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News Release
High compliance and innovative approaches mark second year of ACGME duty hour standards
Data for academic year 2004-05 collected from 8,000 program directors and 33,000 residents
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For immediate release
Contact: Julie A. Jacob
(312) 755-7133
juliej@acgme.org |
CHICAGO, Sept. 21, 2005 – Two years after the ACGME’s common duty hour standards took effect, the vast majority of residency programs are complying, according to a confidential Internet survey of more than 50,000 residents, and programs are using innovative approaches to restructure duty hour schedules for residents.
In addition to questions on duty hours, the resident survey included questions on other important aspects of the resident learning environment, noted David C. Leach, MD, executive director of the Accreditation Council for Graduate Medical Education, including resident supervision, their perceptions on their education, and the amount of non-educational work residents perform.
“It is clear that learning needs to be redesigned; the educational system that worked in an earlier age is now outmoded,” said Dr. Leach. “This information helps in the redesign process.”
As it did last year, the Accreditation Council for Graduate Medical Education gathered data on duty hour compliance from program directors for all 8,038 ACGME-accredited programs during academic year 2004-05. This information was verified by senior graduate medical officials at institutions that sponsor residency programs. ACGME field staff also interviewed approximately 12,000 residents during 1,851 program site visits. Field staff also interviewed program directors and faculty during site visits and reviewed rotation schedules, call rosters, and other duty hour documents.
In addition, the ACGME this year surveyed 33,204 residents in 1,954 residency programs through a confidential Internet survey; the response rate was 89%. Combined with the residents surveyed last year, the ACGME has gathered information on compliance with duty hour standards from 58,380 residents – more than half of all residents in ACGME-accredited programs.
The survey data for this year indicate that 997 residents, or 3% of respondents, reported working more than 80 hours a week during the previous four weeks, compared with 3.3% of respondents last year.
Of the 2,002 programs that were reviewed during the academic year, 7.3% received citations related to duty hour non-compliance. The ACGME issued 195 duty hour citations; 31 were for violations of the 80 hours per week limit, 31 for violations of the 24-hours-plus six-continuous duty hour limit, 19 for violations of the 10-hour minimum rest period, and the rest for a variety of other violations.
During the academic year the ACGME received 16 resident complaints for duty hour violations, compared with 53 complaints the previous year. Of those complaints, four are still being investigated, six were dismissed as unfounded, one is deferred pending
outside litigation, and the remaining resulted in programs receiving various sanctions, including a citation and warning, close monitoring, mandatory progress reports, and proposed probation.
The ACGME duty hour standards went into effect July 1, 2003 for all ACGME-accredited programs. The standards include an 80-hour a week duty hour limit, averaged over four weeks; at least one day in seven free of clinical and educational activities; call limited to no more than once every three nights; and continuous time on duty restricted to 24 hours plus six additional hours for patient hand-offs and paperwork. The entire standards are posted on the ACGME Web site at http://www.acgme.org/acWebsite/dutyHours/dh_Lang703.pdf
Programs in some specialties may apply for an 8-hour increase weekly duty hours. Out of the 8,037 ACGME-accredited programs operating in academic year 2004-05, 68 programs were functioning under the 88-hour a week limit; most of these programs were in neurological surgery (42), orthopaedic surgery (9) and general and thoracic surgery (7).
Because duty hours are just one piece of the learning environment for residents, the ACGME has created a new Committee on Innovation in the Learning Environment. This committee will analyze and make recommendations on various aspects of residents’ educational environment, including duty hours, work flow, and innovations in curriculum and teaching methods.
The ACGME report on duty hour standards for academic year 2004-05, “The ACGME’s Approach to Limiting Duty Hours: A Summary of Achievements for the Second Year under the Common Duty Hour Standards” is posted on the Council’s Web site, www.acgme.org
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The ACGME is a private, non-profit council that accredits 7,800 residency programs
in 27 specialties affecting 100,000 residents. Its mission is to improve the quality
of health care in the United States by ensuring and improving the quality of graduate
medical education for physicians in training.
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