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The association between resident physician work hour regulations and physician safety and health
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7 2020
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Source: Am J Med. 133(7):e343-e354
[PDF-905.18 KB]
Details:
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Alternative Title:Am J Med
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Description:Background
In 2011, the Accreditation Council for Graduate Medical Education (ACGME) instituted a 16-h limit on consecutive hours for first-year resident physicians. We sought to examine the effect of these work-hour regulations on physician safety.
Methods
All medical students matched to a United States residency program from 2002–2007 and 2014–2017 were invited to participate in prospective cohort studies. Each month participants reported hours of work, extended duration shifts, and adverse safety outcomes; including motor vehicle crashes , percutaneous injuries, and attentional failures. The incidence of each outcome was compared before and after the 2011 ACGME work-hour limit. Hypotheses were tested using generalized linear models adjusted for potential confounders.
Results
13% of all first-year resident physicians nationwide participated in the study, with 80,266 monthly reports completed by 15,276 first-year resident physicians. Following implementation of the 16-h 2011 ACGME work-hour limit, the mean number of extended duration (≥24-h) shifts per month decreased from 3.9 to 0.2. The risk of motor vehicle crash decreased 24% (RR 0.76; 0.67–0.85), percutaneous injury risk decreased more than 40% (RR 0.54; 0.48–0.61), and the rate of attentional failures was reduced 18% (IRR 0.82; 0.78–0.86). Extended duration shifts and prolonged weekly work hours were associated with an increased risk of adverse safety outcomes independent of cohort.
Conclusions
The 2011 ACGME work-hour limit was associated with meaningful improvements in physician safety and health. Surveillance is needed to monitor the ongoing impact of work hours on physician safety, health, and well-being.
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Pubmed ID:32061733
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Pubmed Central ID:PMC7469904
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Volume:133
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Issue:7
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