158: Dual Site Neonatal Intensive Care Unit Weekend On-Call Coverage – Does the Presence of a Second Attending Neonatologist on Weekends Alter Perceptions of Clinical Uncertainty, Patient Care and Education?
Bibliographic record
Abstract
The University of Ottawa has two level 3 NICUs, separated by an 8 min walk. In 2010, the on-call schedule changed from having one Attending Neonatologist on-call per weekend, to having two. This allowed for increased Attending supervision in each unit. To examine the perceived impact of this schedule change on resident and fellow uncertainty, patient care, and teaching during weekends. Residents, fellows, clinical assistants, nurses, and Attendings who had worked in the NICU before and after the change were surveyed. Because no survey tool existed, one was created based on domains published in the literature. The survey was piloted for content and readability. Responses were provided on a 5-point Likert scale. Results were analyzed using descriptive statistics and χ2 test for associations. Ninety individuals were eligible. The response rate was 62% (n=56). Perceptions of patient care notably improved after the change, with 87% agreeing there was an improved ability to provide safer care, 81% of respondents believing that overall patient safety was improved, and 98% of respondents agreeing that care was timelier during weekend rounds. Eighty-eight percent of respondents perceived a moderate to great improvement in trainee certainty during clinical decision-making. Trainee certainty regarding the management of resuscitations was also improved (71% of respondents agreed). The respondents' clinical role affected their perceptions, with the greatest impact rated by the nurses, and the least by Attendings. Our results are the first to demonstrate that increased Attending supervision in the NICU decreases resident and fellow uncertainty. It may also improve patient care, and this warrants further objective study in the NICU setting. Results indicate support for one Attending per NICU in the case of two distinct physical sites.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".