Abstract: PO1058
The Battle Between Home Call and Fellows Well-Being
Session Information
- Educational Research
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Educational Research
- 800 Educational Research
Authors
- Cho, Min S., University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
- Alstott, James D., University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
- Fernandes Almeida, Richard S., University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
- Maursetter, Laura J., University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
- Singh, Tripti, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
Background
Night call is traditionally taken by nephrology fellows to provide exposure to after-hour care. Lack of physician wellness and development of burnout are being seen more frequently and may have been enhanced during the COVID-19 pandemic. In an attempt to quantify the burden of call, nephrology fellows at the University of Wisconsin tracked home call activities and aimed to identify areas for improvement.
Methods
Each of the 6 nephrology fellows filled out a daily survey between November 9, 2020 and January 31, 2021, which was the peak of the COVID-19 pandemic in Wisconsin to address: 1) the total amount of sleep hours 2) quality of sleep (restful or fragmented) and 3) whether on-call fellow reported to hospital from home. Responses were collected the following morning to decrease recall bias.
Results
Over the 3-month study period, 100% of the call night data was recorded. The average amount of sleep per night was 5.3 hours. When necessary to report, the average hours of sleep dropped to 4.3 hours. However, if not called in, sleep increased to 5.8 hours per night. The percentage of nights requiring patient evaluation by coming to the hospital overnight was 50% during the study period, with a range of 48% of nights in December and 61% in January. Sleep during night call was described as 55% restful vs. 45% fragmented.
Conclusion
This survey has generated discussion amongst fellowship leadership and current fellows regarding novel ways to improve the night call experience to maximize education and clinical experience during training as well as improve fellow wellness. It was determined that the burden of call did not detract from the fellow education enough to warrant a change to a night float system. However, it did identify changes in management processes such as the timing of labs, implementation of dot phrases, and a sleep expert discussion to improve duration and quality of sleep.
Fellows Home Call Data
| November (11/9/20 - 11/30/20) | December (12/1/20 - 12/31/20) | January (1/1/21 - 1/31/21) | Total Average | |
| Average Hours of Sleep (n) | 5.3 | 5.1 | 5.5 | 5.3 |
| Average Hours of Sleep if Called in (n) | 4.4 | 3.9 | 4.6 | 4.3 |
| Average Hours of Sleep if Not Called in (n) | 5.9 | 5.8 | 5.8 | 5.8 |
| Total Number of Frequency Called In per Month (n) | 10 | 19 | 13 | 14 |
| Percent of Nights Called in (%) | 45 | 61 | 42 | 49 |
| Percent of Nights with Restful Sleep (%) | 55 | 48 | 61 | 55 |
| Percent of Nights with Fragmented Sleep (%) | 45 | 52 | 39 | 45 |