U.S. patent application number 14/489279 was filed with the patent office on 2015-03-19 for time tracking and productivity system.
The applicant listed for this patent is Quinn Baker, Scott Porter. Invention is credited to Quinn Baker, Scott Porter.
Application Number | 20150081487 14/489279 |
Document ID | / |
Family ID | 52668857 |
Filed Date | 2015-03-19 |
United States Patent
Application |
20150081487 |
Kind Code |
A1 |
Porter; Scott ; et
al. |
March 19, 2015 |
TIME TRACKING AND PRODUCTIVITY SYSTEM
Abstract
A system for automatically tracking employee hours. The system
includes a tracking component. The tracking component is configured
to determine the current location of the employee, determine if the
current location of the employee is within a designated location
and track the time spent by the employee within the designated
location. The system also includes an evaluation module. The
evaluation module is configured to receive from the tracking
component the time spent by the employee within the designated
location and determine if the time spent by the employee within the
designated location exceeds a predetermined threshold and or to be
used for the purpose of billing or to monitor and improve
coordination of patient care.
Inventors: |
Porter; Scott; (Davis,
CA) ; Baker; Quinn; (Sacramento, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Porter; Scott
Baker; Quinn |
Davis
Sacramento |
CA
CA |
US
US |
|
|
Family ID: |
52668857 |
Appl. No.: |
14/489279 |
Filed: |
September 17, 2014 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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61879746 |
Sep 19, 2013 |
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Current U.S.
Class: |
705/32 |
Current CPC
Class: |
G06Q 10/1091
20130101 |
Class at
Publication: |
705/32 |
International
Class: |
G06Q 10/10 20060101
G06Q010/10; G06Q 50/22 20060101 G06Q050/22 |
Claims
1. A system for automatically tracking employee hours, the system
comprising: a tracking component configured to: determine the
current location of the employee; determine if the current location
of the employee is within a designated location; and track the time
spent by the employee within the designated location; and an
evaluation module configured to: receive from the tracking
component the time spent by the employee within the designated
location; and determine if the time spent by the employee within
the designated location exceeds a predetermined threshold.
2. The system of claim 1, wherein the tracking component includes
an application on a portable electronic device.
3. The system of claim 2, wherein the portable electronic device
includes a smart phone.
4. The system of claim 1, wherein the tracking component tracks the
current location of the employee using at least one of: GPS;
geofence technology; or iBeacons.
5. The system of claim 1, wherein the predetermined threshold is
stored in a database.
6. The system of claim 1, wherein the time spent by the employee
within the designated location is shown to a supervisor via a user
interface.
7. The system of claim 6, wherein the user interface allows the
supervisor to set the predetermined threshold.
8. The system of claim 1, wherein the time spent by the employee
within the designated location is integrated into at least one of:
electronic medical records; billing statements; or personnel
evaluations.
9. The system of claim 1, wherein the designated location includes
a remote location.
10. The system of claim 1, wherein the tracking component shows the
employee a shift log configured to track the time of the employee's
current shift.
11. The system of claim 1, wherein the tracking component shows the
employee a aggregate log configured to track the total time worked
by the employee over a designated period of time.
12. The system of claim 11, wherein the designated period of time
includes one week.
13. A system embodied on a non-transitory computer-readable storage
medium bearing computer-executable instructions that, when executed
by a logic device, automatically tracks employee hours, the system
comprising: a logic device; and one or more computer readable
media, wherein the one or more computer readable media contain a
set of computer-executable instructions to be executed by the logic
device, the set of computer-executable instructions configured to:
determine the current location of an employee; determine if the
current location of the employee is within a designated location;
track the time spent by the employee within the designated
location; and determine if the time spent by the employee within
the designated location exceeds a predetermined threshold.
14. The system of claim 13, wherein the set of computer-executable
instructions is further configured to alert a supervisor of the
employee if the time spent by the employee within the designated
location exceeds the predetermined threshold.
15. The system of claim 13, wherein determining if the time spent
by the employee within the designated location exceeds a
predetermined threshold includes comparing the time spent by the
employee in a current shift with an assigned shift.
16. The system of claim 13, wherein determining if the time spent
by the employee within the designated location exceeds a
predetermined threshold includes comparing the time spent by the
employee in a current work week with an assigned work week.
17. A method of automatically tracking employee hours, the method
comprising: determining the current location of an employee;
determining if the current location of the employee is within a
designated location; if the current location of the employee is
within the designated location tracking the time spent by the
employee within the designated location; determining if the time
spent by the employee within the designated location exceeds a
predetermined threshold; and alerting a supervisor if the
predetermined threshold is exceeded.
18. The method of claim 17, wherein alerting a supervisor includes
at least one of: a page; an email; a visual alarm; an audio alarm;
a text message; or a push notification.
19. The method of claim 17, wherein the employee includes a
resident physician.
20. The method of claim 17, wherein the designated location
includes a hospital department.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of and priority to U.S.
Provisional Patent Application Ser. No. 61/879,746 filed on Sep.
19, 2013, which application is incorporated herein by reference in
its entirety.
