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ACGME task force proposes graduated duty hour and supervision standards
Date:6/23/2010

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  • establish graduated requirements for minimum time off between scheduled duty periods;
  • expand program and institutional requirements regarding handovers of patient care;
  • set more specific requirements for alertness management and fatigue mitigation strategies designed to ensure both continuity of patient care and resident safety.

"Teamwork, communication, ensuring seamless transitions of care of a patient from one physician to another, and providing appropriate levels of supervision and independence to residents are some of the vitally important issues we addressed. We want first year residents to have the resources and supervision they need to learn and provide excellent patient care while also assuring that residents near the end of their training are prepared to leave the program and practice independently."

Assessing the Data on Fatigue and Medical Errors

Noting that there is limited scientific data on the connection between fatigue and medical errors for the resident community, Dr. Nasca pointed out that ACGME's revised draft standards reflect data showing that fatigue has an influence on the frequency of errors by first-year residents. "These are the least experienced and most vulnerable physicians in training, and the task force saw a need to make the most significant changes in the supervision and duty hour standards for this group," he observed.

As residents progress in their training, the task force also recognized its obligation to adequately prepare individuals to practice medicine outside the learning environment where they will be unsupervised, must think independently, and often must function at their top abilities when fatigued. "Nobody wants the only neurosurgeon in the county to be unable to provide excellent patient care when, after operating all day, he or she is called back to the hospital emergency room to relieve an accident victim's intracranial bleeding," Dr. Nasca said.<
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Contact: Nancy Brennan
312-755-7050
Accreditation Council for Graduate Medical Education
Source:Eurekalert

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