IHWC, October 2011 IHWC, October 2011 Office of Academic Affiliations, VHACO Office of Academic Affiliations, VHACO

Barbara K. Chang, MD, MA

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New U.S. Accreditation New U.S. Accreditation Standards for Standards for

Duty Hours Increase Need for Duty Hours Increase Need for Additional Healthcare WorkersAdditional Healthcare Workers

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Scope of Training in VA ~30% of US residents train annually in VA 2,200+ ACGME-accredited programs in

79 specialties & subspecialties AY 2011-12, 10,300 (~9% US) positions FY 11 trainee budget: $773M direct

Health Profession Trainees

Total

Physician Residents 36,745Medical Students 20,516Nursing 32,662Physician Assistants 1,453All other 23,924

Total 115,300

New ACGME Common Program Requirements – 7/1/2011

Standards pertaining to:•Duty hours & max on-duty•Supervision•Professionalism (quality & patient safety)

•Transitions of care•Alertness/Fatigue management

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VA Study of Facility ‘Readiness’ to Meet New

ACGME Standards

Survey in Feb. 2011; 118/125 (94%) teaching facilities responded

Results:•72 facilities (61%) projected

increased workforce needs (73% of respondents with >10 resident positions)

•>85% had engaged in planning, most with affiliated university involvement 4

Estimates of Staff & Resources to Meet ACGME

Standards

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Comparison with ACGME Study of Resource Impacts

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Summary/Conclusions

Workforce costs & recruitment will present challenges

Our estimates are >2x those of ACGME’s study (which was based upon theoretical assumptions)

Resources will have to be diverted from other clinical operations

Academic healthcare will be further strained by these requirements

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Questions?

barbara.chang@va.gov

http://www.va.gov/oaa

Co-authors: Judy L. Brannen, MD, MBA

Karen M. Sanders, MD

Malcolm Cox, MD

Veterans Health AdministrationEducation Mission

To educate for VA and for the To educate for VA and for the NationNation