ACGME duty hour compliance--Medical resident scheduling

描述(由申请人提供)： 这项研究的目标是创建易于使用的交互式计算机模拟软件，分析符合医学研究生教育认证委员会要求的住院医师安排方案。新的指导方针限制了住院医生在教学医院工作的天数和小时数。因此，住院医师需要从成本、护理的连续性、治疗质量和住院医师教育质量等多个维度对计划结果进行评估。执行住院医师计划分析的桌面模拟软件包将帮助住院医师主任努力遵守ACGME标准，同时保持高质量的医生教育、护理质量和患者安全。它将使住院医师主任能够在实地实施之前，分析与住院医师教育经验、人员配备水平和成本以及患者护理质量有关的时间表的潜在陷阱。第一阶段的具体目标是： 1.创建一个通用的基于Java的模拟，复制发表在《管理科学》上的经过验证的派驻计划模型。 2.将新的ACGME驻留规则融入到基于Java的仿真模型中。 3.通过计算患者转移数据和估计医生活动时间分布来模拟当前的真实系统。 4.开发一个直观易懂、独立于平台的用户界面，该界面设计为在派驻总监的台式计算机上运行。 5.使用从真实系统收集的数据来测试和验证更新后的仿真软件。 由于疲惫的住院医生较少的护理而获得更好的患者安全具有明显的立竿见影的好处，而保持或提高住院医师教育的质量会影响未来半个世纪的患者护理。该项目产生的交互式调度和桌面模拟技术将扩展到医疗保健流程建模的其他领域。最终，基于Java的软件工具集将把医院运营问题的模型与疾病状态模型联系起来，以纳入当地的疾病负担。

DESCRIPTION (provided by applicant): The goal of this study is to create easy-to-use interactive computer simulation software that analyzes residency scheduling alternatives that comply with the requirements of the Accreditation Council for Graduate Medical Education. The new guidelines constrain the number of days and hours that residents are available to work in teaching hospitals. Therefore residency directors need to evaluate schedule outcomes in multiple dimensions including cost, continuity of care, treatment quality, and quality of resident education. A desktop simulation software package that performs medical residency scheduling analysis will aid residency directors in their efforts to comply with ACGME criteria while maintaining quality physician education, quality of care, and patient safety. It will give medical residency directors the ability to analyze the potential pitfalls of a schedule in regards to resident educational experiences, staffing levels and costs, and the quality of patient care before implementation in the field. The Phase I specific aims are to: 1. Create a generalized Java-based simulation that replicates a validated residency scheduling model published in Management Science. 2. Incorporate new ACGME residency rules into the Java-based simulation model. 3. Simulate a current real system by calculating patient transition data and estimating physician activity time distributions. 4. Develop an intuitively understandable, platform-independent user interface that is designed to run on the desktop computers of residency directors. 5. Test and validate the updated simulation software using data collected from a real system. Better patient safety due to less care by tired residents has obvious immediate benefit, while maintaining or improving the quality of resident education affects patient care for the next half century. The interactive scheduling and desktop simulation technology resulting from the project will be extensible to other areas of healthcare process modeling. Ultimately, the Java-based software tool set will link models of a hospital's operational issues with disease state models to incorporate the local burden of disease.