Perceived Impact of a Junior–Senior Inpatient Team Model on Clinical Workflow, Supervision, and Workload in a Tertiary Gastroenterology Department: A Mixed-Methods Study

<b>Background:</b> In many inpatient settings, physician coverage is organized around single-attending responsibility, which can create challenges in supervision and workload distribution, particularly in procedurally intensive environments. To address these issues, our department introduced a junior-senior inpatient team model in which multiple physicians jointly share responsibility for hospitalized patients. This study examined physicians' perceptions of how this restructuring influenced clinical workflow, supervision, and workload. <b>Methods:</b> We performed a mixed-methods cross-sectional survey two months after implementation. Twenty-two physicians (13 junior, 9 senior) completed five-point Likert-scale items and open-ended questions. Responses were analyzed using non-parametric group comparisons. Qualitative comments were examined thematically to identify recurring perspectives on supervision and workload. <b>Results:</b> Junior physicians reported more favorable perceptions across several domains. Significant differences between junior and senior physicians were observed for reassurance during off-site duties (<i>p</i> = 0.013) and perceived reduction in burden when managing critically ill patients (<i>p</i> = 0.002). Qualitative findings indicated that junior physicians experienced greater shared responsibility and easier access to consultation, whereas senior physicians described increased supervisory demands, responsibility extending beyond subspecialty areas, and heavier weekend or holiday duties. Both groups emphasized the importance of flexible patient redistribution during staffing variability. <b>Conclusions:</b> The junior-senior inpatient team model was associated with improved perceived accessibility of supervision and collective support for junior physicians while increasing supervisory demands on senior staff. These findings suggest the potential importance of workload-sensitive implementation strategies and explicit role definition when introducing physician team-based coverage in high-acuity inpatient settings.

Authors

Institutions

Publication Details

Journal
Journal of Clinical Medicine
Published
2026-02-21
DOI
https://doi.org/10.3390/jcm15041632
Primary Topic
Hospital Admissions and Outcomes
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Perceived Impact of a Junior–Senior Inpatient Team Model on Clinical Workflow, Supervision, and Workload in a Tertiary Gastroenterology Department: A Mixed-Methods Study

Akira Uchiyama, Maki Tobari, Hiroyuki Isayama, DAI ISHIKAWA et al.
Journal of Clinical Medicine
Hospital Admissions and Outcomes
article

Perceived Impact of a Junior–Senior Inpatient Team Model on Clinical Workflow, Supervision, and Workload in a Tertiary Gastroenterology Department: A Mixed-Methods Study

Akira Uchiyama, Maki Tobari, Hiroyuki Isayama, DAI ISHIKAWA, Hiroo Fukada, Toshio Fujisawa, Akihito Nagahara, Hirofumi Fukushima
article en

Abstract

<b>Background:</b> In many inpatient settings, physician coverage is organized around single-attending responsibility, which can create challenges in supervision and workload distribution, particularly in procedurally intensive environments. To address these issues, our department introduced a junior-senior inpatient team model in which multiple physicians jointly share responsibility for hospitalized patients. This study examined physicians' perceptions of how this restructuring influenced clinical workflow, supervision, and workload. <b>Methods:</b> We performed a mixed-methods cross-sectional survey two months after implementation. Twenty-two physicians (13 junior, 9 senior) completed five-point Likert-scale items and open-ended questions. Responses were analyzed using non-parametric group comparisons. Qualitative comments were examined thematically to identify recurring perspectives on supervision and workload. <b>Results:</b> Junior physicians reported more favorable perceptions across several domains. Significant differences between junior and senior physicians were observed for reassurance during off-site duties (<i>p</i> = 0.013) and perceived reduction in burden when managing critically ill patients (<i>p</i> = 0.002). Qualitative findings indicated that junior physicians experienced greater shared responsibility and easier access to consultation, whereas senior physicians described increased supervisory demands, responsibility extending beyond subspecialty areas, and heavier weekend or holiday duties. Both groups emphasized the importance of flexible patient redistribution during staffing variability. <b>Conclusions:</b> The junior-senior inpatient team model was associated with improved perceived accessibility of supervision and collective support for junior physicians while increasing supervisory demands on senior staff. These findings suggest the potential importance of workload-sensitive implementation strategies and explicit role definition when introducing physician team-based coverage in high-acuity inpatient settings.

Journal of Clinical MedicineVol. 15(4)
Juntendo University (JP)
Openalex Percentile: Top 50%
Hospital Admissions and Outcomes
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.