IHWC, October 2011 Office of Academic Affiliations, VHACO Barbara K. Chang, MD, MA 1 New U.S. Accreditation Standards for Duty Hours Increase Need for Additional Healthcare Workers 1

2 Scope of Training in VA  ~30% of US residents train annually in VA  2,200+ ACGME-accredited programs in 79 specialties & subspecialties  AY , 10,300 (~9% US) positions  FY 11 trainee budget: $773M direct

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 3

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 5

Comparison with ACGME Study of Resource Impacts 6

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 7

8 Questions? Co-authors: Judy L. Brannen, MD, MBA Karen M. Sanders, MD Malcolm Cox, MD Veterans Health Administration Education Mission To educate for VA and for the Nation