Nighthawk Making Night Float Education and Patient Safety Soar.

Brett W. Sadowski, Hector A. Medina, Joshua D. Hartzell, and William T. Shimeall

Journal of Graduate Medical Education: December 2017, Vol. 9, No. 6, pp. 755-758.

Journal Club Entry by Kimberly Dao, TUSM-Maine Track Program, M18

In 2003, the Accreditation Council for Graduate Medical Education (ACGME) adopted an 80-hour-workweek restriction for residents. In response, many residency programs have implemented night float rotations for patient coverage despite the numerous reports of its negative impacts on patient care and safety, education, and resident satisfaction. To address the educational void created by overnight training, the authors explored a pilot supervision program that sought to optimize patient safety and improve education.The authors found that establishing enhanced supervision, increased teaching, a must-call list, and reduced conflicting resident roles improved education and increased resident satisfaction.

 

Discussion questions:

  1. What is the night float culture like at Maine Medical Center (MMC)?
  2. What are the measures implemented by the MMC residency programs, if any, addressing patient safety and resident education? Which ones work and which ones don’t?
  3. Where is there an opportunity for improvement? Can MMC benefit from piloting a nighthawk system?
  4. What is the value in night float rotations? Does it still have a place in residency training?

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