BACKGROUND OF THE INVENTION
[0002] In an effort to reduce patient care complications related to
resident physician fatigue the ACGME has imposed work hour
restrictions on a national level to limit the number of hours
resident physicians can work. Although work hour restrictions are
quite detailed in general most residents are currently limited to
an 80 hour work week and shifts less than 24 hours.
[0003] Resident based medical institutions (more than 9,000 in the
US) which are governed by the ACGME must therefore track and
document resident work hours. Despite this regulation, work hour
limits continue to be violated for many reasons. When the ACGME
discovers that a residency program is violating work hour
regulations that institution is subject to strict penalties
including fines and probation or suspension.
[0004] Currently work hour restrictions are not adequately enforced
and residents continue to work beyond their limits while
jeopardizing patient care. The reasons for work hour violations are
multiple but include inadequate man power, continuation of previous
culture where residents worked unlimited hours without rest, abuse
of power by superiors, blind neglect by superiors to enforce hours,
inadequate infrastructure to enforce hours. Frequently, resident
violation of work hour restrictions are self-imposed out of loyalty
to the team or a sense that he/she is letting the team down by
going home to rest.
[0005] Regardless of the reason that work hours are violated it is
a fact that work hour violations continue at the expense of the
resident but even more importantly at the expense of the patient.
Currently our extensive survey indicates that institutions utilize
suboptimal methods to track, monitor and report work hours. To the
best of our knowledge and after exhaustive research we have yet to
encounter a system for tracking resident work hours that does not
rely on resident physician self-reporting. Current methods include
self-reporting by way of web based applications, smart phone
applications, surveys, paper documentation and many other methods.
No system to date uses objective or passive methods to collect this
data. These methods that require active resident participation to
log hours are inherently flawed for multiple reasons. Residents are
reluctant to report hours and when they do they feel pressure to
report hours that conform with work hour restrictions. Residents
that were interviewed expressed worries about being viewed as weak
and having repercussions from seniors. They were concerned that the
reporting of work hour overages may lead to suspension of their
program with resulting collateral damage to their training.
Additionally subjective reporting is by nature inaccurate as the
data is not logged in real time and residents may forget or
accidentally document hours that are inaccurate. Residents are
already very busy and it is hard to perform the daily task of
logging hours.
[0006] Accordingly, a system is needed to objectively, passively
(resident is not required to self-report hours) and accurately
track, monitor and not only report resident work hour statistics
but also aid in the correction of those violations. Furthermore,
the same system can be used to serve other functions in the work
place. Including applications to track the time spent by different
users in the hospital setting including time spent by users at
various locations in the hospital and clinical setting for the
purpose of capturing metrics including time spent with patients and
at various locations in the hospital for the purpose of improving
coordination of care and also for billing purposes.
BRIEF SUMMARY OF SOME EXAMPLE EMBODIMENTS
[0007] This Summary is provided to introduce a selection of
concepts in a simplified form that are further described below in
the Detailed Description. This Summary is not intended to identify
key features or essential characteristics of the claimed subject
matter, nor is it intended to be used as an aid in determining the
scope of the claimed subject matter.
[0008] One example embodiment includes a system for automatically
tracking employee hours. The system includes a tracking component.
The tracking component is configured to determine the current
location of the employee, determine if the current location of the
employee is within a designated location and track the time spent
by the employee within the designated location. The system also
includes an evaluation module. The evaluation module is configured
to receive from the tracking component the time spent by the
employee within the designated location and determine if the time
spent by the employee within the designated location exceeds a
predetermined threshold and or to be used for the purpose of
billing or to monitor and improve coordination of patient care.
[0009] Another example embodiment includes a system embodied on a
non-transitory computer-readable storage medium bearing
computer-executable instructions that, when executed by a logic
device, automatically tracks employee hours. The system includes a
logic device. The system also includes one or more computer
readable media, where the one or more computer readable media
contain a set of computer-executable instructions to be executed by
the logic device. The set of computer-executable instructions is
configured to determine the current location of an employee and
determine if the current location of the employee is within a
designated location. The set of computer-executable instructions is
also configured to track the time spent by the employee within the
designated location and determine if the time spent by the employee
within the designated location exceeds a predetermined
threshold.
[0010] Another example embodiment includes a method of
automatically tracking employee hours. The method includes
determining the current location of an employee and determining if
the current location of the employee is within a designated
location. The method also includes if the current location of the
employee is within the designated location tracking the time spent
by the employee within the designated location and both to display
this information to the user and also determining if the time spent
by the employee within the designated location exceeds a
predetermined threshold. The method further includes alerting a
supervisor if the predetermined threshold is exceeded.
[0011] These and other objects and features of the present
invention will become more fully apparent from the following
description and appended claims, or may be learned by the practice
of the invention as set forth hereinafter.
BRIEF DESCRIPTION OF THE DRAWINGS
[0012] To further clarify various aspects of some example
embodiments of the present invention, a more particular description
of the invention will be rendered by reference to specific
embodiments thereof which are illustrated in the appended drawings.
