1 Maintaining Clinical Exposure Following Mandated 2011 Residency Program Redesign A retrospective review of programmatic changes of the Internal Medicine Residency at Johns Hopkins Bayview Medical Center Jonathon Thorp, M.D., M.B.A, Senior Resident, Internal Medicine
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
1
Maintaining Clinical Exposure
Following Mandated 2011 Residency
Program RedesignA retrospective review of programmatic changes of the Internal
Medicine Residency at Johns Hopkins Bayview Medical Center
Jonathon Thorp, M.D., M.B.A,
Senior Resident, Internal Medicine
Disclosures
• None
2
Presentation Objectives
1. Briefly review the historical context of the 2011
duty hour changes.
2. Explain how we applied the duty hour rules to
our internal medicine program.
3. Review the impact of these changes on volume
and types of patients seen by PGY1 trainees.
3
Historical Context
2003
• ACGME mandated a reduction in total hours worked
2008
• IOM report called for greater reduction in duty hours
2011
• ACGME regulated maximum continuous hours worked
4
IOM 2008
Philibert 2011
Philibert 2011
Continuous Hours Worked
• Pre-2011 • Post-2011
5
24
Hours
16
Hours
‡ didactic activities, transfer of patient care, outpatient clinics
+ 6‡
Hours
Types of Redesigns
6
Workload Compression
Workload Reduction
Program Redesign
2006
• Aliki Initiative
• Curriculum: patient centered care and safe transitions of care
2009/10
• Resident Review Oversight Committee
• Goal: increase continuity and improve team based care
2011 & Current
• Application of Duty Hours
• Increased ambulatory & general acute care medicine