Inpatient Attending Physician Staffing ModelNCT00930111
Inpatient Attending Physician Rotation Duration Study
A study testing 2-week rotation and 4-week rotation in people with Inpatient Attending Physician Staffing Model, run by Pamela Gonzalez Sr Director Clinical Research Office at 1 site in United States.
Trial summary
The investigators are testing the effects of a change in teaching attending physicians' rotations (from 4- to 2-week blocks) on patient outcomes (unplanned urgent visits to the health care system, inpatient mortality, and length-of-stay), the educational experiences of residents and medical students and on the quality… Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Inpatient Attending Physician Staffing Model
- What is being tested?
- 2-week rotation and 4-week rotation
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 62 participants
- Where
- 1 siteUnited States
- Study dates
- Jun 2009to Dec 2010
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Attending physician on inpatient general medicine wards of Stroger Hospital, Chicago, IL
Who cannot join
- Scheduled for less than 6 weeks during the 2009 academic year
Trial locations and contacts
1 site in 1 country.
United States1 site
Stroger Hospital of Cook County
Chicago, Illinois, 60612
About this study
The investigators are testing the effects of a change in teaching attending physicians' rotations (from 4- to 2-week blocks) on patient outcomes (unplanned urgent visits to the health care system, inpatient mortality, and length-of-stay), the educational experiences of residents and medical students and on the quality of the professional lives of the attending physicians.
Read the detailed description
Design, Setting, and Participants Cluster randomized crossover noninferiority trial, with attending physicians as the unit of crossover randomization and 4-week rotations as the active control, conducted in a US university-affiliated teaching hospital in academic year 2009. Participants were 62 attending physicians who staffed at least 6 weeks of inpatient service, the 8892 unique patients whom they discharged, and the 147 house staff and 229 medical students who evaluated their performance.
Intervention Assignment to random sequences of 2- and 4-week rotations.
Main Outcome Measures Primary outcome was 30-day unplanned revisits (visits to the hospital's emergency department or urgent ambulatory clinic, unplanned readmissions, and direct transfers from neighboring hospitals) for patients discharged from 2- vs 4-week within-attending-physician rotations. Noninferiority margin was a 2% increase (odds ratio [OR] of 1.13) in 30-day unplanned patient revisits. Secondary outcomes were length of stay; trainee evaluations of attending physicians; and attending physician reports of burnout, stress, and workplace control.
- Being tested
- 2-week rotation, 4-week rotation
- Keywords
- inpatient, hospitalists, residency, job satisfaction, burnout, professional, professional practice, medical education
- Medical subject headings
- Burnout, Professional
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
2-week rotationOther
Attending physician is assigned to a 2-week rotation.
4-week rotationOther
Attending physician is assigned to a 4-week rotation.
| Study group | Role | What they receive |
|---|---|---|
| 2 weeks | Active comparator | Attending physicians are physician-of-records for traditional inpatient ward team (housestaff and medical students) for 2 weeks. Receives: Other: 2-week rotation |
| 4 weeks | Placebo comparator | Attending physicians are physician-of-records for traditional inpatient ward team (housestaff and medical students) for 4 weeks. Receives: Other: 4-week rotation |
What is being measured
The primary outcome is the main question the study is designed to answer.
Patients' unplanned urgent visits to the health care system.
Number pf non-scheduled patient encounters documented in the EHR
Measured: 30 days after discharge
Secondary outcomes (4)
Resident physicians' evaluation of attending physicians' performance.
Self administered performance electronic evaluations - validated tool
Measured: During 14 or 28 day rotations
Medical students' evaluations of attending physicians' performance.
Self administered performance electronic evaluations
Measured: During 14 or 28 day rotations
Urgent visits to health care system among attending physicians' outpatient panel (if attending physician has an outpatient panel)
Number pf non-scheduled patient encounters documented in the EHR
Measured: During and 14 to 28 days after provider's rotation
Attending physicians' work-life balance, perceived stress, and perceived burn-out.
Self administered confidential Burnout assessment survey based on Conceptual Model of Burnout, Perceived Stress Scale \& Maslach Burnout Inventory Human ServiceSurvey and a single item measure from the Notional Job Burnout Survey.
