Longer resident shifts don't threaten patient safety, study finds

A study published in the New England Journal of Medicine examined whether long shifts during medical residencies adversely affect patient safety.

Researchers conducted a trial involving 63 internal medicine residency programs during the 2015-16 academic year. The programs were randomized into two groups — one which adopted the Accreditation Council for Graduate Medical Education's standard duty hours, and another which allowed more flexible duty hours and did not specify limits on shift length or mandatory time-off between shifts.

They found the change in 30-day mortality rates between the pretrial and trial years was similar between the two groups. The 30-day mortality rate changed from 12.6 percent in the pretrial year to 12.5 percent in the trial year among patients in the flexible hours program, as compared to 12.7 percent in the pretrial year versus 12.2 percent in the trial year among patients in the standard hours program.

Additionally, the difference in changes in seven-day readmission rates, patient safety indicators and Medicare payments between the pretrial and trial years was below one percentage point for both groups.

"Allowing program directors flexibility in adjusting duty-hour schedules for trainees did not adversely affect 30-day mortality or several other measured outcomes of patient safety," study authors concluded.

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