Recent Graduates

GRADUATE MEDICAL EDUCATION POLICIES AND PROCEDURES

Subject: Duty Hours (Effective July 2011)

PURPOSE:

The purpose of this Policy is to support the physical and emotional well-being of the Graduate Staff of the Department of Pathology and Cell Biology at New York-Presbyterian Hospital, promote an educational environment, and facilitate patient care. These procedures have been developed to regularly monitor Graduate staff duty hours for compliance with this Policy and the ACGME Institutional Requirements.


POLICY:

1. It is the policy of the Department of Pathology at New York Presbyterian Hospital (“The Program? to comply with New York State 405 Regulations and with ACGME policy on duty hours for postgraduate trainees (i.e. residents and fellows). These are the minimum standards on duty hours that programs must follow.


2. Compliance: The program director and clinical service chief are accountable for ensuring compliance with duty hours policies. The GME Committee, the Medical Board, and the Board of Trustees receive periodic reports on duty hour compliance as part of the QA process.


3. The Program will use an approved Web-based duty hour logging system (currently E*Value). Graduate Staff are required to complete the NYPH duty hour survey monthly as well as log their duty hours quarterly. Compliance of both requirements will be reviewed by the NYPH GME office and the duty hours subcommittee of the GMEC, followed by the full GMEC.


4. Definition: Duty hours are defined as all clinical and academic activities related to the educational program: patient care, both inpatient and outpatient, administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.


5. Duty hours must be limited to 80 hours per week averaged over 4 weeks, inclusive of all in-house activities, clinical assignments, and moonlighting activities


6. Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours (24 consecutive hour rule) for PGY2 and above residents/fellows or 16 hours for PGY1 residents. The Program in Pathology does not have in-house call. For PGY2 and above residents, ACGME strongly suggests strategic napping, especially after 16 hours of continuous duty and between the hours of 10:00 PM and 8:00 AM.

Trainees may remain on duty for up to 3 additional hours of transition time to be used for transfer of patient care, rounds, and grand rounds. No new patient care may be assigned during the 3 hour transition time (total of 27 hours).


7. Per ACGME, in unusual circumstances, residents, on their own initiative, may remain beyond their scheduled period of duty to continue to provide care to a single patient. Justifications for such extensions of duty are limited to reasons of required continuity for a severely ill or unstable patient, academic importance of the events transpiring, or humanistic attention to the needs of patient or family. Under those circumstances, the resident must: a. appropriately hand over the care of all other patients to the team responsible for their continuing care and b. document the reasons for remaining to care for the patient in question and submit that documentation in every circumstance to the program director, who must review and track each submission of this kind.


8. Adequate time for rest and personal activities must be provided. This should consist of a 10 hour time period between all daily duty periods, but at a minimum, must be an 8 hour period, and for PGY2 and above, must consist of a 14 hour time period after in-house 24 hour call.


9. Every trainee must have at least 24 consecutive hours free from all duty, including call from home, each week.


10. Call from home is not counted toward the 80 hour limit. If the trainee is called on-site, the hours are counted toward the 80 hour total.


11. The Call schedule for PGY1 residents and PGY2-3-4 residents, for the 2011-2012 academic year, shall be as outlined below (service pager numbers are in parenthesis):


table of policies
 
 
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