Article : 2-Week vs. 4-Week Rotations...

2-Week vs. 4-Week Rotations for Inpatient Teaching Physicians: A Randomized Trial

Length of stay and readmissions were unaffected, but attending physician burnout was more likely with 4-week rotations.


For attending inpatient physicians who teach, working several consecutive weeks minimizes service handoffs and provides for more longitudinal evaluation of trainees. Whether length of attending rotation affects patient care is unclear. Investigators at Cook County Hospital in Chicago conducted a crossover noninferiority trial to compare the effects of 2- versus 4-week inpatient rotations.

Sixty-two attending physicians were block randomized to sequences of 2- and 4-week rotations, with washout periods of at least 2 weeks of nonservice time between transitions. During the 1-year study, about 12,000 patients were discharged. Numbers of unplanned postdischarge visits (i.e., emergency department visits, urgent care visits, or hospitalizations within 30 days of discharge) were similar during 2-week and 4-week rotations; average length of stay was 2.8 days during both rotations. Resident and medical student ratings of attendings generally were higher during 4-week rotations, whereas attendings reported less burnout after 2-week rotations.


CITATION(S):

Lucas BP et al. Effects of 2- vs 4-week attending physician inpatient rotations on unplanned patient revisits, evaluations by trainees, and attending physician burnout: A randomized trial. JAMA 2012 Dec 5; 308:2199. 

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