Separating residents' inpatient and outpatient responsibilities: improving patient safety, learning environments, and relationships with continuity patients.
Residency training presents challenges to patient safety, including increased handoffs due to duty-hour reform. While residents are completing inpatient and outpatient training simultaneously, providing outpatients with continuity of care poses an additional complication. In this pre-post survey study, investigators found that separating inpatient and outpatient responsibilities for residents enhanced their perceptions of patient safety in both settings. This intervention also improved patient continuity (the proportion of visits for which residents saw their own patients); heightened continuity is thought to foster timely and accurate diagnosis. This study offers a replicable intervention to address some patient safety risks associated with medical residency. A previous WebM&M commentary discusses safety hazards and educational challenges related to academic year-end transfers.