It is appreciated that these drawings depict only illustrated
embodiments of the invention and are therefore not to be considered
limiting of its scope. The invention will be described and
explained with additional specificity and detail through the use of
the accompanying drawings in which:
[0013] FIG. 1 illustrates a block diagram of a system for logging
an employee's work time;
[0014] FIG. 2 illustrates an example of a tracking component during
setup;
[0015] FIG. 3 illustrates an example of a tracking component during
active logging;
[0016] FIG. 4 illustrates an example of a tracking component in a
notification mode;
[0017] FIG. 5 illustrates an example of a tracking component which
is being edited;
[0018] FIG. 6 illustrates an example of a user interface; and
[0019] FIG. 7 illustrates an example of a suitable computing
environment in which the invention may be implemented.
DETAILED DESCRIPTION OF SOME EXAMPLE EMBODIMENTS
[0020] Reference will now be made to the figures wherein like
structures will be provided with like reference designations. It is
understood that the figures are diagrammatic and schematic
representations of some embodiments of the invention, and are not
limiting of the present invention, nor are they necessarily drawn
to scale.
[0021] FIG. 1 illustrates a block diagram of a system 100 for
logging an employee's (e.g., resident physician) work time.
Although a resident's work time is used as exemplary herein the
system 100 could be utilized in other industries including
construction, nuclear power, airlines, etc or for other
individuals, such as nurses, vendors, patients, etc. The system 100
can track a resident's working hours within specific locations. In
particular, as the resident enters a designated location he/she
needs to login to the system 100 so that it start tracking his/her
hours. When the resident leaves the location or explicitly logs out
from the system 100, the server is updated of the resident's exit.
The duration of a resident's presence in a location is deemed to be
his/her working hours in that location. The system 100 allows
hospital administrators to manage various locations within the
workplace and allows program administrators to view various
measurements produced by the system 100. The attending physicians,
residents and nurses can login to the system 100 to view the data
pertaining to the current location in their respective work place.
Attending physicians, residents and nurses can add their schedules
to the system 100 to update the location data.
[0022] FIG. 1 shows that the system 100 can include a network 102.
In at least one implementation, the network 102 can be used to
connect the various parts of the system 100 to one another. The
network 102 exemplarily includes the Internet, including a global
internetwork formed by logical and physical connections between
multiple wide area networks and/or local area networks and can
optionally include the World Wide Web ("Web"), including a system
of interlinked hypertext documents accessed via the Internet.
Alternately or additionally, the network 102 includes one or more
cellular RF networks and/or one or more wired and/or wireless
networks such as, but not limited to, 802.xx networks, Bluetooth
access points, wireless access points, IP-based networks, or the
like. For example, the network 102 can include cloud based
networking and computing. The network 102 can also include servers
that enable one type of network to interface with another type of
network.
[0023] FIG. 1 also shows that the system 100 can include a database
104. The database 104 can store resident or physicians work data.
In particular, the database 104 can include any device that is
capable of storing data. The data can be stored in digital form or
in any other desired form. For example the database 104 can include
memory or memory banks. Additionally or alternatively, the database
104 can run one or more applications which are accessed over the
network 102. For example, the database 104 can include processors
or other logic devices capable of executing software or carrying
out other computer algorithms. The database 104 can allow a
resident to access the hardware of the database 104 for remote
computing or for information retrieval.
[0024] FIG. 1 shows that the system 100 can include a tracking
component 106. The tracking component 106 determines the current
location of a resident. The tracking component 106 can utilize
geographic location functions, such as GPS geofence technology,
iBeacons or any other desired location tracking technology. For
example, during setup latitude and longitude coordinates can be
mapped in a polygon fashion to set a geofence. When the
pre-determined coordinates are crossed or passed (e.g., hospital
walls or designated departments) with a location based electronic
device (e.g., smart phone, tracker, tag, etc.) this is considered
an "event" and triggers an associated clock that will manage the
time based in a time clock fashion on this triggered event. The
tracking component 106 can likewise track the time spent on certain
tasks. For example, the tracking component 106 can track the amount
of time that a resident spends in a particular patient's room, in a
break area, doing paperwork, etc. This can assist in employee
evaluation and/or billing scenarios. For example, if a patient is
to be charged based on the time spent in a certain area (e.g.,
physical therapy) then the tracking component 106 can be used to
determine the time spend in that area. The information from the
tracking component 106 can be integrated into electronic medical
records, billing statements, personnel evaluations, or any other
desired records.
[0025] FIG. 1 also shows that the system 100 can include an
evaluation module 108. The evaluation module 108 compares hours
worked to the hours that should be worked. For example, the
evaluation module can compile and/or compare information about
hours logged, schedules, designated work locations, etc. For
instance, the evaluation module 108 can monitor the time that the
resident enters the designated location and remains active until
the resident goes outside of the designated location. I.e., the
tracking component 106 notes the location of the resident
continuously and the evaluation module 108 determines at which
point the resident enters the designated location and tracks time
within the designated location or receives from the tracking
component 106 the time spent within the designated location. The
evaluation module 108 can compare the time within the designated
location with the actual hours that the resident should be working
and provide alerts if certain thresholds are exceeded (as described
below).
[0026] FIG. 1 additionally shows that the system 100 can include a
user interface 110. The user interface 110 can allow the resident
and/or his/her supervisor(s) to receive information about resident
work hours. For example, the user interface can allow a supervisor
to view, hear or otherwise interact with the information about
resident hours. The user interface 110 can include a graphical user
interface, controls, speakers, displays or any other necessary
hardware and/or software to adequately display the desired
information to the resident and/or his/her supervisor(s), as
described below.
