Hospitalists Can Help Solve Residency Duty-Hour Issues

What’s in the Rules

The ACGME’s residency training regulations went into effect July 1, 2011. Among the requirements:

• First-year residents are limited to a shift of no more than 16 hours. Other resident shifts may last up to 24 hours, with an additional four hours to manage transitions in care. (In 2003, all residents were permitted 24-hour shifts with six hours for transition-of-care management.)
• A physician must be available to provide direct supervision for first-year residents at all times, as needed.
• Residents and faculty must be trained to recognize sleep deprivation. Fatigue-management programs must be in place (e.g. naps or backup call schedules), and institutions must provide sleep facilities and/or safe transportation options for fatigued residents.
• Clinical assignments must be designed to minimize transitions in patient care, and residents must be competent in communicating with team members in handoffs. Residents must also participate in interdisciplinary clinical quality-improvement (QI) and patient safety programs.
• Residents may work up to 80 hours per week, averaged over four weeks (consistent with 2003 regulations). All moonlighting, however, must be included in the work-hour limit, and first-year residents are not permitted to moonlight.

Source: www.acgme.org/acwebsite/dutyhours/dh_index.asp