TITLE: MONITORING FATIGUE IN POST GRADUATE TRAINEES POLICY:
NEWYORK-PRESBYTERIAN HOSPITAL
GRADUATE MEDICAL EDUCATION
POLICIES AND PROCEDURES
MONITORING AND ADDRESSING FATIGUE IN GRADUATE STAFF
TITLE: POLICY:
NewYork-Presbyterian Hospital (“NYPH”), in compliance with the New York State
(“NYS”) Department of Health Regulations and the Accreditation Council for
Graduate Medical Education (“ACGME”) program requirements, requires that all
postgraduate trainees be monitored for signs of fatigue.
It is the responsibility of the Program Director/designee to monitor the on-call and
assignment schedules of all postgraduate trainees so that Graduate Staff are
receiving ample time for rest, in compliance with NYS and ACGME Clinical and
Educational Work Hours requirement.
Graduate Staff and faculty members must demonstrate an understanding of their
personal role in the recognition of impairment from fatigue.
Each program must:
• educate all faculty members and Graduate Staff to recognize the signs of
fatigue and sleep deprivation;
• educate all faculty members and Graduate Staff in alertness management
and fatigue mitigation processes and encourage Graduate Staff to use fatigue
mitigation processes to manage the potential negative effects of fatigue on
patient care and learning;
• have policies and procedures in place that ensure coverage of patient care in
the event that a Graduate Staff Member may be unable to perform their patient
care responsibilities because of fatigue. (ACGME, Common Program
Requirements (CPR), VI.C.2.a). These policies must be implemented without
fear of negative consequences for the Graduate Staff Member who is or was
unable to provide the clinical work (ACGME, CPR, VI.C.2.b));
• ensure continuity of patient care, consistent with the program’s policies and
procedures referenced in VI.C.2-VI.C.2.b, in the event that a Graduate Staff
Member may be unable to perform their patient care responsibilities due to
excessive fatigue or illness, or family emergency (ACGME, CPR, VI.E.3.e);
• in partnership with its Sponsoring Institution, must ensure adequate sleep
facilities and safe transportation options for Graduate Staff Members who may
be too fatigued to safely return home (ACGME, CPR, VI.D.3).
Any postgraduate trainee who is experiencing fatigue should immediately notify
his/her program of his/her state of fatigue. When a Program Director/designee
determines that a Graduate Staff member is too fatigued to perform his/her duties
effectively, the Program Director will arrange for the postgraduate trainee to be
temporarily relieved from all on-call and clinical duties.It is the responsibility of the Program Director/designee to notify the appropriate
individuals of the change in the on-call and clinical assignment schedule.
APPROVAL DATES:
Reviewed by GME Office: Approved by GMEC: September 2014, February 2018, May 2019,
October 2024
September 2008, September 2020, November 2024
Approved by The Medical Board: May 2010, December 2020, December 2024