Shift Length Policy May Have Prevented Some Medical Errors

By Jonathan Springston, Editor, Relias Media

A rule that limited the consecutive hours first-year medical residents could work might have led to fewer medical errors and patient deaths, according to the results of a recent survey.

The Accreditation Council for Graduate Medical Education enacted a rule in 2011 that forbid first-year medical residents from working more than 16 consecutive hours. The policy was revoked in 2017. Researchers wanted to learn more about how this policy might have affected patient safety.

Investigators conducted a national survey to gather information about a period before the rule was enacted (2002-2007) and a period after the rule was enacted (2014-2017). The authors learned that after the policy was implemented, there was a 32% reduction in reports of significant medical errors, a 34% decline in reported preventable adverse events, and a 63% reduction in reported medical errors that caused patient deaths.

Although the study is limited by its observational nature and the fact the authors relied on self-reported data, this paper builds on previous research indicating young medical professionals tend to make more mistakes when asked to work too many consecutive hours.

“We know that people are prone to make more mistakes when they are sleep deprived, and doctors are no exception,” said lead author Matthew Weaver, associate epidemiologist at Brigham and Women’s Hospital in Boston. “What’s important is that we can see that interventions such as work hour limits can have a meaningful effect. In our study, we saw a dramatic reduction in medical errors resulting in harm or leading to patient death when work hours were limited. It’s important that the risk of extended work shifts, and the potential benefit of limits be transparent to patients and to providers,” Weaver said.

For more on this and related subjects, be sure to read the latest issues of Healthcare Risk Management and Hospital Employee Health.