Cockerham W Todd, Cofer Joseph B, Lewis Patricia L, Scroggins Candice M, Burns R Phillip
Department of Surgery, University of Tennessee College of Medicine, Chattanooga Unit, Chattanooga, Tennessee 37403, USA.
Am Surg. 2004 Aug;70(8):687-90.
The Accreditation Council for Graduate Medical Education (ACGME) requires all programs to limit resident work hours to 80 hours per week with some programs allotted an extra 10 per cent for specific educational purposes. The purpose of this study was to evaluate data reflecting changes in resident schedules made in 2002-2003 to be compliant with ACGME requirements without compromising patient care or resident education. Surgery residents originally completed a work-hour survey in May 2002. The survey contained 14 daily time sheets. Residents were asked to document how their time was spent between 14 different categories delineating in-house and out-of-house hours. Changes were made to resident schedules in order to become compliant with the new regulations. After making changes in the schedule, two more surveys were completed and evaluated, once in May 2003 and again in November 2003. Final analyses compared results from May 2002 to November 2003. Surveys were distributed to 30 residents in May 2002. Twenty-two residents completed the survey with 16 surveys eligible for analysis following exclusion of abnormal rotations (i.e., research and vacation). Eighty-eight per cent of junior residents (PGY 1, 2, and 3), 50 per cent of senior residents (PGY 4-5), and 33 per cent of chief residents (PGY 6) worked more than 88 hours per week. In November 2003, surveys were sent to 32 residents. Twenty-four residents who were on our normal call schedule completed the survey. Fourteen per cent of junior residents, 33 per cent of senior residents, and 0 per cent of chief residents worked more than 88 hours per week. By making the changes described, we have substantially reduced the number of resident work-hours while maintaining our academic and patient care missions.
毕业后医学教育认证委员会（ACGME）要求所有项目将住院医师工作时长限制在每周80小时，部分项目出于特定教育目的可额外增加10%。本研究的目的是评估反映2002 - 2003年住院医师排班变化的数据，这些变化旨在符合ACGME要求，同时不影响患者护理或住院医师教育。外科住院医师最初于2002年5月完成了一次工作时长调查。该调查包含14份每日时间表。要求住院医师记录他们在14个不同类别中的时间分配情况，这些类别划分了住院和非住院时间。为了符合新规定，对住院医师排班进行了调整。在调整排班后，又完成并评估了另外两次调查，一次在2003年5月，另一次在2003年11月。最终分析比较了2002年5月至2003年11月的结果。2002年5月向30名住院医师发放了调查问卷。22名住院医师完成了调查，排除异常轮转（即研究和休假）后，16份调查问卷符合分析要求。88%的初级住院医师（PGY 1、2和3）、50%的高级住院医师（PGY 4 - 5）以及33%的主治住院医师（PGY 6）每周工作超过88小时。2003年11月，向32名住院医师发放了调查问卷。24名按正常值班安排的住院医师完成了调查。14%的初级住院医师、33%的高级住院医师以及0%的主治住院医师每周工作超过88小时。通过上述改变，我们在维持学术和患者护理任务的同时，大幅减少了住院医师的工作时长。
