457 - Impact of Academic Half Day Implementation on Resident Education and Patient Safety

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 457
Publication Number: 457.122

Ariel Sugarman, Columbia University Vagelos College of Physicians and Surgeons, Bronx, NY, United States; Audrey Uong, The Children's Hospital at Montefiore, New York, NY, United States; Matthew C. Spence, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Mariam M. Bhuiyan, Cohen Children's Medical Center, Queens, NY, United States; Y. Dana Neugut, The Children's Hospital at Montefiore, Bronx, NY, United States; Kathleen Asas, The Children's Hospital at Montefiore, Scarsdale, NY, United States; Danielle M. Fernandes, Albert Einstein College of Medicine, Bronx, NY, United States; Megan E.. McCabe, The Children’s Hospital at Montefiore, Bronx, NY, United States

Presenting Author(s)

Ariel Sugarman, MD (she/her/hers)

Clinical Fellow
Columbia University Vagelos College of Physicians and Surgeons
Bronx, New York, United States

Background: The Accreditation Council for Graduate Medical Education requires that pediatric residency programs offer a didactic curriculum and protect resident time for education. The Children’s Hospital at Montefiore implemented an Academic Half Day (AHD) in the 2021-22 academic year to address barriers related to the standard noon conference series. We evaluated the transition by assessing the educational impact, patient safety, and patient flow.

Objective:
To determine the impact of AHD implementation on education, patient safety and flow.

Design/Methods: This was a mixed-methods study at a single institution. Likert scale surveys were sent to residents, fellows and faculty before and one year after AHD implementation to assess changes in attitudes and behaviors. Patient care was evaluated by comparing the number of event reports, rapid response team activations, time to admission, and time of discharge on AHD days compared to other weekdays. Student’s T-Test or Mann-Whitney test were used for continuous variables and Chi-squared or Fisher’s Exact test for categorical variables.

Results:
Pre/post survey response rates were: Residents (68%/48% n=85), Fellows (42%/35% n=74), Faculty (59%/29% n=170).

Table 1 shows a significant change in resident attitudes and experience. Fellows did not report a change in disruption to patient care due to resident education with AHD vs noon conference (p=0.44). 27% (13/49) of faculty responded that AHD always or most times impacted patient care, and 53% (26/49) reported that it did impact their divisional workflow.

There were no significant differences in patient safety incident reports (p=0.69) or rapid response team activations (p=0.25) on AHD weekdays compared to other weekdays.

There was not a clinically important difference in median admission time from the emergency department on AHD weekdays (125min) compared to other weekdays (130min, p=0.04). There was no difference in median discharge time on AHD vs other weekdays (p=0.13).

Conclusion(s): The AHD model allows residents to focus on education for a block of time away from patient care. Survey results one year after implementing AHD showed that residents felt there was a better balance of education and patient care and they could better apply what they learn to patient care. In addition, there was no significant negative impact on patient safety or patient flow. AHD may be a useful framework for resident education without compromising patient care.