[0027] In at least one implementation, a graphical user interface
("GUI" sometimes pronounced gooey) is a type of user interface 110
that allows users to interact with electronic devices with images
rather than text commands. GUIs can be used in computers, hand-held
devices such as MP3 players, portable media players or gaming
devices, cell phones, household appliances and office equipment. A
GUI represents the information and actions available to a user
through graphical icons and visual indicators such as secondary
notation, as opposed to text-based interfaces, typed command labels
or text navigation. The actions are usually performed through
direct manipulation of the graphical elements.
[0028] By way of example, the user interface 110 can include a
computer program, app, webpage, website, or some other means for
conveying desired information to a supervisor. For example, the
user interface 100 can include a website that a supervisor can log
on to and view resident hours, scheduled work hours, vacations,
physicians/nurses with whom the resident has worked, etc.
Additionally or alternatively, the user interface 100 can allow the
supervisor to change information within the system 100. For
example, the supervisor can set work hours, locations within the
workplace in which the resident should work, etc.
[0029] FIG. 2 illustrates an example of a tracking component 106
during setup. The tracking component can be installed on a tag, a
badge, a smart phone, a tablet, an electronic device or any other
desired device. For example, the tracking component 106 can include
a smart phone app that automatically logs resident hours based on
the location of the smart phone. Additionally or alternatively, the
tracking component 106 can include a tag which communicates with an
external device via RF signal to indicate when a resident enters or
leaves a designated location.
[0030] FIG. 2 shows that the tracking component 106 can include a
log in 202. The log in 202 allows the resident to set whether the
tracking component 106 is logging time. For example, if the
resident is going to the hospital for non-work reasons he/she would
not want the tracking component 106 to log the hours as if they
were being worked. Additionally or alternatively, the resident may
wish to manually log hours. For example, work hours in a geographic
location where automatic logging is not possible may be logged
manually by a logged in resident.
[0031] FIG. 2 also shows that the tracking component 106 can
include a program designation 204. The program designation 204 can
set the designated location for which the resident's time will be
tracked. I.e., if the program designation 204 is used to select a
certain area of a hospital then time in another area of the
hospital (e.g., the cafeteria) may not be logged against the
resident's work hours.
[0032] FIG. 2 further shows that the tracking component 106 can
include additional information 206. For example, the additional
information 206 can include information about other employees, the
resident's supervisor(s), designated work hours, designated work
location or any other desired information. For instance, the
following may be relatively static (i.e., will not change from day
to day or over the course of their residency with few exceptions)
and could be available as additional information 206: [0033] I.
Unique personal number identifier as well as program specific
number identifier such as FRIDA number. Examples include: [0034] A.
Name [0035] B. Address [0036] C. Residency Institution (UCSD,
Stanford, etc.) [0037] 1. Associated residency program or specialty
(OB, Ortho, G Surg, ENT, etc.) with relevant static data including
[0038] a) Resident Program director for each specialty (physician
within each department responsible for coordinating residents)
[0039] b) Resident Coordinator for each specialty (usually an
administrative person whom assists the Resident Program Director
with the administrative management of residents). [0040] c) All
Attending physicians for each specialty will need to be logged in
the system [0041] d) Start time for resident shifts: i.e., 07:00
hours [0042] 2. Possible call scenarios at institution: home call,
in house call, night float [0043] 3. Any institutions that have
"Work Hour Exceptions" through review committee. i.e., extension to
88 hour work week should be noted and factored into their specific
system. [0044] 4. If moon lighting is allowed the location of moon
lighting should be determined so that GPS data can track when
moonlighting occurs and this can be applied to total work hours.
[0045] II. Demographic and specialty related information
[0046] Additionally or alternatively, the following dynamic
information could be located in additional information 206: [0047]
I. Vacation schedule--obtained in the form of department wide
vacation calendar which is regularly updated and disseminated. This
data must be kept current in the software database so that a
resident on vacation will not be bothered with assignments,
tracking, push notifications etc. [0048] II. Annual rotation
schedule--so that the residents work assignments are known by the
system and can be monitored and accessed by those utilizing various
applications of the software [0049] A. This must also indicate year
of residency i.e., intern vs. 5th year, etc. as this has
implications for the work hour restrictions. [0050] III. Call
schedule--so that "in house call" days, "home call" days and post
call days can be monitored and regulated via system applications to
ensure that residents are compliant with work hour restrictions.
[0051] IV. Operative schedule for each attending (OR time and
Location) [0052] V. Weekly schedule as determined by chief on
service. Chiefs currently email out weekly service schedules but an
application could be built into the system to facilitate this. The
system itself could track the real time whereabouts of the
residents (i.e., in hospital, in OR, in Clinic, in Research
Facility vs. Out for out of hospital, or Home Call).
[0053] FIG. 3 illustrates an example of a tracking component 106
during active logging. Active logging means that the resident has
been deemed to enter the designated location and that the tracking
component 106 is logging time. The tracking component 106 can enter
a power save mode to preserve battery life during active logging or
can remain visible to clearly show information.
