Letter from the Chief Medical Officer

Dear Colleagues:

As we meet the challenges in teaching the next generation of clinical leaders at BWH, we are paying close attention to the quality of work life for our residents. Recently published research findings from our own Charles Czeisler, MD, PhD indicate that academic medical centers may want to set even more aggressive regulations than those established by the Accreditation Council for Graduate Medical Education (ACGME) to bring about a safe and balanced environment for interns and the patients they serve.

As BWH responds to such findings for all residency programs, there is important and ongoing debate regarding the best solutions to implement. In addition to adhering to the ACGME duty hours guidelines, BWH has instituted additional measures to address fatigued residents. One such example is providing cab vouchers to any resident or fellow who has worked a lengthy shift or is feeling sleep deprived at the end of his or her shift. The Department of Surgery proactively initiated round-trip taxi service for those on extended shifts. In addition, the hospital provided 1.5 million for additional residents, fellows and allied health providers. Fiscal and other solutions to address this issue hospital-wide continue to be discussed.

The Department of Medicine is also implementing a plan designed to benefit the performance of post-graduate, year-one interns and increase patient safety. First-year interns may not work more than 24 hours consecutively and may not write orders for patient care activities after 18 consecutive hours on a shift.

We believe these initiatives will be helpful to other institutions in their efforts to increase patient safety and enhance the quality of interns' lives-goals of our nationwide medical system. As the reduction of hours requires hospital-wide support, we have enlisted the support of the entire BWH community in making this important step a reality.

Sincerely,

Andy Whittemore, MD
Chief Medical Officer