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Journal of General Internal Medicine

, Volume 5, Issue 6, pp 501–505 | Cite as

Post-call transfer of resident responsibility

Its effect on patient care
  • Richard P. Lofgren
  • Daniel Gottlieb
  • Rae A. Williams
  • Eugene C. Rich
Original Articles

Abstract

Objective:To determine whether transferring the care of patients to another senior resident the day after admission to the bospital adversely affects the efficiency and quality of care.

Design:Retrospective analysis of a natural experiment.

Setting:The general medical service of the Minneapolis Veterans Affairs Medical Center, a major tertiary teaching hospital of the University of Minnesota internal medicine residency program.

Patients/participants:Subjects were all the patients admitted to the medicine service from 5:00 PM to 6:00 AM over an eight-month period.

Intervention:After 5:00 PM, half of the patients were admitted to the hospital by a cross-covering senior resident (CC group of patients), and their care was transferred to a different senior resident the following day. The other patients were initially evaluated by the primary senior resident (PE group of patients). Assignment to the different services was a random, sequential process.

Measurements and main results:The CC group had significantly more laboratory tests performed during their hospital stay than did the PE group of patients (44 vs. 32, p=0.01), even when adjusted for length of stay. Using multiple linear regression to adjust for other clinical parameters including length of stay, DRG weight, and number of consults, the authors found that being a CC subject was a significant predictor of the number of laboratory tests obtained (p=0.01). Furthermore, the median length of stay in the CC group (n=74) was longer than that in the PE group (n=72) (eight days vs. six days); this was of borderline statistical significance, using a two-sample median test (p=0.06).

Conclusion:Patients transferred to a different resident the day after admission had more laboratory tests performed and longer inpatient stays.

Key words

continuity of care resident education use of bospital resources laboratory testing cost of care transfer of care 

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Copyright information

© Society of General Internal Medicine 1987

Authors and Affiliations

  • Richard P. Lofgren
    • 1
    • 3
  • Daniel Gottlieb
    • 1
  • Rae A. Williams
    • 1
  • Eugene C. Rich
    • 2
    • 4
  1. 1.the Department of Internal Medicine, Veterans Affairs Medical CenterUniversity of MinnesotaMinneapolis
  2. 2.the Department of Internal Medicine, St. Paul Ramsey Medical CenterUniversity of MinnesotaSt. Paul
  3. 3.the Department of Internal MedicineUniversity of PittsburghPittsburgh
  4. 4.the Department of Internal MedicineUniversity of KentuckyLexington

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