[0054] FIG. 3 shows that the tracking component 106 can include a
shift log 302. The shift log 302 shows the resident's most recent
time in the designated location. I.e., the shift log 302 shows the
resident's current time in the designated location or the
resident's last previous time in the designated location. For
example, if the resident is in the middle of a shift the shift log
302 can show how much time the resident has already worked. If the
resident is not currently in the middle of a shift the shift log
302 can show how much time was worked in the last previous shift.
One of skill in the art will appreciate that the shift log 302 can
adjust for designated non-work times. For example, the shift log
302 can adjust for a resident's meal time or other breaks. I.e.,
the shift log 302 can show either the total time of the resident
within the designated location or can show only the time that
counts as work hours and ignores time that the resident should be
taking breaks.
[0055] The shift log 302 can include a short trip buffer. I.e.,
short trips away from the designated location can be counted in the
shift log 302. E.g., pacing in and out of the building while
talking on the cell phone or lunch at a nearby restaurant where the
resident returns to the designated location within a reasonable
time. This reasonable time can be adjusted by system
administrators. The shift log 302 continues to track the time as
though the resident had not left the designated location and this
time is added to the overall work hours for the resident's work
shift. However, if the resident does not return or returns out of
the reasonable time limit then the system would not be added to the
resident's work shift.
[0056] Additionally or alternatively, the shift log 302 can include
information worked at remote locations. For example, an on-call
resident can track time related to home call. For example, the
tracking component 106 can use the home address to calculate
commute time to and from the hospital to home. Each time the
resident is called into the hospital outside of regular working
hours the drive time, the time spent in the hospital, as well as
the time required to field a productive call from home (i.e., a
call that requires the resident to return to the hospital) could be
added together. Either a standard time allotment could be used for
a "productive call" (e.g., 15 or 30 minutes) or the shift log 102
could actually track the time when the resident calls a hospital
phone with a prefix that would be included in the software set as
part of the tracking component. Additionally or alternatively, the
tracking component 106 could consider the residents home address as
a place of "work". While on home call and within a certain
proximity to their home the system would register the resident at
work.
[0057] FIG. 3 also shows that the tracking component 106 can
include an aggregate log 304. The aggregate log 304 shows the work
hours for a designated period of time. That is, the aggregate log
304 is a compilation of shift logs for some designated period of
time to be measured (e.g., a week or a month). I.e., resident hours
are regulated by the accreditation council for graduate medical
education (ACGME). Current resident work hour restrictions per
ACGME are as follows: [0058] I. Duty hours must be limited to 80
hours per week, averaged over a four week period, inclusive of all
in-house call activities and all moonlighting. [0059] A. The
tracking component 106 may track time in work place from Monday to
Sunday of a given week beginning at designated start time (i.e.,
07:00 hours on Monday until the same day and time the following
week) and average this data over a 4 week period. In event that
resident continues to accumulate work hours that are likely to
exceed the remaining hours allowed in the work week the system will
push/text resident a notice a warning about their remaining time in
the hospital before exceeding work hour restrictions. If the
remaining work time allotment prior to exceeding limit reaches 1
hour count down then push notice is sent to the chief resident. If
this time approaches 30 minutes then push notice is escalated up
the seniority ladder and warning is sent to Resident, Chief,
Attending on Call and (reply options should exist in the system for
senior staff to reply with a text or push notice to address the
warning). If time is limited to 10 minutes then the same notice is
repeated and should also be sent to a faculty member or
administrative person such as the Residency Coordinator whom is
always available (not tied up in operating room or with clinical
responsibilities) to field push notifications or texts and to
assist in the coordination of evacuating the resident from the
hospital prior to causing damage to patient care or exceeding work
hour restrictions. If time tracked for a given resident exceeds the
allotted work hour restrictions then the push notification/text
will be sent to Resident, Chief, Attending on Call, Residency
Coordinator and to Program Director (Physician in every department
responsible for resident care) and with a carbon copy to the DIO
(physician or appointed representative for University that
coordinates ALL residents and corresponds with ACGME). The system
would track and tally violations and compile this data with push
notifications to the DIO so that violations can be addressed if
they are redundant. [0060] II. Duty Hour Exceptions. A Review
Committee may grant exceptions for up to 10% or a maximum of 88
hours to individual programs based on a sound educational
rationale. [0061] A. This will be individual to each institution
and will be rare as most institutions have not sought 88 hour
exception. However the aggregate log 302 can be modified for a
specific institution. [0062] III. Time spent by residents in
Internal and External Moonlighting (as defined in the ACGME
Glossary of Terms) must be counted towards the 80-hour Maximum
Weekly Hour Limit. PGY-1 (first year residents or intern residents)
are not permitted to moonlight. [0063] A. When moonlighting is
allowed by a residency program, the system should allow for the
location of moonlighting to be input so that the system can track
these hours as though they are work hours. The system should
distinguish that the hours are from moonlighting so that reports
generated by the program can determine if moonlighting is a culprit
related to work hour violations. [0064] IV. Mandatory Time Free of
Duty: Residents must be scheduled for a minimum of one day free of
duty every week (when averaged over four weeks). At-home call
cannot be assigned on these free days. [0065] A. The tracking
component 106 may track time to ensure resident has minimum of one
day free of duty every week averaged over a four week period (i.e.,
a full 24 hours off). Push notifications or texts should be sent to