Measured: During 14 to 28 day rotations
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Jun 2009 (estimated)
- Study startJun 2009
- Primary completionJul 2010
- Study completionDec 2010
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Inpatient Attending Physician Staffing ModelStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 62 participants (actual)
Sponsor and investigators
- Lead sponsor
- Pamela Gonzalez Sr Director Clinical Research Office
- Sponsor type
- Other government
- Responsible party
- Sponsor-investigator, Pamela Gonzalez Sr Director Clinical Research Office, Cook County Health
- Investigators
- Brian Lucas, MD, Principal investigator, Cook County Health
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00930111
- Sponsor's protocol ID
- 09-063 Cooker 533
- Status last verified
- Jul 2023
- First submitted
- 29 Jun 2009
- Last updated
- 11 Jul 2023
- Results posted
- No
- Data monitoring committee
- No
Publications
Lucas BP, Trick WE, Evans AT, Mba B, Smith J, Das K, Clarke P, Varkey A, Mathew S, Weinstein RA. 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(21):2199-207. doi: 10.1001/jama.2012.36522.
PubMed 23212497
Study at a glance
From the registry record, last updated by the sponsor on 11 Jul 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Inpatient Attending Physician Rotation Duration Study
- ClinicalTrials.gov ID
- NCT00930111
- Acronym / sponsor ID
- 09-063 Cooker 533
- Keywords
- inpatient, hospitalists, residency, job satisfaction, burnout, professional, professional practice, medical education
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 62 participants (actual)
- Lead sponsor
- Pamela Gonzalez Sr Director Clinical Research OfficeOther government
- Study start
- Jun 2009
- Primary completion
- Jul 2010 (actual)
- Study completion
- Dec 2010 (actual)
- First posted
- 30 Jun 2009 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The investigators are testing the effects of a change in teaching attending physicians' rotations (from 4- to 2-week blocks) on patient outcomes (unplanned urgent visits to the health care system, inpatient mortality, and length-of-stay), the educational experiences of residents and medical students and on the quality of the professional lives of the attending physicians.
Detailed description
Design, Setting, and Participants Cluster randomized crossover noninferiority trial, with attending physicians as the unit of crossover randomization and 4-week rotations as the active control, conducted in a US university-affiliated teaching hospital in academic year 2009. Participants were 62 attending physicians who staffed at least 6 weeks of inpatient service, the 8892 unique patients whom they discharged, and the 147 house staff and 229 medical students who evaluated their performance.
Intervention Assignment to random sequences of 2- and 4-week rotations.
Main Outcome Measures Primary outcome was 30-day unplanned revisits (visits to the hospital's emergency department or urgent ambulatory clinic, unplanned readmissions, and direct transfers from neighboring hospitals) for patients discharged from 2- vs 4-week within-attending-physician rotations. Noninferiority margin was a 2% increase (odds ratio [OR] of 1.13) in 30-day unplanned patient revisits. Secondary outcomes were length of stay; trainee evaluations of attending physicians; and attending physician reports of burnout, stress, and workplace control.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| 2 weeks | Active comparator | Other: 2-week rotationAttending physicians are physician-of-records for traditional inpatient ward team (housestaff and medical students) for 2 weeks. |
| 4 weeks | Placebo comparator | Other: 4-week rotationAttending physicians are physician-of-records for traditional inpatient ward team (housestaff and medical students) for 4 weeks. |
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (1 listed)
- Attending physician on inpatient general medicine wards of Stroger Hospital, Chicago, IL
Key exclusion criteria (1 listed)
- Scheduled for less than 6 weeks during the 2009 academic year
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| 2-week rotationAttending physician is assigned to a 2-week rotation. | Other | 2 weeks |
| 4-week rotationAttending physician is assigned to a 4-week rotation. | Other | 4 weeks |
Primary outcome
Patients' unplanned urgent visits to the health care system.
Time frame: 30 days after discharge
Number pf non-scheduled patient encounters documented in the EHR
4 secondary outcomes
Resident physicians' evaluation of attending physicians' performance.
Time frame: During 14 or 28 day rotations
Medical students' evaluations of attending physicians' performance.
Time frame: During 14 or 28 day rotations
Urgent visits to health care system among attending physicians' outpatient panel (if attending physician has an outpatient panel)
Time frame: During and 14 to 28 days after provider's rotation
Attending physicians' work-life balance, perceived stress, and perceived burn-out.
Time frame: During 14 to 28 day rotations
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Jul 2023.
- Derived from this study: PubMed 23212497Lucas BP, Trick WE, Evans AT, Mba B, Smith J, Das K, Clarke P, Varkey A, Mathew S, Weinstein RA. 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(21):2199-207. doi: 10.1001/jama.2012.36522.
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Brian Lucas, MD principal investigator
Cook County Health
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing 2-week rotation and 4-week rotation in people with Inpatient Attending Physician Staffing Model, run by Pamela Gonzalez Sr Director Clinical Research Office at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 11 Jul 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Patients' unplanned urgent visits to the health care system. (time frame: 30 days after discharge). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00930111, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Jul 2023.