study some work hour restrictions on surgical residents may be too strict

Back in 2003, the Accreditation Council for Graduate Medical Education made the controversial decision to amend the work hours for doctors-in-training. Specifically, the organization set the maximum number of hours that interns and residents could work in a given week to 80 hours.

The ACGME revisited this issue again eight years later, making further refinements to the existing rules, which stated that interns and residents could not work longer than 30 consecutive hours. Here, it mandated that interns could not work more than 16 consecutive hours, while residents could not work more than 24 consecutive hours (with an additional four hours allocated for educational activities and transfer care).

These changes were enacted by the ACGME to address what they saw as two major concerns:

  • Overly fatigued interns and residents are perhaps more prone to making medical mistakes.
  • Overly fatigued interns and residents are perhaps more prone to compromise patient safety and outcomes during care transitions.

Interestingly enough, two separate studies published in the recent edition of the Journal of the American Medical Association have found that these changes to the work rules haven’t necessarily produced the desired effect.

The first study, conducted by researchers at the University of Pennsylvania’s Perelman School of Medicine, analyzed Medicare data covering over six million admissions at more than 3,000 U.S. hospitals for various conditions from heart attacks to strokes.

They determined that the 2011 reforms had no noticeable impact on fatality rates, readmissions or improved safety among Medicare patients, and may have actually made things worse by interrupting care continuity.

The second study, conducted by researchers at Northwestern University Feinberg School of Medicine, analyzed the outcomes of more than 200,000 patients who had undergone general surgery at 23 teaching and 31 non-teaching hospitals in the two years before and after the 2011 reforms.

Similarly, they determined that there was no noticeable impact on the rates of fatalities and serious complications among the general surgery patients in the two years after the reforms were introduced.

It is worth noting that some of the authors of these reports have suggested that the 2011 work hour training reforms should be repealed altogether by the ACGME, and that more emphasis should be made by individual hospitals to launch quality improvement programs.

What are your thoughts on this issue?

If the negligence of an intern or resident resulted in serious harm to you or a loved one, you do have options. An experienced legal professional can investigate the matter, outline your rights and pursue justice on your behalf.

Source: HealthDay News, “Cutting docs-in-training hours hasn’t improved patient care: Studies,” Steven Reinberg, Dec. 9, 2014

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