ExtremitiesReconSpine

Resident Duty Hour Limits Haven’t Improved Patient Safety

Megan Brooks

Restrictions on resident duty hours do not appear to have had any significant effect on mortality or readmission rates for hospitalized patients or outcomes for general surgery patients, findings of two new studies show.

Concerns about drowsy and fatigued residents led the Accreditation Council for Graduate Medical Education to restrict duty hours in 2003, with further restrictions set in 2011.

The 2011 revisions maintain the weekly limit of 80 hours set forth by the 2003 reforms but reduced the work hour limit from 30 consecutive hours to 16 hours for first-year residents and 24 hours for upper-year residents (with another 4 hours to perform transitions of care and participate in educational activities).

There has been concern that the reforms may adversely affect patient care, in part by creating more patient hand-offs and less continuity of care, as well as education, with fewer hours for training.

The lack of significant effect on either outcomes or educational performance by these residents seen in the new studies should assuage fears that the duty hour limits would in fact be detrimental to patient outcomes but shows no benefit either in improving outcomes.

The studies are published December 9 in JAMA, a theme issue on medical education.

General Surgery Outcomes

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Josh Sandberg

Josh Sandberg is the President and CEO of Ortho Spine Partners and sits on several company and industry related Boards. He also is the Creator and Editor of OrthoSpineNews.

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