Comparing Electronic and Manual Tracking Systems for Monitoring Resident Duty Hours

Changes in the Accreditation Council for Graduate Medical Education (ACGME) duty hour requirements have created significant monitoring responsibilities for institutions. This study explored the types of tracking systems used and determined for each type of tracking system the number of violations identified and the number of ACGME citations issued.

An 8-question, anonymous, electronic survey was sent to 3,275 residency program coordinators across 24 ACGME-accredited specialties nationwide. The survey was developed by the study investigators to gather data on the type of system used by programs, perceived advantages and disadvantages of the system, the number and types of violations identified, and subsequent ACGME citations for duty hour noncompliance.

Of the 889 responses (27.1% response rate), 780 (87.7%) reported using an electronic system, while 94 (10.6%) used a manual system. Programs found electronic systems significantly superior on most characteristics, including accuracy, effectiveness, ease of use, reliability, reporting variety, and time investment (all P<0.001). Electronic systems identified significantly more violations than their manual counterparts; however, violation identification did not correlate with an increase in ACGME duty hour citations for programs using electronic systems (all P>0.05).

Although a relationship was seen between the tracking system and the number of violations identified, no significant relationship was detected between the system used and the number of citations issued by the ACGME. While programs have invested considerable time, effort, and expense in systems to track duty hours, the real meaning of the data collected and its value to programs, residents, the ACGME, and the healthcare system remains unclear.