Duty-hour limits and patient care and resident outcomes: can high-quality studies offer insight into complex relationships?
Publication/Presentation Date
1-1-2013
Abstract
Long hours are an accepted component of resident education, yet data suggest they contribute to fatigue that may compromise patient safety. A systematic review confirms that limiting duty hours increases residents' hours of sleep and improves objective measures of alertness. Most studies of operative experience for surgical residents found no effect, and there is evidence of a limited positive effect on residents' mood. We find a mixed effect on patient safety, although problems with supervision, rather than the limits, may be responsible or contibute; evidence of reduced continuity of care and reduced continuity in residents' clinical education; and evidence that increased workload under the limits has a negative effect on patient and resident outcomes. We highlight specific areas for research and offer recommendations for national policy.
Volume
64
First Page
467
Last Page
483
ISSN
1545-326X
Published In/Presented At
Philibert, I., Nasca, T., Brigham, T., & Shapiro, J. (2013). Duty-hour limits and patient care and resident outcomes: can high-quality studies offer insight into complex relationships?. Annual review of medicine, 64, 467–483. https://doi.org/10.1146/annurev-med-120711-135717
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
23121182
Department(s)
Administration and Leadership
Document Type
Article