Chief of Service, with CCs to Residency Program Director when this
does not occur. Repeat violations within a given program should be
pushed to DIO and should be populated in reports generated through
report applications so measures can be taken to resolve such
issues. [0066] V. Maximum Duty Period Length: Duty periods of PGY-1
residents must not exceed 16 hours in duration. Duty periods of
PGY-2 residents and above may be scheduled to a maximum of 24 hours
of continuous duty in the hospital. [0067] A. The tracking
component 106 may track time for work shifts for individual days of
the week. This would be set at a designated work start time for
each day based on the desire of a given Residency Program. Default
would be a designated start time (i.e., 07:00 hours for any given
day with end time at the same time the following day). The system
maximum for an intern or PGY1 would be set at 16 hours whereas the
maximum for PGY-2 and beyond to include the Chief would be set at
24 hours. In event that resident continues to accumulate work hours
that are likely to exceed the remaining hours or minutes allowed in
the shift the system will push/text the Resident a warning notice
about their remaining time in the hospital before exceeding work
hour restrictions. If the remaining work time allotment prior to
exceeding limit reaches 1 hour count down then push/text notice is
sent to the chief resident. If this time approaches 30 minutes then
push notice is escalated up the seniority ladder and warning is
sent to Resident, Chief, Attending on Call and (for all scenarios a
reply options should exist in the system for all members but
especially senior staff to reply with a text or push notice to
address the warning. All members should be copied on all
notifications to facilitate communication). If time is limited to
10 minutes then the same notice is repeated and should also be sent
to a faculty member or administrative person such as the Residency
Coordinator whom is always available (not tied up in operating room
or with clinical responsibilities) to field push notifications or
texts and to assist in the coordination of evacuating the resident
from the hospital prior to causing damage to patient care or
exceeding work hour restrictions. If time tracked for a given
resident exceeds the allotted work hour restrictions then the push
notification/text will be escalated to Resident, Chief, Attending
on Call, Residency Coordinator and to Program Director (Physician
in every department responsible for resident care) and with a
carbon copy to the DIO (physician or appointed representative for
University that coordinates ALL residents and corresponds with
ACGME) or any other high level executive that the institution would
like to be apprised of violations. The system would track and tally
violations and compile this data with push notifications to the DIO
so that violations can be addressed if they are redundant. Filters
should exist to allow institution to set the parameters of these
notifications, including the time points at which notifications are
distributed, who is sent notifications, at what point certain
notifications are escalated (i.e., number of violations and when
escalated who do the notices go to). [0068] VI. In unusual
circumstances, residents, on their own initiative, may remain
beyond their scheduled period of duty to continue to provide care
to a single patient. Justifications for such extensions of duty are
limited to reasons of required continuity for a severely ill or
unstable patient, academic importance of the events transpiring, or
humanistic attention to the needs of a patient or family. Under
those circumstances, the resident must: 1. appropriately hand over
the care of all other patients to the team responsible for their
continuing care. 2. Document the reasons for remaining to care for
the patient in question and submit that documentation in every
circumstance to the program director. 3. The program director must
review each submission of additional service, and track both
individual resident and program-wide episodes of additional duty.
[0069] A. The aggregate log 304 can allow a resident to indicate
that the violation is an exception and to facilitate documentation
of above requirements. [0070] VII. Minimum Time Off between
Scheduled Duty Periods: PGY-1 residents should have 10 hours, and
must have eight hours, free of duty between scheduled duty periods.
Intermediate-level residents [as defined by the Review Committee]
should have 10 hours free of duty, and must have eight hours
between scheduled duty periods. They must have at least 14 hours
free of duty after 24 hours of in-house duty. Residents in the
final years of education [as defined by the Review Committee] must
be prepared to enter the unsupervised practice of medicine and care
for patients over irregular or extended periods This preparation
must occur within the context of the 80-hour, maximum duty period
length, and one-day-off-in-seven standards. While it is desirable
that residents in their final years of education have eight hours
free of duty between scheduled duty periods, there may be
circumstances [as defined by the Review Committee] when these
residents must stay on duty to care for their patients or return to
the hospital with fewer than eight hours free of duty.
Circumstances of return-to-hospital activities with fewer than
eight hours away from the hospital by residents in their final
years of education must be monitored by the program director.
[0071] A. The aggregate log 302 can allow for Chief resident (in
final year of residency) to make exceptions to rules with
exceptions to the above when permitted. [0072] VIII. Maximum
Frequency of In-House Night Float. Residents must not be scheduled
for more than six consecutive nights of night float. [The maximum
number of consecutive weeks of night float, and maximum number of
months of night float per year may be further specified by the
Review Committee.] [0073] IX. Maximum In-House On-Call Frequency:
PGY-2 residents and above must be scheduled for in-house call no
more frequently than every-third-night (when averaged over a
four-week period) Specific push notifications [0074] X. At-Home
Call: Time spent in the hospital by residents on at-home call must
count towards the 80-hour maximum weekly hour limit. The frequency
of at-home call is not subject to the every-third-night limitation,
but must satisfy the requirement for one-day-in-seven free of duty,
when averaged over four weeks. At-home call must not be so frequent
or taxing as to preclude rest or reasonable personal time for each
resident. Residents are permitted to return to the hospital while
on at-home call to care for new or established patients. Each
episode of this type of care, while it must be included in the
80-hour weekly maximum, will not initiate a new "off-duty
period".
