Statement on Peak Performance and Management of Fatigue

The following statement was developed by the American College of Surgeons (ACS) Committee to Enhance Peak Performance in Surgery through Recognition and Mitigation of Fatigue through general consensus. The ACS Board of Regents approved the statement at its June 2014 meeting in Chicago, IL.

The ACS has had a long-standing commitment to defining and promoting excellence in patient care and surgical practice. With greater knowledge and understanding of the impact of fatigue on performance, it is crucial that potential detrimental effects of fatigue be considered and appropriate strategies developed to mitigate them, keeping in mind the distinctive nature of surgical practice and the importance of the continuum of care.

The fundamental characteristics of surgery differentiate it from other disciplines. Surgical proficiency necessitates intellectual, emotional, and physical preparation for all phases of patient care. Surgical practice requires decisive surgical judgment; operative intervention involving mental, physical, and tactile skills; and comprehensive, thoughtful postoperative care. Each part of this process involves sustained attentiveness, vigilance, and commitment to the patient’s care and well-being. Teamwork is an integral component of surgical practice, and the surgeon, as the leader of the team, has the opportunity and privilege to directly affect the patient’s disease process, along with ultimate responsibility for each patient. In 2012, the ACS appointed the Committee to Enhance Peak Performance in Surgery through Recognition and Mitigation of Fatigue, composed of surgeon leaders from various surgical specialties, internationally renowned sleep experts, as well as other national stakeholders, to address this important and complex national issue through far-reaching recommendations and innovative educational resources.