• Paed Child Healt Can · Mar 2015

    An innovative on-call system for paediatric residency programs: The alternate night float.

    • Gregory P Moore, Susanna Talarico, Anna Kempinska, Sarah E Lawrence, and Dany E Weisz.
    • Department of Pediatrics, Division of Neonatology, Children's Hospital of Eastern Ontario; ; Department of Obstetrics and Gynecology, Division of Newborn Care, The Ottawa Hospital - General Campus, Ottawa;
    • Paed Child Healt Can. 2015 Mar 1; 20 (2): 77-81.

    BackgroundNight-float systems, in which residents work consecutive nights, have been increasingly adopted in paediatric programs, but may be detrimental to residents' sleep and mood.ObjectiveTo describe the self-reported impact of a novel system consisting of two consecutive weeks of 16 h overnight shifts every second day that was piloted at the Children's Hospital of Eastern Ontario (Ottawa, Ontario).MethodsA survey of 28 senior paediatric residents examined their experience with the alternate night-float system in three domains (patient care, resident professional development and well-being) and their comparison of the system with the traditional overnight on-call system.ResultsTwenty-six of 28 residents responded. Nearly all (96%) felt familiar with important details of inpatients and that handover was effective (92%). Results were mixed for professional development, with concerns about the quality of supervisors' feedback and perceived difficulty in attending daytime teaching. All residents believed that the night-float system provided a better learning experience compared with the traditional system. Less than 35% considered fatigue to be a notable problem, although 20% increased use of sleep aids or stimulants beyond their typical use. Ninety-six percent believed their workload was appropriate. All residents felt equally or less fatigued under the night-float system compared with the traditional system. Ninety-six percent recommended that the night-float model continue as the on-call system.ConclusionsThis novel night-float system is an alternative method of providing paediatric inpatient night coverage because it meets duty hour regulations and has strong resident approval. Studies to examine its impact on residents and patient care in comparison with other systems are warranted.

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