title: Comparing Electronic and Manual Tracking Systems for Monitoring Resident Duty Hours.
abstract: BACKGROUND
  Changes in the Accreditation Council for Graduate Medical Education (ACGME) duty hour requirements have created significant monitoring responsibilities for institutions. This study explored the types of tracking systems used and determined for each type of tracking system the number of violations identified and the number of ACGME citations issued.
  
  
  METHODS
  An 8-question, anonymous, electronic survey was sent to 3,275 residency program coordinators across 24 ACGME-accredited specialties nationwide. The survey was developed by the study investigators to gather data on the type of system used by programs, perceived advantages and disadvantages of the system, the number and types of violations identified, and subsequent ACGME citations for duty hour noncompliance.
  
  
  RESULTS
  Of the 889 responses (27.1% response rate), 780 (87.7%) reported using an electronic system, while 94 (10.6%) used a manual system. Programs found electronic systems significantly superior on most characteristics, including accuracy, effectiveness, ease of use, reliability, reporting variety, and time investment (all P<0.001). Electronic systems identified significantly more violations than their manual counterparts; however, violation identification did not correlate with an increase in ACGME duty hour citations for programs using electronic systems (all P>0.05).
  
  
  CONCLUSIONS
  Although a relationship was seen between the tracking system and the number of violations identified, no significant relationship was detected between the system used and the number of citations issued by the ACGME. While programs have invested considerable time, effort, and expense in systems to track duty hours, the real meaning of the data collected and its value to programs, residents, the ACGME, and the healthcare system remains unclear.
authors.affiliation: Medical Education, Advocate Lutheran General Hospital, Park Ridge, IL.
authors.forename: Maggie
authors.initials: M
authors.lastname: Petre
authors.affiliation: Operational Integration and Communication/Clinical Affairs, Cancer Treatment Centers of America, Schaumburg, IL.
authors.forename: Roxana
authors.initials: R
authors.lastname: Geana
authors.affiliation: Illinois Bone & Joint Institute, Morton Grove, IL.
authors.forename: Nancy
authors.initials: N
authors.lastname: Cipparrone
authors.affiliation: Psychiatry Residency Training Program, Advocate Lutheran General Hospital, Park Ridge, IL.
authors.forename: Linsey
authors.initials: L
authors.lastname: Harrison
authors.affiliation: Psychiatry Residency Training Program, Advocate Lutheran General Hospital, Park Ridge, IL.
authors.forename: Marla
authors.initials: M
authors.lastname: Hartzen
authors.affiliation: James R. & Helen D. Russell Institute for Research & Innovation, Advocate Lutheran General Hospital, Park Ridge, IL.
authors.forename: Suela
authors.initials: S
authors.lastname: Sulo
authors.affiliation: James R. & Helen D. Russell Institute for Research & Innovation, Advocate Lutheran General Hospital, Park Ridge, IL.
authors.forename: Ina
authors.initials: I
authors.lastname: Zamfirova
keywords: Accreditation; citations; duty hours; graduate medical education; patient safety; violations