How to Improve Patient Safety? Reduce Resident Work Hours

Agency for Health Research and Quality, “10 Patient Safety Tips for Hospitals.” May 2006, AHRQ Pub. No. 06-P020. (Download in PDF)

Encouraging “evidence-based information” and “support[ing] efforts to translate research into practice” are at the heart of the mission of the Agency for Health Research and Quality (AHRQ), a part of the US Department of Health and Human Services, to “improve the quality, safety, efficiency, and effectiveness of health care.” Considering the mounting body of scientific evidence displaying the performance effects of sleep deprivation and fatigue, it comes as no surprise that AHRQ has concluded that resident work hours need to be shortened.

In a May 2006 publication entitled “10 Patient Safety Tips for Hospitals,” AHRQ twice highlighted the dangers associated with the long work shifts that are currently permitted by the Accreditation Council for Graduate Medical Education (ACGME), the body which oversees residency programs in the US.

Tip number two recommends that hospitals “limit shifts of more than 24 hours for medical residents and make sure they do not drive home after working extended shifts. Medical residents who work longer than 24 hours are more than twice as likely to have a car crash leaving the hospital and 5 times as likely to have a near-miss incident on the road than medical interns who work shorter shifts.”

The next tip, number three on the list, follows in urging hospitals to “eliminate the tradition of shifts of more than 30 consecutive hours by interns working in hospital ICUs. The rate of serious medical errors at two Boston hospital intensive care unites (ICUs) committed by first-year interns dropped by 36 percent when 30-hour-in-a-row work shifts were eliminated.”


*****************************************

Visit AHRQ on the web at www.ahrq.gov