Patient safety has long been a critical concern for hospitals, in particular for those training new doctors. Since 1984, when the death of 24-year-old Libby Zion at a New York hospital was attributed to an overtired medical resident, training programs have faced restrictions on the length of work shifts for the least-experienced medical doctors. Last year, the ACGME, which oversees residency programs, issued the most restrictive guidelines to date: Residents should serve no longer than 16-hour shifts in the hospital.
"Our results showed that the duty-hour limitations may not be a quick fix to an important problem," says Mayo Clinic internist and co-author Darcy Reed, M.D., M.P.H. (http://www.mayoclinic.org/bio/12376205.html).
The survey sent to directors of residency programs around the country found that many are concerned that the duty-hour limitations to be implemented by July 2011 will impinge on physician education. Of the nearly 500 respondents from the fields of surgery, internal medicine and pediatrics, 87 percent of program directors felt that the shortened shifts will interrupt the interactions between residents and hospitalized patients. "Many survey respondents expressed concern that the limits will decrease the continuity of care. As residents face more handoff of responsibilities within a 24-hour period, they have less opportunity to see and learn how patients' care progresses," Dr. Reed says.
Significantly, up to 78 percent of directors felt the restricted shifts are likely to result in graduates who fall short in the key competency areas defined by the ACGME. Those core areas include patient care, medical knowledge, interpersonal and communications skills, and professionalism. Among the various fields surveyed, directors of surgery programs expressed the greatest concern. "Further research is necessary to understand the particular concerns of directors of surgery programs," Dr. Reed says, "but it's possible some directors may feel residents will not get sufficient time in the OR."
Moreover, residency directors were skeptical about whether the new limits will reduce physician fatigue, the problem they are designed to address. Among respondents, 65 percent felt that the limits will have no effect on fatigue, and 6 percent felt the restrictions may even increase fatigue. "Other studies have found that reducing work hours doesn't necessarily lead to people going home to sleep," Dr. Reed says.
The results of the study suggest that resident schedules require further evaluation and perhaps other tweaks to ensure both patient safety and high standards of physician education. "This will probably not be the final iteration of recommendations that are set in place," says Dr. Reed. "Obviously patient outcomes are of the utmost importance, but training the future workforce of excellent physicians also is in patients' interests. I believe we'll continue to see these policies evolve."
A peer-reviewed journal, Mayo Clinic Proceedings publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research and clinical epidemiology. Mayo Clinic Proceedings is published monthly by Mayo Foundation for Medical Education and Research as part of its commitment to the medical education of physicians. The journal has been published for more than 80 years and has a circulation of 130,000 nationally and internationally. Articles are available online at www.mayoclinicproceedings.com.
About Mayo Clinic
Mayo Clinic is a nonprofit worldwide leader in medical care, research and education for people from all walks of life. For more information, visit www.mayoclinic.org/about/ and www.mayoclinic.org/news.Contact:
Rebecca Eisenman | EurekAlert!
Drone vs. truck deliveries: Which create less carbon pollution?
31.05.2017 | University of Washington
New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)
An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.
Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...
Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.
Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...
Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.
As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...
Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.
With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...
Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine
Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...
19.06.2017 | Event News
13.06.2017 | Event News
13.06.2017 | Event News
26.06.2017 | Life Sciences
26.06.2017 | Physics and Astronomy
26.06.2017 | Information Technology