Literature DB >> 19266585

Four years of accreditation council of graduate medical education duty hour regulations: have they made a difference?

David C Shonka1, Tamer A Ghanem, Matthew A Hubbard, Daniel A Barker, Bradley W Kesser.   

Abstract

OBJECTIVES/HYPOTHESIS: Measure compliance with the Accreditation Council of Graduate Medical Education (ACGME) residents' work hour regulations and evaluate their impact on patient care and residents' performance on the Otolaryngology Training Examination (OTE). STUDY
DESIGN: Retrospective review of an otolaryngology residency program's resident duty hours violations and OTE scores, and review of the associated hospital's benchmark patient data.
METHODS: Residents' duty hour violations were compiled and analyzed for individual violation, postgraduate year (PGY), and service in the program. Annual OTE scores and the department's hospital benchmark measures (inpatient mortality, inpatient length of stay, 30-day readmission rate) were compared before and after the institution of the ACGME duty hours mandate.
RESULTS: The 10-hour rule was most frequently violated; residents on the oncology service and PGY-2 year were most commonly in violation. There was no difference before and after institution of the ACGME duty hours mandate in 30-day hospital readmission rates (P = .42), hospital mortality index (P = .55), length of stay (P = .55), OTE scores (P = .11, Student's t test), and graduating resident's operative volume.
CONCLUSIONS: Institution of the ACGME duty hour regulations did not improve patient care as measured by the 30-day readmission rate, inhospital mortality, and patient's length of stay. Residents' performance on the OTE did not change after implementation of the ACGME rules. Further studies are warranted to assess the impact of the ACGME work hour regulations on patient care and resident-physicians' training.

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Year:  2009        PMID: 19266585     DOI: 10.1002/lary.20144

Source DB:  PubMed          Journal:  Laryngoscope        ISSN: 0023-852X            Impact factor:   3.325


  8 in total

Review 1.  Effectiveness of external inspection of compliance with standards in improving healthcare organisation behaviour, healthcare professional behaviour or patient outcomes.

Authors:  Gerd Flodgren; Marie-Pascale Pomey; Sarah A Taber; Martin P Eccles
Journal:  Cochrane Database Syst Rev       Date:  2011-11-09

2.  Duty hour restrictions, ambulatory experience, and surgical procedural volume in obstetrics and gynecology.

Authors:  Sarah M Kane; Nazema Y Siddiqui; Jennifer Bailit; May Hsieh Blanchard
Journal:  J Grad Med Educ       Date:  2010-12

3.  The effect of reducing maximum shift lengths to 16 hours on internal medicine interns' educational opportunities.

Authors:  Cecelia N Theobald; Daniel G Stover; Neesha N Choma; Jacob Hathaway; Jennifer K Green; Neeraja B Peterson; Kelly C Sponsler; Eduard E Vasilevskis; Sunil Kripalani; John Sergent; Nancy J Brown; Joshua C Denny
Journal:  Acad Med       Date:  2013-04       Impact factor: 6.893

4.  The impact of resident duty hour reform on hospital readmission rates among Medicare beneficiaries.

Authors:  Matthew J Press; Jeffrey H Silber; Amy K Rosen; Patrick S Romano; Kamal M F Itani; Jingsan Zhu; Yanli Wang; Orit Even-Shoshan; Michael J Halenar; Kevin G Volpp
Journal:  J Gen Intern Med       Date:  2010-11-06       Impact factor: 5.128

Review 5.  Patient safety, resident education and resident well-being following implementation of the 2003 ACGME duty hour rules.

Authors:  Kathlyn E Fletcher; Darcy A Reed; Vineet M Arora
Journal:  J Gen Intern Med       Date:  2011-03-03       Impact factor: 5.128

Review 6.  External inspection of compliance with standards for improved healthcare outcomes.

Authors:  Gerd Flodgren; Daniela C Gonçalves-Bradley; Marie-Pascale Pomey
Journal:  Cochrane Database Syst Rev       Date:  2016-12-02

7.  The Relationship Between ACGME Duty Hour Requirements and Performance on the American Board of Emergency Medicine Qualifying Examination.

Authors:  Francis L Counselman; Terry Kowalenko; Catherine A Marco; Kevin B Joldersma; Robert C Korte; Earl J Reisdorff
Journal:  J Grad Med Educ       Date:  2016-10

Review 8.  A systematic review of the effects of resident duty hour restrictions in surgery: impact on resident wellness, training, and patient outcomes.

Authors:  Najma Ahmed; Katharine S Devitt; Itay Keshet; Jonathan Spicer; Kevin Imrie; Liane Feldman; Jonathan Cools-Lartigue; Ahmed Kayssi; Nir Lipsman; Maryam Elmi; Abhaya V Kulkarni; Chris Parshuram; Todd Mainprize; Richard J Warren; Paola Fata; M Sean Gorman; Stan Feinberg; James Rutka
Journal:  Ann Surg       Date:  2014-06       Impact factor: 12.969

  8 in total

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