ACGME Duty Hours Committee New Inpatient Model

1. ACGME Duty Hours CommitteeNew Inpatient Model Department of Pediatrics UC San Diego

2. New ACGME Duty Hour Requirements • Maximum 80 hours per week • Length of shift • Interns = 16 hours max • Residents = 24+4 hours max • Any shift over 18 hours must have an available nap • Time off • 10 hours between shifts (minimum) • Days off • One day off in seven days • Supervision of interns and residents more precisely delineated

3. The Approach • Points of emphasis • Maintain and enhance resident education • Ensure patient safety • Appropriate supervision • Resident well-being • Maintain balance of inpatient and outpatient rotations • Committee members • Representatives from each class • Chief residents • Key faculty and administration

4. New Wards Model

5. Four Ward Day Teams Yellow Team SR1 MR1 JR1 JR2 Green Team SR2 MR2 JR3 JR4 Blue Team SR4 MR4 JR7 JR8 Red Team SR3 MR3 JR5 JR6

6. One Ward Night Team

7. Sample Intern Wards Schedule

8. Predicted Changes

9. Predicted Changes • Non-Resident Patients • Anticipate increase of up to 2-3 non-resident patients per subspecialty • Highly educational admissions will receive priority for resident coverage • Nurse Practitioners for General Pediatrics • Existing service will continue • Prioritize NP admissions during resident transitions • Protect residents during education and patient transfers