Fatigue Risk Management Guidelines

Approved by PGME Committee - November 4, 2021

Fatigue Risk Management Guidelines [PDF-204KB]


Mission statement: Striving for patient, postgraduate trainees, and staff/educator safety through the framework of Fatigue Risk Management.

Fatigue Risk Management (FRM) is a set of ongoing fatigue prevention and mitigation practices, principles, and procedures integrated throughout all levels of the clinical and academic work environment.  These are designed to monitor, ameliorate, and manage the effects of fatigue and associated risks for the health and safety of healthcare personnel and the patient population they serve. FRM is a shared responsibility among all those in medical education including, institutions, educators, program directors and staff and postgraduate trainees.

The objective of this policy is to prevent, mitigate and manage the hazard of fatigue during residency training, and to promote health and wellbeing for physicians for the provision of quality patient care.

This policy applies to all postgraduate trainees and those involved in post graduate medical education at Dalhousie University, for the duration of all activities associated with the performance of their trainee and/or educational duties.

Key roles and responsibilities:

Faculty of Medicine
•  Allocate resources to support the implementation of this FRM policy and practices
•  Work with Program Directors to develop FRM approaches appropriate to the local contexts of the affiliated training sites
•   Ensure processes are developed to respond to reports of fatigue-related incidents, errors, and/or behaviours in an appropriate manner

Clinical Educators and Supervisors
•  Participate in FRM training and education
•  Ensure postgraduate trainees under their supervision comply with the local FRM policy
•  Advise program directors of barriers preventing the effective management of fatigue- related risks
•  Arrive at shift in a state fit to safely conduct duties
•  Responsibility to role model, encourage, and support appropriate fatigue risk management practices.
•   Respond to declarations of fatigue in a manner that upholds patient and postgraduate trainee’s health and safety.
•   Respond to reports of fatigue-related incidents, errors, and/or behaviours appropriately and as per program/institution policies
•   Utilize appropriate Fatigue Risk Mitigation Strategies when postgraduate trainees experience fatigue and take appropriate action if a postgraduate trainee is not fit for duty

Program Directors and Resident Program Committees:
•   Work with the Associate Dean of Postgraduate Medical Education and Office of Resident Affairs to develop a program specific approach.
•   Incorporate educational resources and information on fatigue prevention, mitigation, and recognition strategies in program learning environment and curriculum.
•   Advise Postgraduate Dean of barriers preventing the effective management of fatigue- related risks

Responsibility of the Postgraduate Trainee
•   Arrive at shift in a state fit to safely conduct duties
•   Use time outside of work to obtain adequate rest and to ensure fitness for work
•    Report to clinical supervisor or program director when they have not been able obtain sufficient sleep or believe they are at risk of making a fatigue-related error.
•    Individually report specific errors and fatigue-related behaviours or situations that may present a fatigue-related risk
•   Employ appropriate Fatigue Risk Mitigation Strategies
•   To participate in FRM training and education made available.

   Each program and clinical service is required to develop fatigue risk management strategies specific to their areas of work.
·   Residents and clinical supervisors are advised to familiarize themselves with the current MarDocs contract elements that support FRM activities.

(please see collective agreement: https://www.maritimeresidentdoctors.ca)

Related resources and other information: