1. PROMOTING RESIDENT WELLNESS: A NOVEL CLINIC SCHEDULING MODEL DURING PEDIATRIC INTENSIVE CARE UNIT ROTATIONS

Abstract

Background Pediatric residents at our program self-reported feeling “moral distress” when leaving the pediatric intensive care unit (PICU) for multiple half-day continuity clinics. Few studies have outlined alternative clinic scheduling during PICU months beyond X+Y scheduling or clinic cancellation. Objective To implement and evaluate a novel continuity clinic schedule and measure changes in moral distress and continuity of care. Methods Each pediatric resident was scheduled for one half-day continuity clinic session and one full-day continuity clinic session during their PICU rotation. Residents were not scheduled for clinic on a call day. Residents who had completed at least one PICU rotation were invited to fill out a baseline survey on their perceptions of continuity clinic attendance during the PICU rotation. Following implementation of the new schedule, a post-intervention survey was distributed. Survey questions used Likert scales (range 1-5; 1=never, 5=almost always). Baseline and post-intervention survey data was analyzed using a two-sided Wilcoxon two-sample rank-sum test. Results The pre-intervention survey found over 50% of residents felt moral distress and perceived PICU care was compromised when leaving for clinic. Post-intervention surveys showed a decrease in residents reporting moral distress and compromised PICU care (p Conclusions This novel continuity clinic scheduling model is associated with a decrease in moral distress and improvement in perceived continuity clinic value. Additionally, this model decreased the number of PICU handoffs, which potentially decreased opportunities for medical errors.