NEW YORK PRESBYTERIAN WORK HOURS POLICY

It is the policy of NewYork-Presbyterian Hospital to comply with New York State 405 Regulations and with ACGME policy on work hours for post-graduate trainees (i.e. residents and fellows).   These are the minimum standards on work hours that programs must follow.   Individual programs may choose to follow more restrictive guidelines.  

The program directors and clinical service chiefs are accountable for ensuring compliance with work hours policies.    The GME Committee, the Medical Board, and the Board of Trustees receive periodic reports on work hour compliance as part of the QA process.

Policies and procedures must be implemented in all programs to relieve a post-graduate trainee due to fatigue.

Duty hours are defined as all clinical and academic activities related to the educational program: 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.

A duty hour work-week is defined as a maximum of 80 hours averaged over 4 weeks, inclusive of all in-house activities, clinical assignments, and moonlighting activities.   (Please refer to the NYPH moonlighting policy for other information about moonlighting.)

Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours (24 consecutive hour rule).   Trainees may remain on duty for up to 3 additional hours of transition time to be used for transfer of patient care, rounds, and grand rounds.   No new patient care may be assigned during the 3 hour transition time (total of 27 hours).

Only surgical programs can use an exception to the 24 consecutive hour rule above; this must be done under the following conditions: the trainee documents 4-5 hours of sleep, the duty shift is followed by a non-working period of 16 hours, and the maximum shift is 30 hours from start to end of on-call.

Work in the emergency department is limited to 12 consecutive hours followed by a minimum of 12 hours off duty.

Adequate time for rest and personal activities must be provided.   This consists of a 10 hour time period between all daily duty periods and after in-house call.

Every trainee must have at least 24 consecutive hours free from all duty, including call from home, each week.

In house call can be no more frequent than every 3rd night.  

Call from home is not counted toward the 80 hour limit.   If the trainee is called on-site, the hours are counted toward the 80 hour total.

Updated 8/1/03