Setting and Problem
In studies conducted on physician burnout, physicians reported that time spent on administrative tasks led to increased frustration and “lower levels of career satisfaction.”1 The Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements state that residency programs must minimize “excessive reliance on residents to fulfill non-physician obligations.”2 However, programs must ensure appropriate completion of requirements associated with accreditation. Coordinators investigated the use of administrative time on residents’ schedules to increase compliance and job satisfaction of trainees.
Intervention
After Children’s Mercy in Kansas City implemented rolling basic life support requirements, the residency leadership team implemented proctored administrative time to increase the compliance rate of resident administrative task completion, reduce the administrative burden on resident physicians, and improve the well-being of resident physicians through organizing and supporting completion of tasks during working hours.
To facilitate administrative time:
Leadership generated a list of more than 50 annual tasks.
Residents are scheduled for a quarterly 2-hour session to complete individualized tasks with a coordinator present to coach task completion. Coordinators schedule protected time on ambulatory (Y) weeks at a computer lab with 15 to 17 residents per cohort.
Individualized checklists of tasks are created prior to each session by the coordinator.
Outcomes to Date
During the first quarter of administrative time (January to March 2021), 80 residents (100%) completed a pre-survey on typical hours needed to complete required tasks outside of working hours, their understanding of why these tasks are required, whether they had processes in place to complete requirements, and if this work creates frustration. A post-survey was completed by 66 of 80 residents in our program (June to September 2022) after each resident had completed 3 sessions. Post-survey questions assessed whether residents found administrative days to be beneficial.
Implementation correlates with increased compliance with program and regulatory requirements including education modules and ACGME survey completion rates (Table). There was strong agreement that administrative days were beneficial. Eighty-five percent of residents (56 of 66) strongly agreed/agreed that admin time reduced administrative burden and/or burnout during clinical and personal time. When asked if residents had adequate time to complete administrative work during their working day on the pre-survey, 24% (19 of 80) strongly disagreed, 9% (7 of 80) agreed, and 0 strongly agreed. After implementation, 3% (2 of 66) strongly disagreed, 42% (28 of 66) agreed, and 23% (15 of 66) strongly agreed (Figure). There was also a 33% increase in positive responses for the number of residents that said they have a successful process in place to complete tasks. We saw a 12% reduction in the number of residents spending 2 to 3 hours of time on administrative tasks throughout a resident’s week and a 16% positive increase in residents spending 0 to 1 hour. ACGME survey results also had an increase in compliance from 2021 (94%) to 2025 (97%) for “Education compromised by non-physician obligations.”
Table.
Program Improvements Pre- and Post-Implementation of Admin Days
| Pre-Admin Days | Post-Implementation |
|---|---|
| Email Reminders to Program Annually Were Reduced | |
| 63 emails | 32 emails |
| Increased ACGME Survey Response Rate | |
| 81% | 86% |
| Annual Education Module Compliance (10 days prior to deadline) | |
| 77% completion | 100% completion |
Figure.
Pre- and Post-Survey Responses to “I Have Adequate Time During Working Hours to Complete Administrative Work”
On open-ended questions, residents noted “administrative time is incredibly beneficial. It is a truly dedicated time to ensuring we complete these tasks. I look forward to getting things done during this time” and “admin time has been so helpful in completing required tasks and takes a lot of stress/strain out of the picture.”
By implementing structured time for administrative tasks, we discovered administrative half days are a feasible and accepted intervention strategy to reduce the administrative burden on residents. Although most residents agreed that administrative time reduced administrative burden and burnout during clinical and home hours, similar percentages of residents found administrative tasks still add frustration to their day and only sometimes completed tasks by deadlines. Greater attention is needed in celebrating the amount of work completed by the residents by deadlines. Finally, further research is needed to explore coordinator job satisfaction burnout with the reduction of reminders for tasks and increased autonomy by turning task-related work into educational coaching.
References
- 1.Rao SK, Kimball AB, Lehrhoff SR, et al. The impact of administrative burden on academic physicians: results of a hospital-wide physician survey. Acad Med. 2017;92(2):237–243. doi: 10.1097/ACM.0000000000001461. doi: [DOI] [PubMed] [Google Scholar]
- 2.Accreditation Council for Graduate Medical Education. ACGME Common Program Requirements (Residency) Accessed March 4, 2026. https://www.acgme.org/globalassets/pfassets/programrequirements/cprresidency_2022v3.pdf.