Perceptions of a night float system for intern doctors in an internal medicine program: an Asian perspective

Korean J Med Educ. 2019 Sep;31(3):271-276. doi: 10.3946/kjme.2019.137. Epub 2019 Aug 26.

Abstract

Long duty hours have been associated with significant medical errors, adverse events, and physician "burn-out". An innovative night float (NF) system has been implemented in our internal medicine program to reduce the negative effects of long duty hours associated with conventional full-call systems. However, concerns remain if this would result in inadequate training for interns. We developed a structured questionnaire to assess junior doctors' perceptions of the NF system compared to full calls, in areas of patient safety, medical training, and well-being. Ninety-seven (71%) of the 137 doctors polled responded. Ninety-one (94%) felt the NF system was superior to the full call system. A strong majority felt NF was beneficial for patient safety compared to full call (94% vs. 2%, p<0.001). The NF system was also perceived to reduce medical errors (94% vs. 2%, p<0.001) and reduce physician "burn-out" (95% vs. 5%, p<0.001). Beyond being a practical solution to duty-hour limitations, there was a significant perceived benefit of the NF system compared to the full call in terms of overall satisfaction, patient safety, reducing medical errors and physician "burn-out".

Keywords: After-hours care; Medical education; Patient safety.

MeSH terms

  • Adult
  • After-Hours Care / organization & administration
  • Attitude of Health Personnel
  • Burnout, Professional / prevention & control
  • Female
  • Humans
  • Internal Medicine / education*
  • Internship and Residency / organization & administration*
  • Male
  • Medical Errors / prevention & control
  • Medical Staff, Hospital / education
  • Medical Staff, Hospital / psychology
  • Medical Staff, Hospital / statistics & numerical data
  • Patient Safety
  • Personnel Staffing and Scheduling* / organization & administration
  • Singapore
  • Surveys and Questionnaires
  • Young Adult