Literature DB >> 16377824

Implementing duty-hour restrictions without diminishing patient care or education: can it be done?

Bradley R Mathis1, Tiffiny Diers, Richard Hornung, Mona Ho, Gregory W Rouan.   

Abstract

PURPOSE: To implement and evaluate a new ward team call system that would meet the Accreditation Council on Graduate Medical Education's (ACGME) duty-hour requirements without compromising patient care or detracting from resident education.
METHOD: The new system was implemented in the internal medicine residency program at the University Hospital at the University of Cincinnati Medical Center. In 2003-04, residents and faculty were surveyed about their experiences with the new and old ward systems relative to duty-hour requirements, patient care, and resident education. Responses were given on a five-point scale (5 = strongly agree, 1 = strongly disagree). Data were compiled and compared using a two-sample t-test.
RESULTS: Faculty believed the new system improved compliance with the duty-hour requirements (mean = 4.3, 95% confidence interval [CI]: 4.1-4.6), although were neutral regarding patient care (mean = 3.5, 95% CI: 3.2-3.8) and education (mean = 3.3, 95% CI: 2.9-3.6). Residents were more neutral regarding ACGME requirements (mean = 3.5, 95% CI: 3.3-3.7) and patient care (mean = 3.2, 95% CI 3.0-3.3). Residents reported a slightly negative impact on education (mean = 2.8, 95% CI: 2.5-3.0). In response to an exclusive question, residents reported that the new system did not reduce fatigue (mean = 2.7, 95% CI: 2.6-3.0).
CONCLUSIONS: Respondents perceived that this ward call system met ACGME requirements and maintained quality patient care but may have sacrificed some traditional resident education tenets.

Entities:  

Mesh:

Year:  2006        PMID: 16377824     DOI: 10.1097/00001888-200601000-00018

Source DB:  PubMed          Journal:  Acad Med        ISSN: 1040-2446            Impact factor:   6.893


  4 in total

1.  Factors associated with non-compliance during 16-hour long call shifts.

Authors:  Jed Gonzalo; Shoshana Herzig; Eileen Reynolds; Julius Yang
Journal:  J Gen Intern Med       Date:  2012-04-13       Impact factor: 5.128

2.  Relationships of the location and content of rounds to specialty, institution, patient-census, and team size.

Authors:  James R Priest; Sylvia Bereknyei; Kambria Hooper; Clarence H Braddock
Journal:  PLoS One       Date:  2010-06-21       Impact factor: 3.240

3.  Educating resident physicians using virtual case-based simulation improves diabetes management: a randomized controlled trial.

Authors:  JoAnn Sperl-Hillen; Patrick J O'Connor; Heidi L Ekstrom; William A Rush; Stephen E Asche; Omar D Fernandes; Deepika Appana; Gerald H Amundson; Paul E Johnson; Debra M Curran
Journal:  Acad Med       Date:  2014-12       Impact factor: 6.893

Review 4.  Organizational interventions in response to duty hour reforms.

Authors:  Madelyn P Law; Elaina Orlando; G Ross Baker
Journal:  BMC Med Educ       Date:  2014-12-11       Impact factor: 2.463

  4 in total

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