INTRODUCTION: In anticipation of the 2011 ACGME duty hour requirements, we redesigned our internal medicine resident ward experience. Our previous ward structure included a maximum 30-hour duty period for postgraduate year-1 (PGY-1) residents. In the redesigned ward structure, PGY-1 residents had a maximum 18-hour duty period. METHODS: We evaluated resident conference attendance and duty hour violations before and after implementation of our new ward redesign. We administered a satisfaction survey to residents and faculty 6 months after implementation of the new ward redesign. RESULTS: Before implementation of the ward redesign, 30-hour continuous and 80-h/wk duty violations were each 2/year, and violations of the 10-hour rest between duty periods were 10/year for 74 residents. After implementation of the ward redesign, there were no 30-hour continuous or 80-h/wk duty violations, but violations of the 10-hour rest between duty periods more than doubled (26/year for 75 residents). Duty hours were reported by different mechanisms for the 2 periods. Conference attendance improved. Resident versus faculty satisfaction scores were similar. Both groups judged overall professional satisfaction as slightly worse after implementation. CONCLUSION: Our ward rotation redesign eliminated 30-hour continuous and 80-h/wk duty violations as well as improved conference attendance. These benefits occurred at the cost of more faculty hires, decreased resident elective time, and slightly worse postimplementation satisfaction scores.
INTRODUCTION: In anticipation of the 2011 ACGME duty hour requirements, we redesigned our internal medicine resident ward experience. Our previous ward structure included a maximum 30-hour duty period for postgraduate year-1 (PGY-1) residents. In the redesigned ward structure, PGY-1 residents had a maximum 18-hour duty period. METHODS: We evaluated resident conference attendance and duty hour violations before and after implementation of our new ward redesign. We administered a satisfaction survey to residents and faculty 6 months after implementation of the new ward redesign. RESULTS: Before implementation of the ward redesign, 30-hour continuous and 80-h/wk duty violations were each 2/year, and violations of the 10-hour rest between duty periods were 10/year for 74 residents. After implementation of the ward redesign, there were no 30-hour continuous or 80-h/wk duty violations, but violations of the 10-hour rest between duty periods more than doubled (26/year for 75 residents). Duty hours were reported by different mechanisms for the 2 periods. Conference attendance improved. Resident versus faculty satisfaction scores were similar. Both groups judged overall professional satisfaction as slightly worse after implementation. CONCLUSION: Our ward rotation redesign eliminated 30-hour continuous and 80-h/wk duty violations as well as improved conference attendance. These benefits occurred at the cost of more faculty hires, decreased resident elective time, and slightly worse postimplementation satisfaction scores.
Authors: T Michael Kashner; Steven S Henley; Richard M Golden; John M Byrne; Sheri A Keitz; Grant W Cannon; Barbara K Chang; Gloria J Holland; David C Aron; Elaine A Muchmore; Annie Wicker; Halbert White Journal: Acad Med Date: 2010-07 Impact factor: 6.893
Authors: Christopher P McCoy; Andrew J Halvorsen; Conor G Loftus; Furman S McDonald; Amy S Oxentenko Journal: Mayo Clin Proc Date: 2011-02-09 Impact factor: 7.616
Authors: Ryan M Antiel; Scott M Thompson; Frederic W Hafferty; Katherine M James; Jon C Tilburt; Michael P Bannon; Philip R Fischer; David R Farley; Darcy A Reed Journal: Mayo Clin Proc Date: 2011-02-09 Impact factor: 7.616
Authors: Vineet M Arora; Emily Georgitis; Juned Siddique; Ben Vekhter; James N Woodruff; Holly J Humphrey; David O Meltzer Journal: JAMA Date: 2008-09-10 Impact factor: 56.272