[0075] FIG. 3 further shows that the tracking component 106 can
include time remaining in current shift 306. Time remaining in
current shift 306 can include time to scheduled cessation of the
current shift. I.e., if the resident is scheduled to work until
5:00 pm the time remain in current shift 306 can be the time until
5:00 pm is reached. Additionally or alternatively, the time
remaining in current shift 306 can be time at which the resident
will reach work limits. I.e., if the resident would violate ACGME
requirements if he/she worked beyond a certain time the time
remaining in current shift 306 can reflect the time remaining until
a violation occurs.
[0076] FIG. 3 additionally shows that the tracking component 106
can include aggregate time remaining 308. Aggregate time remaining
308 can include time within the designated period which remains
available for the resident to work. For example, if the resident
has currently worked 60 hours of his/her allowed 80 hour work week
then the aggregate time remaining 308 can reflect a time of 20
hours that may still be worked in the week.
[0077] FIG. 3 moreover shows that the tracking component 106 can
include an average time worked 310. The average time worked 310 can
include an average of recent aggregate logs 304. That is, the
average time worked 310 can be an average of n recent aggregate
logs 304. For example, the average time worked can be the average
of the aggregate time worked over the most recent four weeks.
[0078] FIG. 4 illustrates an example of a tracking component 106 in
a notification mode. A notification mode alerts a resident and/or
his/her supervisor(s) that some action needs to occur. For example,
the action may include the resident ending his/her shift, beginning
his/her shift, ceasing to work, or a violating work hours or other
information regarding work schedule.
[0079] FIG. 4 shows that the tracking component 106 can include an
alarm 402. The alarm 402 can alert the resident and/or
supervisor(s) that the resident's hours are above allowed limits.
One of skill in the art will appreciate that either the current log
302, the aggregate log 304, the average time worked 310 or any
combination thereof can trigger a notification to the resident
and/or the resident's supervisor(s). I.e., the current log 302, the
aggregate log 304 and/or the average time 310 can be compared to
the work rules and notify a resident and/or his/her supervisor that
a violation has occurred to allow for corrective actions when
desired.
[0080] For example, if logged hours are near maximum allowed limits
a page, text, email, push notification, visual alarm, audio alarm
or other alert may be sent to a resident that indicate time left
before violating work hour restrictions. The resident may also have
the option to respond to these messages with various predefined
responses and this communication would be tracked by the cloud
based database for each resident. In the event that the tracking
component 106 pushes a notice to the smart phone that the resident
has violated a work hour restriction, this communication may lead
to a number of functions including text warnings but it also alerts
the resident's supervisor.
[0081] Additionally or alternatively, the alarm 402 can include
communicating to a badge give to the resident. I.e., an ID badge
with a built in hardware indicator (auditory or visual indicator)
and transponder that communicates with the tracking component 106.
For example, the badge can include a clock which may change colors
depending on the work time status of the resident. E.g., when a
resident has gone over the allotted hours then the "clock" may turn
from green to red. Additionally or alternatively, when the resident
has a limited amount of time remaining before a violation (e.g., 30
minutes) the clock will change to yellow. Or if the resident is
over hours but on allotted education time and in an area that is
designated for education or research (which is allowed by the
current ACGME guidelines) the clock could blink green. Different
indicators could be used on the badge to openly indicate the status
of the resident and other features may be included such as an LCD
display, etc. This will be valuable information to colleagues but
more importantly to patients. For the first time in history a
patient under the care of a physician will know for certain that
the physician is within the boundaries of industry accepted
standards for their shift.
[0082] FIG. 5 illustrates an example of a tracking component 106
which is being edited. For example, the resident may visit a friend
or colleague before work hours, may be engaging in education time
that should not be logged, may forget the tracking device or other
errors may occur. The edit function allows the resident to change
the beginning time of logging to reflect the actual start time
rather than the start time created as the resident enters the
designated location.
[0083] FIG. 6 illustrates an example of a user interface 110. The
user interface 110 allows a resident and/or his/her supervisor to
see desired information. For example, the user interface 110 can
include a time log, either for an individual resident or for
multiple residents simultaneously. Additionally or alternatively,
the user interface 110 can allow a supervisor to enter information
such as schedules, vacation times, program requirements, etc.
[0084] FIG. 6 shows that the user interface 110 can include a time
log 602. The time log 602 can include all logged information for a
resident. Additionally or alternatively, the time log 602 can
include any alerts that are given for the resident and may allow
the supervisor to note why the alert should be or is subject to an
exemption.
[0085] Additionally or alternatively, the user interface 110 can
provide reports to the resident. For example, the user interface
110 can show residents who are actively working vs. those residents
who are away from the hospital and are not on vacation so that
available man power can be evaluate and harnessed by either
suggesting residents that may be placed on call or asked to work to
facilitate locating needed employees without violating work hour
restrictions.
