI | 10.1016/j.jpeds.2015.08.052 |
Alternate Journal | J. Pediatr. |
PubMed ID | 26411863 |