New+Innovations+Logging+Primer

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**Duty Hour Logging in New Innovations: A Primer **
 * Why do we care? ** ACGME requires that we log hours and justify violations, so we all need to know **//what//** all these hours requirements are so we can help each other avoid true violations, and **//how//** to log in New Innovations to avoid false violations due to software quirks.


 * __What __**** are those ACGME requirements? **
 * 1) **Weekly hours **: No more than 80 hours/week averaged over 4 weeks. //Callback only counts towards this for hours you actually worked in the hospital.//
 * 2) **Shift length: **For R2/R3’s: No more than 24 consecutive hours + 4 additional for transitional activities. For R1’s: no more than 16 consecutive hours (no transition time beyond this)
 * 3) **Short Break: ** must have 10 hours __scheduled__ between shifts. 8h is bare minimum and acceptable if there is a specific justification for patient care / safe hand-off. //Rule does NOT apply when called in from callback.//
 * 4) **Night Float: ** no more than 6 consecutive nights
 * 5) **Day Off: ** at least one 24 hour period without scheduled activity per week averaged over 4 weeks


 * __How __****<span style="color: #222222; font-family: Arial,sans-serif; font-size: 12pt;"> to log in New Innovations **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 12pt;">:
 * 1) <span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt; line-height: 1.5;">Log your hours each and every week.
 * 2) **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;">Log all hours continuously for the day **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;">to avoid false "short break" violations. Do NOT put gaps in your schedule for lunch, for an afternoon off, between anesthesia and ED shift, etc. Just log it as if you were working continuously even if you actually went home and took a nap.
 * 3) **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;">Be mindful of the shifts with exactly 10 hours scheduled off **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;"> (see below). Help each other get out on time and log time you stay over as “sign-out time”. Must still have minimum of 8h off.
 * 4) <span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt; line-height: 1.5;">Log any hours past 24h on OB as “sign-out time” (up to 4h)
 * 5) <span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt; line-height: 1.5;">For callback: log ONLY the hours you were called in as “Callback – called in”. These hours count towards 80h/wk but short break violations are excused. Do NOT log “Callback – not called in”.
 * 6) <span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt; line-height: 1.5;">Log vacation days as 8h vacation per weekday you are off
 * 7) <span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt; line-height: 1.5;">For continuity deliveries: log these hours, if you get a violation then document it was for a continuity delivery


 * <span style="color: #222222; font-family: Arial,sans-serif; font-size: 12pt;">Watch out for these shifts that come up against duty hours: **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;">please help each other get out on time!
 * 1) **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;">Short Break **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;"> – must have at least 10h scheduled, if stay over, minimum 8 (log extra hours as “sign out time”)
 * **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt; line-height: 1.5;">Evening ICU **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;"> resident must leave by **9pm** (back at 7am the next morning)
 * **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt; line-height: 1.5;">Short Admit **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;"> must leave hospital by **10pm** (outpatient activity at 8am next morning)
 * **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt; line-height: 1.5;">Inpatient **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;">: you should not be working past **8pm** the day prior (back at 6am). If you are, stop and ask your attending to help you with any pending work the next day.
 * **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt; line-height: 1.5;">NHO **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;"> must leave promptly at **7am** on Fridays (back at 5pm)
 * **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt; line-height: 1.5;">NF (Night ICU) **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;">must leave at 8am (back at 6pm).
 * 1) **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt; line-height: 1.5;">Shift Length : 24h OB call **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;"> must leave by **10:30am** (24+4) and document hours beyond 24 as “sign out time”
 * 2) **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt; line-height: 1.5;">80h/wk : **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;">ICU and inpatient often come close to this, and sometimes residents go over. It is really important that you keep track of your hours on an on-going basis and work with your attending to stay under this limit.


 * <span style="color: #222222; font-family: Arial,sans-serif; font-size: 12pt;">It is residency program's intention to never schedule a resident in such a way that violates any of the ACGME duty hour rules, or impose a workload that results in their violation **<span style="color: #222222; font-family: Arial,sans-serif; font-size: 12pt;">.
 * 1) <span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;">If you are concerned that you are scheduled in a way that may be a violation, please contact the scheduler ( schedule@ccfamilymed.com <span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;"> or text/call/page Kendra) right away so she can fix it
 * 2) <span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt; line-height: 1.5;">There will soon be a system in place for attendings and residents to review hours weekly on inpatient and ICU rotations (where we have the most issues going over hours) so you can work collaboratively together to adjust your workload and workflow to keep you under hours.

<span style="color: #222222; font-family: Arial,sans-serif; font-size: 10pt;"> Your chiefs, October 2015