ACGME approves final duty hour and supervision standards

New duty hour rules received final approval, keeping work levels of 80 hours per week but also detailing supervision for first-year residents and capping their work to 16 hours a day.

The Accreditation Council for Graduate Medical Education (ACGME) approved last week the new rules, which take effect July 2011.

Other changes include:

• establishing graduated requirements for minimum time off between scheduled duty periods;expanding program and institutional requirements regarding handovers of patient care; andsetting more specific requirements for alertness management and fatigue mitigation strategies designed to ensure both continuity of patient care and resident safety.

The standards are based on recommendations made by the Institute of Medicine in 2008, which were based on a scientific review of sleep issues, patient safety and resident training, as well as testimony from more than 100 experts on those topics and statements from 100 medical organizations.

A cost impact analysis will be posted on the ACGME website next week. A compliance review is under development. Under this program, ACGME will review every residency program for its ability to integrate residency education, supervision and fatigue management into its existing patient safety and quality improvement initiatives.

In related news, the Association of American Medical Colleges advocated that ACGME keep the sole oversight role of resident duty hours. In a letter to the Occupational Safety and Health Administration, the organization urged OSHA to reject a petition by public watchdog groups to the contrary.