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Shift Hours Easing For Medical Residents

June 24, 2011

First-year residents have always expected to work grueling hospital shifts that last more than 24 hours, but new rules are coming that may alleviate some of the medical errors that extended shift hours create, Reuters is reporting.

Beginning July 1, new rules will require first-year residents to be on duty no longer than 16 hours at a stretch. That will not, however, spare more experienced residents from working as long as 28 hours on any given shift.

A report was published Friday in the journal Nature & Science of Sleep journal by a group of 26 doctors and patient safety experts calling for limiting all resident physician work to shifts of 12 to 16 hours.

“What started as a good system has evolved into a system where the residents are extremely sleep deprived, caring for some of the sickest patients in the country, and that’s a set-up for disaster,” Dr. Christopher Landrigan, one of the report’s authors, said in an interview with Reuters.

“Few people enter a hospital expecting that their care and safety are in the hands of someone who has been working a double-shift or more with no sleep,” said Dr. Lucian Leape, adjunct professor of health policy at the Harvard School of Public Health and a co-author of the report.

“If they knew, and had a choice, the overwhelming majority would demand another doctor or leave,” he said in a statement.

The study cited US government statistics that show as many as 180,000 patients each year die due to harm resulting from their medical care.

The Institute of Medicine recommends the updated work rules which estimate implementation would cost $1.7 billion. This cost increase would be mostly in hiring additional hospital staff. The costs would be offset by reducing medical errors, Landrigan explains.

“If they knew, and had a choice, the overwhelming majority would demand another doctor or leave,” he said in a statement.

The Accreditation Council for Graduate Medical Education (ACGME), the body that oversees residency training, issued the new rules for first-years in September 2010. It has said it was committed to examining resident hours “with a goal of making them better.”

Landrigan said he does not expect the report to change the rules for other residents anytime soon, because of tradition and costs.

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