Effect of 16-Hour Duty Periods on Patient Care and Resident Education

March 2011
Mayo Clinic Proceedings;Mar2011, Vol. 86 Issue 3, p192
Academic Journal
OBJECTIVE: To measure the effect of duty periods no longer than 16 hours on patient care and resident education. PATIENTS AND METHODS: As part of our Educational innovations Project, we piloted a novel resident schedule for an Inpatient service that eliminated shifts longer than 16 hours without increased staffing or decreased patient admissions on 2 gastroenterology services from August 29 to November 27, 2009. Patient care variables were obtained through medical record review. Resident well-being and educational variables were collected by weekiy surveys, end of rotation evaluations, and an electronic card-swlpe system. RESULTS: Patient care metrics, Including 30-day mortality, 30-day readmisslon rate, and length of stay, were unchanged for the 196 patient care episodes in the 5-week intervention month compared with the 274 episodes in the 8 weeks of control months. However, residents felt less prepared to manage cross-cover of patients (P=.006). There was a nonsignificant trend toward decreased perception of quality of education and balance of personal and pro- fessional life during the intervention month. Residents reported working fewer weekly hours overall during the intervention (64.3 vs 68.9 hours; P=.40), but they had significantly more episodes with fewer than 10 hours off between shifts (24 vs 2 episodes; P=.004). CONCLUSION: Inpatient hospital services can be staffed with residents working shifts less than 16 hours without additional residents. However, cross-cover of care, quaiity of education, and time off between shifts may be adversely, affected. Mayo Clin Proc. 2011;86(3):192-196.


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