Category: Specialty Development
Seventy-five percent of residents reported symptoms of burnout from stressors including increased time demands and frequent interruptions from pagers, nurses, and physicians. We aimed to determine if adjustments to systemic education could reduce the number of non-urgent pages overnight to the on-call resident by 50% in an attempt to decrease burnout among Physical Medicine and Rehabilitation residents.
This is a prospective study. A pre-intervention survey determined that pages on EKG results, non-critical labs results, information to pass on to day team, and to change respiratory therapy (RT) orders were the most common non-emergent pages, and the basis to implement our intervention. We instructed on-call residents to schedule EKGs for the mornings and to instruct RTs to address issues with primary teams instead of the on-call resident. The number of non-emergent pages was recorded daily.
There was a 57.5% decrease in the number of total pages and average number of pages per night (pre-intervention: 120 total with an average of 2.35 pages/night vs. post-intervention: 51 total with an average number of 1.50 pages/night).
Post intervention, the number of pages related to EKG results decreased from 28 to 10 (64% total decrease; 46.4% decrease in daily pages), non-critical labs decreased from 21 to 8 (62% total decrease; 68.6% decrease in daily pages), information to pass onto day team increased from 17 to 27 (59% total increase; 1.9% increase in daily pages), and RT orders decreased from 16 to 6 (63% total decrease; 85.7% decrease in daily pages).
We achieved our goal of decreasing the number of total non-urgent pages by 50% with the interventions of scheduling EKGs the following day and encouraging RTs to address order changes with primary teams. Our interventions may be promising in improving patient care and safety, increasing workflow efficiency, addressing pager fatigue, and ultimately, preventing resident burnout.
Tracey Isidro– Physician, Baylor College of Medicine
Bei Zhang– Resident Physician, University of Texas Health Science Center at Houston
Jay Karri– Resident Physician, Baylor College of Medicine
Alex Wu– Resident Physician, University of Texas Health Science Center at Houston
Maya Newman– Resident Physician, Baylor College of Medicine
Vivian Hui– Physician, Baylor College of Medicine
Patrick Mollett– Physician, University of Texas Health Science Center at Houston
Monica Verduzco-Gutierrez– VC & Associate Professor; Medical Director, Brain Injury and Stroke Program, McGovern Medical School at UTHealth at Houston