02. Housestaff Service Structure Changes

Documents pertaining to housestaff service structure changes were heterogeneous and varied significantly according to document type, author, breadth, and depth. The most common document types available were hospital/program policy documents and emails from program leadership to housestaff. The authors of the documents were frequently difficult to ascertain with certainty as most documents did not list an author. Of those that listed authors, program director and chief resident were the most common.

Service structure changes that were addressed were those which involved redeployment of residents on COVID-19 service, faculty-only COVID-19 services, and more explicit jeopardy/backup call. A minority of the institutions included comprehensive and detailed information regarding: (1) policies and procedures relating to resident care of COVID-19 patients (e.g., opt in vs out, census caps, moonlighting), (2) scheduling (jeopardy/backup, surge schedules, changes to resident electives/vacations), and (3) variations in procedures over time according to surge status. Notably, most institutions touched on only one or two of these domains or described all domains but with minimal detail.