Restricting resident work hours does not improve surgical patient safety: 5 things to know

In July 2011, work hour restrictions for resident physicians were revised in order to protect patients against trainee fatigue-related errors, apparently to little effect, according to new research published online in the Journal of the American College of Surgeons.

Here are five things to know about the research.

• Changing the work hour restrictions have not had the desired effect of lowering postoperative complication rates in several surgical specialties.
• There was no significant difference in measured surgical patient outcomes between one year before and two years after the 2011 work hour reform went into effect.

• The researchers examined five surgical specialties, and after controlling for external factors that could influence surgical outcomes, found no significant association between the work reform and the number of 30-day patient deaths and serious postoperative complications in the two years that followed, or either year separately.
• Prior studies concluded that the 2011 work hour restriction did not affect patient outcomes for general surgical patients either.
• "Our finding suggests the ACGME reform is not meeting its goal of improved patient safety in surgery," Ravi Rajaram, MD, lead investigator for the research, said in a statement. He concludes that additional work is needed to determine how to best structure resident hours to improve patient outcomes.

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