Residents' Work and On-Call Schedule Policy for the University of Washington Medical Center Department of Otolaryngology-Head and Neck Surgery

I. Duty hours

A. 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, and scheduled academic activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.

B. Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.

C. Residents must be provided with 1 day in 7 free from all educational and clinical responsibilities, averaged over a 4-week period, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative activities.

D. Adequate time for rest and personal activities must be provided. This should consist of a 10 hour time period provided between all daily duty periods.

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II. On-Call Activities

The objective of on-call activities is to provide residents with continuity of patient care experiences throughout a 24-hour period.

A. Continuous on-site duty must not exceed 24 consecutive hours. Residents may remain on duty for up to six additional hours to participate in didactic activities, transfer care of patients, conduct outpatient clinics, and maintain continuity of medical and surgical care as defined in Specialty and Subspecialty Program Requirements.

C. No new patients, as defined in Specialty and Subspecialty Program Requirements, may be accepted after 24 hours of continuous duty. A new patient is defined as one for whom the otolaryngology service or department has not previously provided care. During this time, residents may assist in surgery. The resident should evaluate the patient before participating in surgery.

D. At-home call (pager call) is defined as call taken from outside the assigned institution.

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III. At-Home Call

The frequency of at-home call is not subject to the every third night limitation. However, at-home call 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 completely free from all educational and clinical responsibilities, averaged over a 4-week period.

A. When residents are called into the hospital from home, the hours residents spend in-house are counted toward the 80-hour limit.

B. 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.

• A Resident Work Hour survey will be completed on a weekly basis. Our week is defined as Monday through Sunday. Duty hour entry in Verinform tracking system is mandatory for all residents.
  
• The duty hours for all residents will be reviewed on a weekly basis by the Chief Resident of each service. The duty hours for all residents and clinical sites will be reviewed monthly at Quality Assurance Conference. This will be presented by each Chief resident at each clinical site for all of the residents at that location. Included in this presentation will be a description of which days the resident had completely free of clinical responsibility. Any problem areas will be discussed with the residents and faculty as a whole.

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