Benefits of Resident Work Hours Regulation

Abstract

In the Balance18 May 2004Benefits of Resident Work Hours RegulationKelley M. Skeff, MD, PhD, Stephen Ezeji-Okoye, MD, Peter Pompei, MD, and Stanley Rockson, MDKelley M. Skeff, MD, PhDFrom Stanford University, Stanford, California.Search for more papers by this author, Stephen Ezeji-Okoye, MDFrom Stanford University, Stanford, California.Search for more papers by this author, Peter Pompei, MDFrom Stanford University, Stanford, California.Search for more papers by this author, and Stanley Rockson, MDFrom Stanford University, Stanford, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-10-200405180-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The new regulations for resident work hours are part of a long evolutionary process of change in medical education, representing the most dramatic innovation in recent history to calibrate the work hours for residents. Implementing the requirements has not been easy. Most institutions and departments have experienced serious challenges (1-3). Moreover, many educators are concerned that by focusing on a maximum number of work hours and a “deadline” for leaving the hospital, the regulations threaten both the educational process and the meaning of professional responsibility.Despite these current challenges, we highlight several positive effects of the new regulations. This is ...References1. Whang EE, Perez A, Ito H, Mello MM, Ashley SW, Zinner MJ. Work hours reform: perceptions and desires of contemporary surgical residents. J Am Coll Surg. 2003;197:624-30. [PMID: 14522334] CrossrefMedlineGoogle Scholar2. Lawrence HC. The impact of residents' work-hour restrictions. Curr Womens Health Rep. 2003;3:487-91. [PMID: 14613670] MedlineGoogle Scholar3. Johnson T. Limitations on residents' working hours at New York teaching hospitals: a status report. Acad Med. 2003;78:3-8. [PMID: 12525401] CrossrefMedlineGoogle Scholar4. Laine C, Goldman L, Soukup JR, Hayes JG. The impact of a regulation restricting medical house staff working hours on the quality of patient care. JAMA. 1993;269:374-8. [PMID: 8418344] CrossrefMedlineGoogle Scholar5. Petersen LA, Brennan TA, O'Neil AC, Cook EF, Lee TH. Does housestaff discontinuity of care increase the risk for preventable adverse events? Ann Intern Med. 1994;121:866-72. [PMID: 7978700] LinkGoogle Scholar6. Petersen LA, Orav EJ, Teich JM, O'Neil AC, Brennan TA. Using a computerized sign-out program to improve continuity of inpatient care and prevent adverse events. Jt Comm J Qual Improv. 1998;24:77-87. [PMID: 9547682] MedlineGoogle Scholar7. Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136:358-67. [PMID: 11874308] LinkGoogle Scholar8. Clever LH. Who is sicker: patients—or residents? Residents' distress and the care of patients [Editorial]. Ann Intern Med. 2002;136:391-3. [PMID: 11874312] LinkGoogle Scholar9. Baldwin DC, Daugherty SR, Tsai R, Scotti MJ. A national survey of residents' self-reported work hours: thinking beyond specialty. Acad Med. 2003;78:1154-63. [PMID: 14604880] CrossrefMedlineGoogle Scholar10. Gurjala A, Lurie P, Haroona L, Rising JP, Bell B, Strohl KP, et al. Petition to the Occupational Safety and Health Administration requesting that limits be placed on hours worked by medical residents. HRG publication #1570. 30 April 2001. Accessed at www.citizen.org/publications/release.cfm?ID=6771 on 26 March 2004. Google Scholar11. Cruess RL, Cruess SR, Johnston SE. Renewing professionalism: an opportunity for medicine. Acad Med. 1999;74:878-84. [PMID: 10495726] CrossrefMedlineGoogle Scholar12. Souba WW. Academic medicine and the search for meaning and purpose. Acad Med. 2002;77:139-44. [PMID: 11841973] CrossrefMedlineGoogle Scholar13. Darosa DA, Bell RH, Dunnington GL. Residency program models, implications, and evaluation: results of a think tank consortium on resident work hours. Surgery. 2003;133:13-23. [PMID: 12563233] CrossrefMedlineGoogle Scholar14. Berwick DM. Improvement, trust, and the healthcare workforce. Qual Saf Health Care. 2003;12:448-52. [PMID: 14645761] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Stanford University, Stanford, California.Disclosures: None disclosed.Corresponding Author: Kelley M. Skeff, MD, PhD, Stanford University Medical Center, 300 Pasteur Drive, Room S101, Stanford, CA 94305.Current Author Addresses: Drs. Skeff and Pompei: Stanford University Medical Center, 300 Pasteur Drive, Room S101, Stanford, CA 94305.Dr. Ezeji-Okoye: Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, MS11C, Palo Alto, CA 94304.Dr. Rockson: Falk Cardiovascular Research Center, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305. 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Schroeder, MD 18 May 2004Volume 140, Issue 10Page: 816-817KeywordsFatigueForecastingHealth careHealth care qualityHospitalsMedical educationPatientsPrevention, policy, and public healthSocial welfareVeteran care ePublished: 18 May 2004 Issue Published: 18 May 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...