Besides resident physician fatigue, the recommendations cover six other areas: workload and supervision; moonlighting; resident physician safety; hand-over practices and training in quality improvement; monitoring and oversight of the Accreditation Council for Graduate Medical Education, the body that oversees residency programs; and funding for reform implementation.
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Key recommendations include:
• Limiting all resident physician work hours to shifts of 12-16 hours. As of July 1, 2011, the ACGME has agreed to limit the shifts of first-year residents to no more than 16 hours without sleep. However, it will continue to permit shifts of 28 consecutive hours for more senior residents, including surgical residents.
• Making ACGME work-hour compliance a condition of participation for Medicare graduate medical education support.
• Identifying in real time when a resident physician’s workload is excessive and additional staff should be activated.
• Requiring attending physicians to supervise all hospital admissions.
• Mandating in-house supervision for all critical care services, including emergency, intensive care and trauma services.
• Making comprehensive fatigue management a Joint Commission National Patient Safety Goal.
Read the news release about reforms to address physician fatigue.
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