July, that time of year can be a dangerous place for you to be hospitalized at a university or teaching hospital. Statistics revealed a higher incidence of complications which may be attributed to inexperienced trainees at the beginning of their years of training.
This study was designed to investigate the relationship between the clinical experience of resident physicians and quality of care. This investigation was done by examining the month of the year when patients were treated by resident physicians and a comprehensive set of quality indicators. Quality of care was assessed by a severity-weighted index of adverse events consisting of 47 quality indicators that were screened from 28,541 medical records during a 12-month period.
Hospital-wide results indicate that there was no overall relationship between the house officers experience and severity-adjusted adverse events, with the exception of one surgical department that had a higher index of adverse events in the first part of the academic year. Although this study finds no support for a "July Phenomenon" in terms of quality of clinical care, house officers were found to be more likely to have poor documentation practices earlier in the academic year. This may no longer be true since the use of electronic health records has been implemented.
Office of Clinical Outcome Assessment and Quality Management, Hospital of the University of Pennsylvania, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania Medical Center, and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
Dr.Shulkin was nominated as Secretary of Veteran's Affairs in the Trump Administration
This article was published in 1995, and may not accurately portray events in 2017. David J. Shulkin
American Journal of Medical Quality: pp. 14-17.
The July Phenomenon Revisited: Are Hospital Complications Associated with New House Staff? - David J. Shulkin, 1995: