Excessive fatigue and sleep deprivation can have an adverse effect on patient safety and resident well being.
The goal of the Medical College of Wisconsin Affiliated Hospitals (MCWAH) fatigue policy is to assist graduate medical education (GME) programs in support of high quality education and safe, effective patient care. MCWAH is committed to meeting the requirements of ACGME Duty Hour Policies. All faculty should be educated in fatigue and substance abuse.
In the event that any housestaff experiences excessive fatigue that is interfering with the ability to safely perform duties, (s)he is obligated to report this to the senior resident or fellow (as appropriate), or faculty on service.
Further, the following expectations apply:
• All faculty, fellows, and residents are expected to be observant of any signs of excessive fatigue in housestaff. Faculty and housestaff are urged to report these occurrences to the senior resident or fellow (as appropriate), faculty and/or the Program Director. In accordance with each program’s contingency plan, the housestaff will be relieved of duties until the effects of fatigue abate.
• Residents and fellows have a responsibility to maximize sleep during off-hours and to be proactive in anticipating possible sleep deprivation when going on overnight call. They should not drive when fatigued.
• Each GME program must develop a contingency plan to manage the transfer of clinical responsibilities or patient care from a fatigued resident to other residents, fellows, or faculty who are not fatigued.
MCWAH supports education on and awareness of the signs of fatigue and techniques to mitigate fatigue. A companion document has been prepared for program use and can be found on the MCWAH website under Administrative Resources. Educational training is available from MCWAH to educate faculty and housestaff on the manifestations of fatigue and ways to alleviate it.
This policy was approved by the MCWAH Graduate Medical Education Council on December 21, 2009.