[0086] FIG. 7, and the following discussion, is intended to provide
a brief, general description of a suitable computing environment in
which the invention may be implemented. Although not required, the
invention will be described in the general context of
computer-executable instructions, such as program modules, being
executed by computers in network environments. Generally, program
modules include routines, programs, objects, components, data
structures, etc. that performs particular tasks or implement
particular abstract data types. Computer-executable instructions,
associated data structures, and program modules represent examples
of the program code means for executing steps of the methods
disclosed herein. The particular sequence of such executable
instructions or associated data structures represents examples of
corresponding acts for implementing the functions described in such
steps.
[0087] One skilled in the art will appreciate that the invention
may be practiced in network computing environments with many types
of computer system configurations, including personal computers,
hand-held devices, mobile phones, multi-processor systems,
microprocessor-based or programmable consumer electronics, network
PCs, minicomputers, mainframe computers, and the like. The
invention may also be practiced in distributed computing
environments where tasks are performed by local and remote
processing devices that are linked (either by hardwired links,
wireless links, or by a combination of hardwired or wireless links)
through a communications network. In a distributed computing
environment, program modules may be located in both local and
remote memory storage devices.
[0088] With reference to FIG. 7, an example system for implementing
the invention includes a general purpose computing device in the
form of a conventional computer 720, including a processing unit
721, a system memory 722, and a system bus 723 that couples various
system components including the system memory 722 to the processing
unit 721. It should be noted however, that as mobile phones become
more sophisticated, mobile phones are beginning to incorporate many
of the components illustrated for conventional computer 720.
Accordingly, with relatively minor adjustments, mostly with respect
to input/output devices, the description of conventional computer
720 applies equally to mobile phones. The system bus 723 may be any
of several types of bus structures including a memory bus or memory
controller, a peripheral bus, and a local bus using any of a
variety of bus architectures. The system memory includes read only
memory (ROM) 724 and random access memory (RAM) 725. A basic
input/output system (BIOS) 726, containing the basic routines that
help transfer information between elements within the computer 720,
such as during start-up, may be stored in ROM 724.
[0089] The computer 720 may also include a magnetic hard disk drive
727 for reading from and writing to a magnetic hard disk 739, a
magnetic disk drive 728 for reading from or writing to a removable
magnetic disk 729, and an optical disc drive 730 for reading from
or writing to removable optical disc 731 such as a CD-ROM or other
optical media. The magnetic hard disk drive 727, magnetic disk
drive 728, and optical disc drive 730 are connected to the system
bus 723 by a hard disk drive interface 732, a magnetic disk
drive-interface 733, and an optical drive interface 734,
respectively. The drives and their associated computer-readable
media provide nonvolatile storage of computer-executable
instructions, data structures, program modules and other data for
the computer 720. Although the exemplary environment described
herein employs a magnetic hard disk 739, a removable magnetic disk
729 and a removable optical disc 731, other types of computer
readable media for storing data can be used, including magnetic
cassettes, flash memory cards, digital versatile discs, Bernoulli
cartridges, RAMs, ROMs, and the like.
[0090] Program code means comprising one or more program modules
may be stored on the hard disk 739, magnetic disk 729, optical disc
731, ROM 724 or RAM 725, including an operating system 735, one or
more application programs 736, other program modules 737, and
program data 738. A user may enter commands and information into
the computer 720 through keyboard 740, pointing device 742, or
other input devices (not shown), such as a microphone, joy stick,
game pad, satellite dish, scanner, or the like. These and other
input devices are often connected to the processing unit 721
through a serial port interface 746 coupled to system bus 723.
Alternatively, the input devices may be connected by other
interfaces, such as a parallel port, a game port or a universal
serial bus (USB). A monitor 747 or another display device is also
connected to system bus 723 via an interface, such as video adapter
748. In addition to the monitor, personal computers typically
include other peripheral output devices (not shown), such as
speakers and printers.
[0091] The computer 720 may operate in a networked environment
using logical connections to one or more remote computers, such as
remote computers 749a and 749b. Remote computers 749a and 749b may
each be another personal computer, a server, a router, a network
PC, a peer device or other common network node, and typically
include many or all of the elements described above relative to the
computer 720, although only memory storage devices 750a and 750b
and their associated application programs 736a and 736b have been
illustrated in FIG. 7. The logical connections depicted in FIG. 7
include a local area network (LAN) 751 and a wide area network
(WAN) 752 that are presented here by way of example and not
limitation. Such networking environments are commonplace in
office-wide or enterprise-wide computer networks, intranets and the
Internet.
[0092] When used in a LAN networking environment, the computer 720
can be connected to the local network 751 through a network
interface or adapter 753. When used in a WAN networking
environment, the computer 720 may include a modem 754, a wireless
link, or other means for establishing communications over the wide
area network 752, such as the Internet. The modem 754, which may be
internal or external, is connected to the system bus 723 via the
serial port interface 746. In a networked environment, program
modules depicted relative to the computer 720, or portions thereof,
may be stored in the remote memory storage device. It will be
appreciated that the network connections shown are exemplary and
other means of establishing communications over wide area network
752 may be used.
[0093] The present invention may be embodied in other specific
forms without departing from its spirit or essential
characteristics. The described embodiments are to be considered in
all respects only as illustrative and not restrictive. The scope of
the invention is, therefore, indicated by the appended claims
rather than by the foregoing description. All changes which come
within the meaning and range of equivalency of the claims are to be
embraced within their scope.
* * * * *