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Reduced duty-hour resident programs believed to adversely affect patient care
Reduced duty-hour resident programs believed to adversely affect patient care

July 23, 2007 (Insidermedicine) Medical faculty members believe that restrictions on the number of hours a hospital resident can work negatively affects aspects of patient care, as well as the residents’ education and professionalism, but improves residents’ well-being, according to a study published in the Archives of Internal Medicine.

Resident’s duty hours were restricted in 2003 to reduce the risk of adverse events that result from sleep deprivation and to enhance residents’ well-being. Before the restrictions took place, some experts were concerned that these reductions might have unanticipated negative effects on patient care, resident education, and professionalism. In addition, some feared that a reduction in residents’ duty hours would be accompanied by an increase in workload for the clinical faculty. Several studies show improvements in residents’ well-being and quality of life; however effects on patient care, and education and professionalism among residents remain unclear.

To assess the ramifications of the restrictions, researchers surveyed more than 150 key clinical faculty from nearly 40 internal medicine residency programs in the US.

They found that 87% of faculty believed resident duty-hour restrictions worsened patient continuity of care, and 60% reported worsening of overall patient care. In addition, 70% reported worsening of bedside teaching. However, 85% believed the restrictions lessened residents’ fatigue and improved well-being and personal-professional life balance, and half thought it decreased resident burnout. 

With regard to the effect of the restrictions on faculty members, more than half reported a decrease in satisfaction in teaching residents, and one-third reported a decrease in satisfaction with their own careers. This may be due to the increased demand for faculty members to deliver clinical care, which interferes with teaching responsibilities.

Experts believe that residency programs should continue to investigate ways to optimize experiences for residents and faculty within the confines of duty-hour restrictions.

Reporting for Insidermedicine, I’m Dr. Susan Sharma. 

 
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