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Duty Hours in Emergency Medicine: Balancing Patient Safety, Resident Wellness, and the Resident Training Experience: A Consensus Response to the 2008 Institute of Medicine Resident Duty Hours Recommendations.
- Source :
- Academic Emergency Medicine; Sep2010, Vol. 17 Issue 9, p1004-1011, 8p
- Publication Year :
- 2010
-
Abstract
- Representatives of emergency medicine (EM) were asked to develop a consensus report that provided a review of the past and potential future effects of duty hour requirements for EM residency training. In addition to the restrictions made in 2003 by the Accreditation Council for Graduate Medical Education (ACGME), the potential effects of the 2008 Institute of Medicine (IOM) report on resident duty hours were postulated. The elements highlighted include patient safety, resident wellness, and the resident training experience. Many of the changes and recommendations did not affect EM as significantly as other specialties. Current training standards in EM have already emphasized patient safety by requiring continuous on-site supervision of residents. Resident fatigue has been addressed with restrictions of shift lengths and limitation of consecutive days worked. One recommendation from the IOM was a required 5-hour rest period for residents on call. Emergency department (ED) patient safety becomes an important concern with the decrease in the availability and in the patient load of a resident consultant that may result from this recommendation. Of greater concern is the already observed slower throughput time for admitted patients waiting for resident care, which will increase ED crowding and decrease patient safety in academic institutions. A balance between being overly prescriptive with duty hour restrictions and trying to improve resident wellness was recommended. Discussion is included regarding the appropriate length of EM training programs if clinical experiences were limited by new duty hour regulations. Finally, this report presents a review of the financing issues associated with any changes. ACADEMIC EMERGENCY MEDICINE 2010; 17:1004–1011 © 2010 by the Society for Academic Emergency Medicine [ABSTRACT FROM AUTHOR]
- Subjects :
- ACADEMIC medical centers
CIRCADIAN rhythms
CLINICAL competence
CONTINUUM of care
EMERGENCY medical services
EMERGENCY medicine
EMERGENCY physicians
FATIGUE (Physiology)
HEALTH care rationing
HOSPITAL medical staff
WORKING hours
INDUSTRIAL hygiene
INTERNSHIP programs
LABOR demand
MEDICAL education
MEDICAL records
MEDICAL societies
STUDY & teaching of medicine
PATIENT safety
SHIFT systems
SLEEP
STUDENTS
SUPERVISION of employees
WORK environment
EMPLOYEES' workload
JOB performance
EDUCATION
EMPLOYEES
STANDARDS
ECONOMICS
Subjects
Details
- Language :
- English
- ISSN :
- 10696563
- Volume :
- 17
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- Academic Emergency Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 53420444
- Full Text :
- https://doi.org/10.1111/j.1553-2712.2010.00789.x