The Effect of Overnight In-House Attending Coverage on Perceptions of Care and Education on a General Medical Service

Abstract

An increased emphasis on patient safety has led to calls for closer supervision of medical trainees. It is unclear what effect an increased degree of faculty presence will have on educational and clinical outcomes. The aim of this study was to evaluate resident and attending attitudes and preferences regarding overnight attending supervision. This study was a cross-sectional electronic survey of physicians. Participants were resident and faculty physicians recently on inpatient service rotations after implementation of an overnight attending coverage system. Of 58 total respondents, most faculty (91%) and resident (92%) physicians reported they were satisfied with the overall quality of care delivered and believed the quality of care delivered overnight improved with an in-house attending system (90% and 85%, respectively). Most resident physicians (82%) believed the educational experience improved with the system of increased attending availability. Nearly all faculty (95%) and resident (97%) physicians preferred the in-house attending system to the traditional system of attendings being available by pager. The implementation of such coverage resulted in increased cost to the hospital for compensating covering hospitalist physicians. In-house attending coverage was acceptable to both residents and faculty, with perceived improvements in quality and educational experience.