Intern call structure and patient satisfaction

Our institution has instituted 'short-call' and 'nightfloat' systems to reduce the number of admissions to the traditional 'long-call' housestaff. However, the nightfloat system introduces increased discontinuity to patient care, and interns may spend less time with short-call patients because they are not required to spend the night on-call. Discontinuity and less time spent with patients may result in decreased patient satisfaction. Over a 6- month period, data were collected on 145 consecutive patients admitted to a teaching Veterans Affairs Medical Center with the primary diagnoses of congestive heart failure and chronic obstructive pulmonary disease. We found that patients admitted to either short-call or nightfloat interns were significantly less satisfied with their care than patients admitted to long- call housestaff, controlling for intent gender, patient age, and patient severity of illness (p = .02). Residency program directors need to realize that changes in the structure of teaching environment may have an impact on patient satisfaction.