614 - Reinventing Interventional Radiology Night Call: Impact of Two Call Models on Clinical Productivity, Physician Wellness and Academic Missions

Purpose: To assess the impact of two interventional radiology (IR) call models on clinical productivity, physician wellness, and academic missions.

Materials and Methods: Two different IR call models were implemented at a tertiary academic medical center. Under Model A (2022 and 2023), the inpatient service was covered by a different attending each weekday in 24-hour shifts with attendings expected to work clinically the day following the 24-hour shift. Under Model B (2024), there was a separate weekday inpatient daytime attending and night float attending; these attendings remained on the same shift for the whole week. Data regarding yearly IR division work relative value units (wRVUs) and clinical full-time equivalents (cFTEs) were collected. An anonymized survey was sent to 10 attendings who practiced under both call models. Questions were graded on a Likert scale or prompted a preference between the 2 models, where applicable. Responses were compared using a Wilcoxon signed-rank test.

Results: Divisional wRVUs per cFTE were 6017, 7149, and 6186 for 2022, 2023 and 2024, respectively. Under Model B, when time spent on the night float attending was counted towards cFTE, the 2024 divisional wRVU per cFTE was 5832 (6% decrease compared to 6186). The survey response rate was 100%. Attendings reported significantly increased hours of sleep (P=0.04) under model B (median 6, IQR 6-8) compared to model A (median 5.5, IQR 5-6). Attendings also felt more prepared to work the following day under model B (P =0.04). There was a trend towards less fatigue under model B (P =0.11). For direct comparative questions (Model B/Modal A/Equivalent), attendings stated that model B was superior to model A in providing better quality of patient care (60%/0%/40%), greater patient safety (70%/0%/30%), promoting physician wellness (70%/0%/30%), achieving the division’s educational mission (50%/0%/50%) and achieving the division’s research mission (40%/0%/60%). Overall, 60% of attendings preferred model B and 40% had no preference. No responder found model A to be superior to model B for any question.

Conclusion: A night float attending call model may promote physician wellness and better achieve a division’s clinical and academic missions with minimal impact on clinical productivity compared to a traditional 24-hour call model.