Plastic Surgery Resident Perceptions of the Accreditation Council for Graduate Medical Education's 2011 Duty Hour Regulation Changes: Are Patients at Risk?
Johannes Hascall, Jennifer Jo
The death of Libby Zion, a New York City college student, in 1984 was blamed in part on fatigued and under-supervised residents. Her death brought about a grand jury investigation and eventually prompted the Accreditation Council for Graduate Medical Education (ACGME) to create and enforce multiple duty hour regulations for residents throughout the United States since that time. The ACGME last made changes to its duty hour regulations on July 1, 2011. These changes were more stringent than previous regulations and may affect patient safety. Little research exists concerning the new regulations’ effects on patient safety, and hardly any research focuses on residents’ perceptions of duty hour regulations and patient safety. While internal medicine and other medical residents have been studied, plastic surgery residents have largely been ignored. Therefore, the purpose of this ethnographic study was to describe plastic surgery residents’ perceptions of the ACGME’s 2011 duty hour regulations’ effects on patient safety. Ten plastic surgery residents were interviewed to determine their perceptions of the 2011 duty hour changes and patient safety. Fourteen questions were used to guide each interview. Interviews were transcribed, and transcripts were checked for accuracy. Open and axial coding was used to separate and organize data into themes. Five themes emerged regarding patient safety, which were resident fatigue, resident inexperience, patient hand-offs, at-home call, and night float. Information gained from this study may aid the medical community when considering future changes for resident duty hour regulations. Keywords: ACGME, Duty Hour Regulations, Plastic Surgery Residents, Patient Safety
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