(Re)turning the pages of residency: The impact of localizing resident physicians to hospital units on paging frequency

BACKGROUND: Geographic localization of physicians to patient care units may improve communication, decrease interruptions, and reduce resident workload. This study examines whether interns on geographically localized patient care units receive fewer pages than those on teams that are not. METHODS: The study is a retrospective analysis of the number of pages received by interns on 5 internal medicine teams: 2 in a geographically localized model (GLM), 2 in a partial localization model (PLM), and 1 in a standard model (SM) over 1 month at New York-Presbyterian Hospital/Weill Cornell. Multivariate linear regression techniques were used to analyze the relationship between the number of pages received per intern and the type of team. RESULTS: The number of pages received per intern per hour, adjusted for team census and number of admissions, was 2.2 (95% confidence interval [CI]: 2.0-2.4) in the GLM, 2.8 (95% CI: 2.6-3.0) in the PLM, and 3.9 (95% CI: 3.6-4.2) in the SM; all differences were statistically significant (P<0.001). CONCLUSION: Geographic localization of resident teams to patient care units was associated with significantly fewer pages received by interns during the day. Such patient care models may improve resident workload in part by decreasing pages, and consequently has important implications for patient safety and medical education.