Pediatric trainees systematically under-report duty hour violations compared to electronic health record defined shifts

Autoři: Adam C. Dziorny aff001;  Evan W. Orenstein aff003;  Robert B. Lindell aff002;  Nicole A. Hames aff003;  Nicole Washington aff004;  Bimal Desai aff004
Působiště autorů: Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America aff001;  Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America aff002;  Department of Pediatrics, Emory University School of Medicine and Division of Hospital Medicine, Children’s Healthcare of Atlanta, Atlanta, Georgia, United States of America aff003;  Division of General Pediatrics, Department of Pediatrics, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America aff004
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article


Duty hour monitoring is required in accredited training programs, however trainee self-reporting is onerous and vulnerable to bias. The objectives of this study were to use an automated, validated algorithm to measure duty hour violations of pediatric trainees over a full academic year and compare to self-reported violations. Duty hour violations calculated from electronic health record (EHR) logs varied significantly by trainee role and rotation. Block-by-block differences show 36.8% (222/603) of resident-blocks with more EHR-defined violations (EDV) compared to self-reported violations (SRV), demonstrating systematic under-reporting of duty hour violations. Automated duty hour tracking could provide real-time, objective assessment of the trainee work environment, allowing program directors and accrediting organizations to design and test interventions focused on improving educational quality.

Klíčová slova:

Electronic medical records – Fatigue – Graduates – Inpatients – Intensive care units – Medical education – Pediatrics – Trainees


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2019 Číslo 12
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