III.
Up one level to ACGME Institutional Requirements 2018
| III. | The Learning and Working Environment | |||||||||
| III.A. | The Sponsoring Institution and each of its ACGME-accredited programs must provide a learning and working environment in which residents/fellows have the opportunity to raise concerns and provide feedback without intimidation or retaliation, and in a confidential manner, as appropriate. | (Core) | ||||||||
| III.B. | The Sponsoring Institution is responsible for oversight and documentation of resident/fellow engagement in the following: | (Core) | ||||||||
| III.B.1. | Patient Safety: The Sponsoring Institution must ensure that residents/fellows have: | |||||||||
| III.B.1.a) | access to systems for reporting errors, adverse events, unsafe conditions, and near misses in a protected manner that is free from reprisal; and, | (Core) | ||||||||
| III.B.1.b) | opportunities to contribute to root cause analysis or other similar risk-reduction processes. | (Core) | ||||||||
| III.B.2. | Quality Improvement: The Sponsoring Institution must ensure that residents/fellows have: | |||||||||
| III.B.2.a) | access to data to improve systems of care, reduce health care disparities, and improve patient outcomes; and, | (Core) | ||||||||
| III.B.2.b) | opportunities to participate in quality improvement initiatives. | (Core) | ||||||||
| III.B.3. | Transitions of Care: The Sponsoring Institution must: | |||||||||
| III.B.3.a) | facilitate professional development for core faculty members and residents/fellows regarding effective transitions of care; and, | (Core) | ||||||||
| III.B.3.b) | in partnership with its ACGME-accredited program(s), ensure and monitor effective, structured patient hand-over processes to facilitate continuity of care and patient safety at participating sites. | (Core) | ||||||||
| III.B.4. | Supervision and Accountability: | |||||||||
| III.B.4.a) | The Sponsoring Institution must oversee: | |||||||||
| III.B.4.a).(1) | supervision of residents/fellows consistent with institutional and program-specific policies; and, | (Core) | ||||||||
| III.B.4.a).(2) | mechanisms by which residents/fellows can report inadequate supervision and accountability in a protected manner that is free from reprisal. | (Core) | ||||||||
| III.B.5. | Clinical Experience and Education: | |||||||||
| III.B.5.a) | The Sponsoring Institution must oversee: | |||||||||
| III.B.5.a).(1) | resident/fellow clinical and educational work hours, consistent with the Common and specialty-/subspecialty- specific Program Requirements across all programs, addressing areas of non-compliance in a timely manner; | (Core) | ||||||||
| III.B.5.a).(2) | systems of care and learning and working environments that facilitate fatigue mitigation for residents/fellows; and, | (Core) | ||||||||
| III.B.5.a).(3) | an educational program for residents/fellows and core faculty members in fatigue mitigation. | (Core) | ||||||||
| III.B.5.b) | The Sponsoring Institution, in partnership with its ACGME- accredited program(s), must ensure adequate sleep facilities and safe transportation options for residents/fellows who may be too fatigued to return safely home. | (Core) | ||||||||
| III.B.5.b).(1) | Sleep facilities must be safe, quiet, and private, and must be available and accessible for residents/fellows to support education and safe patient care. | (Core) | ||||||||
| III.B.6. | Professionalism: | |||||||||
| III.B.6.a) | The Sponsoring Institution, in partnership with the program director(s) of its ACGME-accredited program(s), must provide a culture of professionalism that supports patient safety and personal responsibility. | (Core) | ||||||||
| III.B.6.b) | The Sponsoring Institution, in partnership with its ACGME- accredited program(s), must educate residents/fellows and faculty members concerning the professional responsibilities of physicians, including their obligation to be appropriately rested and fit to provide the care required by their patients. | (Core) | ||||||||
| III.B.6.c) | The Sponsoring Institution must provide systems for education in and monitoring of: | |||||||||
| III.B.6.c).(1) | residents’/fellows’ and core faculty members’ fulfillment of educational and professional responsibilities, including scholarly pursuits; and, | (Core) | ||||||||
| III.B.6.c).(2) | accurate completion of required documentation by residents/fellows. | (Core) | ||||||||
| III.B.6.d) | The Sponsoring Institution must ensure that its ACGME-accredited program(s) provide(s) a professional, respectful, and civil environment that is free from unprofessional behavior, including mistreatment, abuse and/or coercion of residents/fellows, other learners, faculty, and staff members. | (Core) | ||||||||
| III.B.6.d).(1) | The Sponsoring Institution, in partnership with its ACGME- accredited program(s), must have a process for education of residents/fellows and faculty members regarding unprofessional behavior, and a confidential process for reporting, investigating, monitoring, and addressing such concerns. | (Core) | ||||||||
| III.B.7. | Well-Being | |||||||||
| III.B.7.a) | The Sponsoring Institution must partner with its ACGME- accredited program(s) to address well-being of residents/fellows and faculty members, consistent with the Common and specialty-/subspecialty-specific Program Requirements. | (Core) | ||||||||
| III.B.7.b) | The Sponsoring Institution, in partnership with its ACGME- accredited program(s), must educate faculty members and residents/fellows in identification of the symptoms of burnout, depression, and substance abuse, including means to assist those who experience these conditions. This responsibility includes educating residents/fellows and faculty members in how to recognize those symptoms in themselves, and how to seek appropriate care. | (Core) | ||||||||
| III.B.7.c) | The Sponsoring Institution, in partnership with its ACGME- accredited program(s), must: | (Core) | ||||||||
| III.B.7.c).(1) | encourage residents/fellows and faculty members to alert their program director, DIO, or other designated personnel or programs when they are concerned that another resident/fellow or faculty member may be displaying signs of burnout, depression, substance abuse, suicidal ideation, or potential for violence; | (Core) | ||||||||
| III.B.7.c).(2) | provide access to appropriate tools for self screening; and, | (Core) | ||||||||
| III.B.7.c).(3) | provide access to confidential, affordable mental health assessment, counseling, and treatment, including access to urgent and emergent care 24 hours a day, seven days a week. | (Core) | ||||||||
| III.B.7.d) | The Sponsoring Institution must ensure a healthy and safe clinical and educational environment that provides for: | (Core) | ||||||||
| III.B.7.d).(1) | access to food during clinical and educational assignments; and, | (Core) | ||||||||
| III.B.7.d).(2) | safety and security measures for residents/fellows appropriate to the participating site. | (Core) | ||||||||
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