Resident Work Hours In Line, State Health Department Says
Monday, January 16, 2006
Diane Hartmann, M.D.
The New York State Department of Health has found Strong Memorial Hospital in compliance with state-established work hour limits for medical residents.
The state’s decision follows a lengthy inspection that was conducted in November.
“Being in compliance means that residents have the opportunity to find a better balance between their professional and personal lives,” said Diane Hartmann, M.D., associate dean for Graduate Medical Education at the University of Rochester School of Medicine and Dentistry. “There is also a much greater chance that when they are here they are awake and alert and capable of better patient care decisions as well as more fully participatory in their educational activities. For the patients, they have better rested physicians who should be more capable of making more thoughtful and safer decisions.”
New YorkState has had work hour regulations for residents or physicians in training since 1989. The rules include: a maximum of 80 hours a week (including moonlighting); at least 8 hours off after 24 hours of call; shifts in the emergency department of no more than 12 hours; and at least one day off each week.
In 1998, the University of Rochester School of Medicine and Dentistry became the first in the state to develop an internal survey process to monitor resident work hours. The anonymous survey requires resident to keep work-hour diaries. Strong also has devised systems to more efficiently allocate work hours for residents. In some instances, the hospital has attending physicians and nurse practitioners perform duties once completed by residents.
To determine whether a program meets the work hour regulations, the state health department hires the Island Peer Review Organization (IPRO) to make unannounced visits annually to facilities across New York State.
IPRO was at Strong for 10 days in November, 2005. The IPRO team conducted interviews with approximately 300 residents and fellows in internal medicine, anesthesia, surgery, pediatrics and obstetrics and gynecology, and with the directors of resident training programs. The inspection team reviewed all rotations and call schedules as well as instruction schedules. They also examined operating room and birth logs and selected medical records.
IPRO turns over their findings over to the state, which makes the final compliance decision.