Chandra Rakesh K
Department of Otolaryngology--Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
Laryngoscope. 2004 Aug;114(8):1394-8; discussion 1319. doi: 10.1097/00005537-200408000-00014.
To identify strategies employed by surgical departments to address recently implemented resident duty hour regulations, and to assess resident and faculty acceptance of these changes.
Attendees to the 2003 Residency Program Coordinator/Administrator Workshop for sub-specialties (Denver, CO) were surveyed.
The study population included 46 respondents spanning 9 surgical sub-specialties. Forty-eight percent of programs instituted at least 1 administrative change specifically to comply with duty hour regulations. The most commonly employed strategies were the hiring of nurse practitioners or physician assistants (30%) and the use of Internet-based software to track resident duty hours (30%). Other changes included giving call responsibilities to residents on research rotations (19%), institution of home-call (13%), and assignment of a night-float resident (11%). Perceptions of program coordinators indicated that junior residents and junior faculty accepted changes better than did senior residents and senior faculty (P=.025).
The resident 80-hour work week is a major health care policy change that has required academic sub-specialty departments to make significant alterations in their administrative structure. Further study is necessary to determine how these changes affect both quality of training and patient care in the short and long term.
确定外科科室为应对最近实施的住院医师值班时间规定所采用的策略，并评估住院医师和教员对这些变化的接受程度。
对参加2003年亚专科住院医师培训项目协调员/管理员研讨会（科罗拉多州丹佛）的人员进行了调查。
研究人群包括来自9个外科亚专科的46名受访者。48%的项目至少进行了1项行政变更，专门以符合值班时间规定。最常用的策略是雇佣执业护士或医师助理（30%）以及使用基于互联网的软件来跟踪住院医师值班时间（30%）。其他变更包括让参与研究轮转的住院医师承担呼叫职责（19%）、实行家中待命（13%）以及安排夜间轮值住院医师（11%）。项目协调员的看法表明，初级住院医师和初级教员比高级住院医师和高级教员更能接受这些变化（P = 0.025）。
住院医师每周80小时工作制是一项重大的医疗保健政策变化，要求学术亚专科科室对其行政结构进行重大调整。有必要进一步研究这些变化在短期和长期内如何影响培训质量和患者护理。
