Duty hour policy must be strictly followed and enforced. It is incumbent upon the Program Director, Faculty and Resident to strictly adhere to AOA policy for duty hours. Institutions and programs can require more strict policies. An example of an institutional policy for duty hours follows.
POLICY Duty Hours
Duty hours are
defined as all clinical and academic activities related to the residency
program, ie, patient care (both inpatient and outpatient), administrative duties
related to 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.
Duty hours must
be limited to 80 hours per week, averaged over a four-week period, inclusive of
all in-house call activities.
Residents must be provided with 1 day in 7 free
from all educational and clinical responsibilities, or 2 days in 14, inclusive
of call. One day is defined as one continuous 24-hour period free from all
clinical, educational, and administrative activities.
Adequate time for rest and personal activities must be provided. This should consist of a 12 hour time period provided between all daily duty periods and after in-house call.
On-Call Duty Hours are to provide residents with continuity of patient care experiences throughout a 24 hour period.
Are those duty hours beyond the normal workday, when residents are required to be immediately available in the medical center. In-house call must occur no more frequently than every third night, averaged over a four-week period.
Continuous on-site duty (24+6 hours)
Continuous on-site duty including in-house call must not exceed 24 consecutive hours. Residents may remain on duty for up to six (6) additional hours to participate in didactic activities, transfer care of patients, conduct outpatient clinics, and maintain continuity of medical and surgical care. No new patients may be accepted after 24 hours of continuous duty.
At-home call (or pager call) is defined as a call taken from outside the assigned institution. The frequency of at-home call is not subject to the every-third-night limitation. At-home call, however, must not be so frequent as to preclude rest and reasonable personal time for each resident. Residents taking at-home call must be provided with 1 day in 7, or 2 days in 14 completely free from all educational and clinical.
When residents are called into the hospital from home, the hours residents spend in-house are counted toward the 80-hour limit.
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.