A major downside to capping resident work-hours is increasing the number of patient handoffs between doctors.
Further decreasing allowable work-hours to 56 hours per week will only exacerbate the problem.
A survey of MGH residents suggested that this practice led to significant patient harm, almost as serious as medication-related events:
More than half of the 161 medical or surgical residents who responded to the anonymous survey said they recalled at least one occasion in their last month-long rotation when a patient suffered from flawed handoffs. About one in nine said the harm that resulted was significant.
Related posts:
- Patient hand-offs are a source of serious patient harm
- How to reduce the risk of medical errors from patient hand-offs
- A 48-hour physician workweek will kill patients
- Old-school doctors on resident work-hour restrictions
- Resident work hour restrictions: Good for nothing?
- Would you want a tired doctor who knows you, or a rested one that doesn’t?
- How work-hour restrictions harms resident surgeon training
KevinMD.com on Facebook
{ 6 comments }
This is the time in the ER where most errors occur. Signout. Unfortunately, working 24 hours a day until the patient is discharged or dies is not a good option.
Or they can start standardizing their handoff process and making it better suited to changing shifts.
I know they are overworked and it’s difficult to add yet another improvement process in the mix, but in the long run, you guys need to understand that residents need a life too and better rested residents with better handoff processes will eventually lead to fewer mistakes than before the 80 hours/week threshold.
Would not better, more specific, easily-scanned, electronic patient records help?
Anecdotes are not data. Why do doctors refuse to believe this?
Evidence suggests hour limits better for patients.
http://www.medicalnewstoday.com/articles/121683.php
A single-institution study is an anecdote? Ironic that anon cites another single-institution study as counterpoint. The following 2 studies are the real deal. Nothing beats national data when you’re trying to evaluate the effect of a national intervention.
http://jama.ama-assn.org/cgi/content/abstract/298/9/975?ct
http://jama.ama-assn.org/cgi/content/short/298/9/984
Excuse me, the gall bladder study was in fact a study with real data, not a survey, which is the detritus of all empirical research.
Comments on this entry are closed.