title: Resident work hour changes in children's hospitals: impact on staffing patterns and workforce needs.
abstract: 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.
authors.affiliation: Child Health Evaluation and Research (CHEAR) Unit, University of Michigan, 300 North Ingalls Building, Room 6E08, Ann Arbor, MI 48109-0456, USA. gfreed@med.umich.edu
authors.forename: Gary L
authors.initials: GL
authors.lastname: Freed
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Dunham
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Moran
authors.forename: Laura
authors.initials: L
authors.lastname: Spera
mesh_terms: D019538:Health Care Surveys; D020445:Hospitalists; D006776:Hospitals, Pediatric; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008505:Medical Staff, Hospital / Q000458:organization & administration*; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D010371:Pediatric Nursing; D010372:Pediatrics / Q000193:education*; D010561:Personnel Staffing and Scheduling; D011795:Surveys and Questionnaires; D014481:United States; D000078329:Workforce; D016526:Workload