Keeping Duty Hours in Hand: Exploiting Texting to Ensure Compliance.

Area of Science:

• Medical Education
• Healthcare Quality Improvement
• Surgical Residency Programs

Background:

• Accreditation Council for Graduate Medical Education (ACGME) duty hour regulations are critical for resident wellbeing and patient safety.
• Traditional web-based duty hour reporting systems often suffer from inaccuracies and delays, hindering effective oversight.
• Previous reporting methods led to noncompliance and citations, necessitating a more robust monitoring solution.

Purpose of the Study:

• To develop and implement a proactive, real-time duty hour monitoring system.
• To improve compliance with ACGME regulations through accurate, real-time work hour data.
• To facilitate timely administrative interventions and prevent potential duty hour violations.

Main Methods:

• A prospective educational quality improvement initiative using an automated text-message-based reporting system.
• Residents received daily text prompts to report duty hours, with responses logged in a shared scheduling calendar.
• Program leadership reviewed logged hours for compliance, schedule appropriateness, and to intervene proactively.

Main Results:

• The real-time system significantly improved duty hour logging accuracy and timeliness compared to previous web-based methods.
• Implementation led to a reduction in recorded violations and facilitated schedule adaptations to prevent future noncompliance.
• High resident response rates and data validity improved compliance, leading to the resolution of ACGME citations.

Conclusions:

• A proactive, real-time monitoring system using text messages enhances duty hour reporting accuracy and timeliness.
• This automated, mobile-based approach increases resident engagement and provides actionable data for leadership.
• The model is adaptable for other programs to improve duty hour oversight and resident wellbeing.