III.F.1 Adequate Rest for House Officers Policy

The following policies are in place to ensure House Officers have adequate rest between duty periods and after on-call duty:
1. The Clinical and Educational Work Hours Policy states:

1. 1. House Officers must have at least 14 hours free of clinical work and required education after 24 hours of in-house duty.
   2. House Officers must be scheduled for a minimum of one day in seven off from clinical work and required education (averaged over four weeks). At-home call cannot be assigned on these off days.

2. All employees of LSUHSC must adhere to Chancellor's Memorandum 37 (CM-37), the LSUHSC Fitness for Duty policy, which defines when employees are both fit and safe to work. It includes what are considered unsafe/impaired behaviors, the requirement for self or supervisor referral to the Campus Assistance Program, and what steps should be taken thereafter.
3. The Sponsoring Institution's Policy of Professionalism and Learning Environment expands further upon the responsibility of House Officers to assure they are well rested and fit for duty:
House Officers must take personal responsibility for, and faculty must model behaviors that promote:

1. Assurance for fitness of duty
2. Assurance of the safety and welfare of patients entrusted in their care
3. Management of their time before, during and after clinical assignments
4. Recognition of impairment (e.g., illness or fatigue) in self and peers
5. Honest and accurate reporting of clinical and educational work hours, patient outcomes, and clinical experience data

4. The moonlighting policy anticipates potential trouble areas and describes a method for monitoring the effects of moonlighting on House Officers
5. Adequate sleep facilities are in place at each institution and the alertness management/fatigue mitigation policy encourages good sleep hygiene and recommends strategic napping and post-call naps.
6. Faculty are expected to model behaviors that encourage fitness for duty as noted above; the Supervision Policy requires faculty to observe for signs of fatigue, especially during transitions.