Resident Work Hour Changes in Children’s Hospitals: Impact on Staffing Patterns and Workforce Needs

Author:

Freed Gary L.123,Dunham Kelly M.12,Moran Lauren M.12,Spera Laura12

Affiliation:

1. Child Health Evaluation and Research (CHEAR) Unit, University of Michigan, Ann Arbor, Michigan;

2. Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan; and

3. Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan

Abstract

BACKGROUND AND OBJECTIVE: Changes to the structure and nature of resident duty hour assignments can create compensatory workforce needs in hospital or outpatient settings to ensure appropriate patient care. The objective of this study was to understand what, if any, adjustments children’s hospitals have made in staffing and assignments of specific duties during the past 2 years as a result of residency duty hour changes, and what changes are anticipated in the upcoming 2 years. METHODS: Mail survey to chief executive officers and chief operating officers of 114 freestanding children’s hospitals or children’s hospitals within a larger hospital. RESULTS: Response rate was 65.4%. Respondents from more than half of hospitals (57%, N = 36) reported increasing the overall full-time equivalent (FTE) of hospitalists in response to the 2011 resident work hour changes. Forty-eight percent (N = 30) increased the overall FTE of pediatric nurse practitioners (PNPs), and 42% (N = 27) increased the FTE of neonatal nurse practitioners (NNPs). Most hospitals plan to increase the number of hospitalists (69%, N = 44), PNPs (59%, N = 37), or pediatric attending physicians (56%, N = 35) over the next 2 years. Forty-three percent (N = 27) of hospitals plan to increase the number of NNPs over the next 2 years, and a quarter plan to increase physician assistants (25%, N = 16) or pediatric house staff (24%, N = 15). CONCLUSIONS: Changes in work hours for pediatric residents appear to have an impact on workforce planning within pediatric hospitals. Decreases in available resident work hours will create an increasing demand, primarily for nonresident physicians, PNPs, and NNPs.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Reference13 articles.

1. Accreditation Council for Graduate Medical Education. Navigation pages. Available at: www.acgme.org/acWebsite/navPages/av_Public.asp. Accessed April 2, 2012

2. Accreditation Council for Graduate Medical Education. ACGME duty hours standards fact sheet. Available at: www.acgme.org/acWebsite/newsRoom/newsRm_dutyHours.asp. Accessed April 2, 2012

3. Residents’ duty hours and professionalism.;Rybock;N Engl J Med,2009

4. Krupa C. Resident work hours, supervision face new round of restrictions. Available at: www.ama-assn.org/amednews/2010/07/05/prl10705.htm. Accessed April 2, 2012

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