Family medicine residents say the 80-hour limit on duty hours improves patient care, reduces medical errors and allows better concentration during educational sessions.
Those were some results of a survey presented by Dennis Jensen, M.D., during "The Impact of Resident Duty Hours," a session at the June 5 - 7 Workshop for Directors of Family Medicine Residencies here. Jensen is a third-year resident at the AnMed Health Family Medicine Residency Program, Anderson, S.C.
Residents Say Duty-Hour Limits Improve Care
By Leslie Champlin
• Kansas City, Mo.
7/16/2005
Jensen surveyed 85 family medicine chief residents during the 2004 - 2005 academic year. Most residency programs involved in the survey had between five and eight first-year residents.
More than three-fourths of the residents said the 80-hour duty limit improved patient care, and 55 percent said they thought the limit resulted in fewer medical errors, Jensen reported. Moreover, 82 percent said the rules improved their ability to concentrate during rounds, conferences and seminars, and 46 percent said they used their extra time to pursue additional educational opportunities.
"This was a survey about how residents felt about the change in duty hours," said Jensen, adding the survey did not attempt to measure whether duty-hour limits actually affected patient safety or resident education.
From July 2003 to May 2004, the Accreditation Council for Graduate Medical Education found that 16.9 percent of family medicine residency programs had received duty-hour violation complaints. Family medicine programs were among those specialties receiving a small number of complaints.
Ninety-four percent of the residents said their training programs enforced the duty-hour rules set out in July 2003. Among those rules: Residents cannot work more than 80 hours a week, averaged over four weeks; they cannot work more than a total of 30 hours per shift; they must have a 10-hour rest period between shifts; and they must have one day in seven free from patient care and educational obligations.
Jensen's survey found that although residency programs enforce the rules, some infractions did occur. In 92 percent of those cases, the residents -- either on their own or in consultation with others -- decided to exceed the limits. The survey found that at some point in the previous four-week reporting period:
More than three-fourths of the residents said the 80-hour duty limit improved patient care, and 55 percent said they thought the limit resulted in fewer medical errors, Jensen reported. Moreover, 82 percent said the rules improved their ability to concentrate during rounds, conferences and seminars, and 46 percent said they used their extra time to pursue additional educational opportunities.
"This was a survey about how residents felt about the change in duty hours," said Jensen, adding the survey did not attempt to measure whether duty-hour limits actually affected patient safety or resident education.
From July 2003 to May 2004, the Accreditation Council for Graduate Medical Education found that 16.9 percent of family medicine residency programs had received duty-hour violation complaints. Family medicine programs were among those specialties receiving a small number of complaints.
Ninety-four percent of the residents said their training programs enforced the duty-hour rules set out in July 2003. Among those rules: Residents cannot work more than 80 hours a week, averaged over four weeks; they cannot work more than a total of 30 hours per shift; they must have a 10-hour rest period between shifts; and they must have one day in seven free from patient care and educational obligations.
Jensen's survey found that although residency programs enforce the rules, some infractions did occur. In 92 percent of those cases, the residents -- either on their own or in consultation with others -- decided to exceed the limits. The survey found that at some point in the previous four-week reporting period:
- 13 percent of residents reported exceeding the 80-hour limit;
- 25 percent reported a rest period shorter than 10 hours; and
- 26 percent reported working beyond the 30-hours-per-shift limit.
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