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BCRP Adapted to New Duty Hour Standards in 2011-2012 |
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BCRP Adapted to New Duty Hour Standards in 2011-2012 |
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Based on the new ACGME Duty Hour Standards that went into effect for July 2011, the BCRP leadership, the Residency Program Training Committee members and residents from all three training years developed a new approach to call schedules and team structure to achieve compliance starting in July 2011. Throughout the year, with close monitoring of duty hours and potential violations, the BCRP made modifications to the original call and shift schedules, workload, and daily tasks to adapt to these duty hour standards. The program continues to look for improvements to optimize the training environment while remaining in compliance with accreditation standards.
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| Happy at work |
We first developed guiding principles to inform the work process. These included the idea that we need to balance educational and service responsibilities and, at the same time, maximize the time residents spend engaged in patient care. It is important to us to prioritize the time interns spend on family-centered rounds and to continue the tradition of case-based instruction and to emphasize time at the bedside. Another important principle was that residents should continue to follow patients they admit and provide longitudinal care over time. This drove our efforts to facilitate patient ownership and responsibility. It was of the utmost importance to us to avoid creating a shift work mentality with shortened shifts and numerous handoffs. We contemplated eliminating certain rotations but decided in the end that we must maintain those unique curricular elements that are so much a part of our pediatric training. It was also a guiding principle that the models of team structure must support residents' lives outside of the workplace, so we paid careful attention to the timing of rounds, evening sign-out, lengths of day and night shifts, and the need for time off on weekends to support friendships and family life. The focus on night shifts made us re-examine our didactic curriculum and we are developing new educational sessions during night shifts. Finally, we consulted our sleep science experts here and at the Brigham to use evidence about clinical performance and patient safety and apply that evidence to our final models.
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