Standards Limiting New Residents’ Hours Could Mean Safer Hospital Visits in July

As you may have heard before, July is the worst time of the year to go to the hospital due largely to the influx of brand new residents, fresh from medical school who are more apt to make medical mistakes. But this summer – thanks to new standards enacted by the Accreditation Council for Graduate Medical Education – it might not be quite as bad. New standards limiting shift lengths of first-year residents take effect this July, with the hope that restricting new residents’ hours will cut down on hospital mistakes and improve patient safety. Starting July 1, 2011, first-year residents are limited to working only 16-hour shifts. Experienced residents can work up to 24 hours per shift (with additional hours for transferring patient care to the next shift).

The newly adopted standards also include additional training programs designed to educate new doctors to recognize the signs of sleep deprivation as well as help improve scheduling in order to cut down on how often patients are transferred from one resident to another between shifts.

How Residents Feel About the New Standards

A recent survey published in The New England Journal of Medicine, asked residents what they thought about the new standards. The Journal surveyed residents on a number of areas, including impact to their education and patient safety. The article revealed mixed results, that:

• Quality of life: 51 percent of residents believe the changes will improve their well-being; 28 percent said the changes wouldn’t impact quality of life.
• Education: 48 percent did not believe that the changes would positively affect their overall education, but 26 percent thought there would be a positive impact. In fact, 63 percent said the changes would make it more difficult for them to be prepared for senior roles later in their career.
• Patient care: 41 percent did not believe that limiting their hours will improve patient care, but 33 percent thought it would improve overall patient care.
• Patient safety: 34 percent thought that limiting hours would improve patient safety, while 39 disagreed that it would have an impact.

While limiting hours worked may help cut down on medical mistakes and misdiagnosis made due to sleep deprivation, many residents are concerned about continuity of patient care. They want to be able “to know not only about the information in the medical chart, but about the patient as a person,” said Dr. Lucy Spalluto, one of the co-authors of the article.

Many medical schools and institutions are currently working to revamp their programs, to figure out how to best implement the changes and continue to educate residents without prolonging their programs.

Source: New duty-hour standards get mixed reception from residents