Objective:

To assess the impact of transitioning from a 24-hour traditional night call (TNC) schedule to a night float (NF) system on resident quality of life, education, and patient care.

Background:

Although residency schedules vary across programs, resident fatigue, burnout, and uneven call distribution are common challenges all face. Schedule modifications to enhance resident quality of life and education while preserving hospital coverage and high standards of patient care are essential.

Design/Methods:

Questionnaires assessing the perceived effects of implementing an NF schedule were completed by residents (n = 9) and attendings (n = 10) within a neurology residency program of 15 residents. Following the transition, post-intervention surveys were administered using the same questions to gauge changes in perception. Additionally, we collected and analyzed call-count data for each residency class before (2021-2022, 2022-2023) and after (2023-2024) transitioning to the NF system.

Results:

Post-intervention, preference for the NF system increased among residents and attendings. Agreement that NF improves resident quality of life increased among residents (22.2% to 75%) and remained high among attendings (90% to 87.5%), while agreement on its educational benefits rose for both residents (44.4% to 62.5%) and attendings (70% to 87.5%). During night calls, fewer residents felt prone to making mistakes (22.2% to 0%) or that continuity of care was compromised (77.8% to 25%). More residents had a solid understanding of floor patients (22.2% to 62.5%), and fewer felt their notes were rushed (44.4% to 12.5%). NF pediatric neurology residents had 13.3 fewer call days than those on the TNC system (p<0.001). NF PGY-4s had more call counts than TNC PGY-4s (26.8 vs 20.4; p<0.001), and the call count gap between PGY-2s and PGY-4s decreased by 16 days.

Conclusions:

Implementing the NF system improved resident quality of life, education, and patient care while balancing call counts.