Pediatric Residency Duty Hours Before and After Limitations

Cull, William L.; Mulvey, Holly J.; Jewett, Ethan Alexander; Zalneraitis, Edwin L.; Allen, Carl E.; Pan, Richard

doi:10.1542/peds.2006-0210

Cited by 28 publications

(24 citation statements)

References 18 publications

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“…Numerous studies have linked resident workload to wellness and education [1][2][3][4][5][6] ; however, the vast majority of existing research on resident workloads has focused on the quantity of hours worked, rather than the content of those hours. Additionally, most research has studied self-reported hours data, which can be unreliable.…”

mentioning

confidence: 99%

Pediatric Resident Workload Intensity and Variability

Wąs

Blankenburg²,

Park

2016

Pediatrics

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mentioning

confidence: 99%

Pediatric Resident Workload Intensity and Variability

Wąs

Blankenburg²,

Park

2016

Pediatrics

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“…Next, we selected substitute providers. After 2003, programs shifted work among existing residents, hired midlevel providers (nurse practitioners and physician assistants), and gave attendings additional responsibilities; teaching hospitals hired more nurses 10,[17][18][19][20][21][22][23][24][25] . Few programs expanded, likely because the Balanced Budget Act caps Medicare-supported residency positions 26 .…”

Section: Individual Requirementsmentioning

confidence: 99%

Cost Implications of ACGME’s 2011 Changes to Resident Duty Hours and the Training Environment

Nuckols

Escarce

2011

J GEN INTERN MED

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“…After implementation of the 2003 duty hour limitations, fully 73% of residents in that survey still reported falling asleep during a conference, 20% reported falling asleep while driving from work, 8% reported making an error in patient care because of fatigue, and 14% to 18% reported working more than 80 h/wk on inpatient and critical care services. 23 Consecutive duty hours of 16 hours or less are associated with marked decreases in attention failures and serious medical errors. 24 National and international legal initiatives to hold administrators responsible for medical errors and even MVAs caused by fatigued residents 25 provide additional imperatives for elimination of 24-hour call from all residency programs in the United States.…”

Section: Discussionmentioning

confidence: 99%

Toward a New Paradigm in Graduate Medical Education in the United States: Elimination of the 24-Hour Call

Mautone¹

2009

Journal of Graduate Medical Education

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Evidence was emerging in 2003, and has been corroborated quite conclusively since then, that sleep deprivation negatively affects resident performance and safety. [1][2][3][4][5] Concerns over potential deleterious effects of sleep-deprived residents on patient care prompted efforts to reduce resident work hours. Duty hours limitations for all US residents were instituted by the Accreditation Council for Graduate Medical Education (ACGME) effective July 1, 2003, capping duty hours for most residents at 80 h/wk, mandating defined rest periods between assigned shifts, and limiting consecutive duty hours to 24 plus an additional 6 hours to transfer patient care, participate in educational activities, and attend outpatient clinics. 6 Initially implemented for most workers in 1993, the European Working Time Directive was extended to doctors in training in 2004, setting 13-hour shifts and initially 58 h/wk (to be further reduced to 48 h/wk after 5 years) as the maximum permissible for residents in the European Community. 7,8 In 2003 New Jersey was the first state to adopt Maggie's Law, 9 which upgraded vehicular homicide to a crime of the first degree when caused by a driver who was without sleep for a period in excess of 24 hours.The decision to embark on a major redesign of duty hours for the pediatric residency program at University of Medicine and Dentistry of New Jersey-New Jersey Medical This work was supported in part by a Title VII grant from the Health Resources Services Administration, Bureau of Health Professions, US Department of Health and Human Services, for Residency Training in Primary Care (D58HP05187). The funding agency had no role in data collection and analysis, the decision to publish, or manuscript preparation.The author thanks Dr Soyeon Kim for statistical support. Many thanks also go to the program's residents and faculty, current and former, for their ideas, enthusiasm, commitment to quality patient care, and willingness to embrace change. AbstractBackground Sleep deprivation negatively affects resident performance, education, and safety. Concerns over these effects have prompted efforts to reduce resident hours. This article describes the design and implementation of a scheduling system with no continuous 24-hour calls. Aims included meeting Accreditation Council for Graduate Medical Education work hour requirements without increasing resident complement, maximizing continuity of learning and patient care, maintaining patient care quality, and acceptance by residents, faculty, and administration.

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Pediatric Residency Duty Hours Before and After Limitations

Cited by 28 publications

References 18 publications

Pediatric Resident Workload Intensity and Variability

Pediatric Resident Workload Intensity and Variability

Cost Implications of ACGME’s 2011 Changes to Resident Duty Hours and the Training Environment

Toward a New Paradigm in Graduate Medical Education in the United States: Elimination of the 24-Hour Call

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