GRADUATE MEDICAL EDUCATION

POLICIES & PROCEDURES

Graduate Medical Education Policy For
Resident Duty Hours at Texas Health Presbyterian Hospital Dallas
 Policy Number: 9
Date Issued: 11/2002
Prior Revision Date:10/2010
  Date Revised: 07/2013
PURPOSE To provide interns, residents and fellows (hereafter all will be referred to as trainees) with a sound academic and clinical education while ensuring patient safety and resident well being. The graduate medical education department has adopted the duty hours policy consistent with the Accreditation Council for Graduate Medical Education (ACGME) requirements effective July 1, 2007.
SCOPE All trainees employed by Texas Health Presbyterian Hospital Dallas.
PROVISIONS

Duty hours are defined as all clinical and academic activities related to the training program, i.e., patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site

  1. Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities
  2. The trainee must be provided with 1 day in 7 free from all educational and clinical responsibilities, averaged over a four week period, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical educational, and administrative activities.
  3. A-10 hour time period for rest and personal activities must be provided between all daily duty periods, and after in-house call.

On-Call Activities:

  1. In-house call must occur no more frequently than every third night, averaged over a four-week period
  2. Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours. Trainees may remain on duty for up to 6 additional hours to participate in didactic activities, maintain continuity of medical and surgical care, transfer care of patients, or conduct outpatient continuity clinics.
  3. No new patients may be accepted after 24 hours of continuous duty, except in outpatient continuity clinics.
  4. At-home call
    1. The frequency of at-home call is not subject to the every third night limitation. However, at-home call must not be so frequent as to preclude rest and reasonable personal time for each resident. Trainees taking at-home call must be provided with 1 day in 7 completely free from all educational and clinical responsibilities, averaged over a 4-week period.
    2. When trainees are called into the hospital from home, the hours trainees spend in-house are counted toward the 80-hour limit.
    3. The program director and the faculty must monitor the demands of at-home call in their programs and make scheduling adjustments as necessary to mitigate excessive service demands and/or fatigue.

LESLIE H. SECREST, MD
Medical Director, Graduate Medical Education

AURORA ESTEVEZ, MD
Chief Medical Officer