Wednesday, August 4, 2010

Study: Shorter Medical Resident Shifts Improve Quality of Care

A comprehensive literature review demonstrates why working medical residents past the point of exhaustion is a policy that’s quickly falling out of favor. Residents make fewer mistakes and lead a better quality of life when their shift lasts less than 16 hours, the study reports.

Regular hospital shifts lasting 24 hours or longer are traditionally a rite of passage for future medical practitioners. In recent years a countermovement calling for limits on resident work hours has gained momentum. Last year the Institution of Medicine recommended a maximum of 16 consecutive hours without sleep. The move has been greeted with controversy in the medical community because of high costs and uncertain benefits.

The authors of the study published in the August issue of the journal SLEEP set out to demonstrate the benefits of imposing a cap on resident work hours. Using an online literature search, the authors identified 23 peer-reviewed studies involving the outcomes of reducing shift lengths for medical residents in the United States.

Every study found that reducing or eliminating extended shifts improved residents’ quality of life. Quality of patient care improved in most of the studies after shift lengths were slashed. It’s unclear whether there were benefits to resident education; the findings were generally unchanged after a reduction in shift length.

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