Monitoring of Resident Duty Hours

According to a recent Harvard study*, interns working a typical on-call schedule, which often includes shifts exceeding 30 hours, made 36% more serious medical errors and nearly six times more serious diagnostic errors than when working shifts of 16 hours or less. In the interest of patient safety, the national Accreditation Council for Graduate Medical Education (ACGME) has mandated limits on weekly and continuous work hours for medical residents.

THE IPRO Solution

IPRO's Resident Work Hour Compliance Monitoring Program was created in 2001 to improve the compliance of New York's 120 teaching hospitals with state regulated resident working hour requirements. Since then, the rate of New York hospitals' compliance has increased from 36% to 88%, based on annual surveys.

Using a collaborative approach that ensures resident confidentiality, IPRO's compliance team offers a comprehensive program, which includes:

• Conducting pre-ACGME Review survey audits (including unannounced, on-site observations, resident interviews, medical record verification and complaint investigations) to identify any potential areas of concern
• Reviewing program schedules, including on-call and off-site clinic schedules
• Validating resident working hours
• Providing comprehensive recommendations for meeting compliance objectives
• Conducting educational seminars and training sessions on the ACGME regulations, problem prevention and program strengths for attending physicians, program directors, residents, resident associations and individual hospital departments.

IPRO's monitoring process addresses all aspects of conducting an effective review, including conducting entrance and exit conferences, reviewing facility documents, interviewing residents and program directors, collecting and analyzing data and preparing our findings for state approval. IPRO's training program ensures that facilities fully understand program requirements and how to achieve compliance. IPRO also investigates complaints and performs follow-up visits to assess implementation of corrective action by the facilities.

IPRO's compliance team is composed of highly skilled health care professionals with expertise in clinical nursing, management and administration, survey work, data analysis, managed care, nursing informatics, quality assessment and improvement, coding, medico-legal issues, regulatory matters, accounting and health care research.

The IPRO Advantage

• The services of a company that has assisted states in dramatically improving hospital compliance with resident working hour regulations
• The skills and knowledge of professional compliance reviewers who have conducted more than 40,000 resident interviews and completed more than 700 compliance reviews
• Proven processes and methods for data collection, analysis and reporting, which have been tested and refined over time.
• A team of reviewers with extensive knowledge of the ACGME requirements
• An approach based on trust and communication that has achieved a high level of cooperation between the hospitals and review teams

Contact Veronica Wilbur, RN, MBA, CLNC, Senior Director at 518-426-3300, ext. 103 or vwilbur@ipro.org

Since 1983, IPRO has been collaborating with federal, state and local government to improve health outcomes across the continuum of care. IPRO's staff of over 350 health care assessment and quality improvement professionals develop innovative solutions that help our clients optimize the quality of their health care programs and the value of their health care dollars.