When working at night, housestaff benefit from complete ancillary support and a senior resident who functions as a Medical Consultant. The hospital provides free meals on call, including pizza on Friday, Saturday and Sunday nights. Intern call rooms are private rooms with shower facilities located in close proximity to patient care areas. Junior and senior residents have rooms in the Resident Call Suite. This suite includes a lounge with a television, vending area, computers, and classrooms. Individual resident call rooms are equipped with a computer, television and shower facility. We are more than willing to assist resident couples in coordinating their call schedules.
Current workhour regulations are carefully adhered to at OSUWMC. To minimize handoffs, which are increasingly recognized as causing almost as many errors as does physician fatigue, we have designed a day team/night team system. Regular inpatient ward teams on general medicine and subspecialty services manage their patients from 7 AM to 6 PM each week day and until work rounds are finished on weekends and holidays. At 6 PM, a dedicated night team appears and assumes responsibility for the ongoing management of the patients. This night team is assigned for the month to the same set of day teams, so that they become familiar with that team’s patients and patterns of care. Night teams work Sunday through Thursday night and have the weekend off. On the weekends, residents on inpatient services only take call from 6am to 7pm. We continue the night float theme by having interns and residents from clinic and consults cover from 6pm on 7am on Friday and Saturday night. These residents will only work one weekend of night float per month while on consults or clinic blocks.
Night Team Curriculum: The medical consultant is an upper level resident (3rd year categorical IM or 4th year med-peds) who is responsible for triaging all internal medicine admissions from the emergency department at night. Additionally, this resident provides education and supervision for the interns and residents on the night float team. He or she often teaches the interns and residents about the patients they are admitting, and also often finds articles on highly relevant topics to provide a stimulus for discussion amongst the residents. The medical consultant is responsible for responding to all in house ERTs (early response team) and code blues. Lastly, he or she does STAT cardiology and general internal medicine consults. The medical consultant, however, is not responsible for staffing any admissions. All admissions are staffed with on call faculty attending physicians.
Night Team Evaluations: Night team members get feedback on their evaluations and write ups from their day team attendings.
Night Team: What's in a name? While you may catch us “slipping” and referring to this rotation as “Night Float”, we emphasize that those working at night are not simply babysitting patients but are providing essential patient care that contributes significantly to the patient’s experience and outcome, and that this care is delivered by a team—with members of the night team and day team working together. The educational experience at night is a valuable component of the overall curriculum.
Interns and residents on inpatient services take call from 7am to 6pm on Saturday and Sunday. Teams that are not on call on the weekend leave after they have finished their work rounds and patient care activities, typically by 12 noon. Interns and residents from consults and clinic take one weekend of nights on a Friday and Saturday from 6pm to 7am.
Each weekday evening, one senior resident stays after clinic/elective to do late admissions until 10:00pm so the work load for night teams remains reasonable.