Longer resident duty hours don’t affect patient safety

In response to concerns about patient safety and resident well-being, the Accreditation Council for Graduate Medical Education (ACGME) in 2003 implemented regulations that limited resident duty hours to 80 hours per week, capped overnight shift lengths, and mandated minimum time off between shifts.

In 2011, ACGME implemented further restrictions. However, there continues to be concern about the effect of current surgical resident duty-hour policies on patient outcomes and resident education and well-being.

In this multicenter study, researchers tested whether surgical-patient outcomes under flexible, less-restrictive duty-hour policies would be no worse than outcomes under standard ACGME policies. Resident satisfaction and perceptions of patient care, resident education, and resident well-being were also assessed.

The flexibility for surgical residents to work longer shifts than currently allowed or take less time off between shifts to provide continuity of care was not associated with a greater risk of postoperative patient complications or death.

There was also no significant difference in residents’ satisfaction with their overall well-being and quality of training when less restrictive work hour policies were implemented.

The study, which included 117 general surgery residency programs and 151 hospitals, is the first national randomized trial of resident duty-hour policies.

−Bilimoria K Y, Chung J W, Hedges L V, et al. National cluster-randomized trial of duty-hour flexibility in surgical training. N Engl J Med. Published online February 25, 2016.

http://www.nejm.org/doi/full/10.1056/NEJMoa1515724#t=articleTop