Researchers at Harvard Medical School recently published results of an intensive study comparing the performance of first-year interns working the traditional 85-hour week, including two extended 30+ consecutive hour shifts, as opposed to the intervention schedule, which required 20 hours less per week of work, six hours a week more sleep, and continuous shifts of only 16 hours. The conclusion is that the traditional scheduling practice for interns is not good for patients.
According to Charles Czeisler, Baldino Professor of Sleep Medicine, “Interns made 36 percent more serious medical errors during a traditional work schedule than during an intervention schedule that eliminated extended work shifts. These included 21 percent more serious medication errors and 5.6 times as many serious diagnostic errors.”
The study, which was conducted at Brigham and Women’s Hospital, resulted in two articles for the October 28 issue of the New England Journal of Medicine. Christopher Landrigan, lead author of one of the journal reports, admitted that, “If the most serious of the errors had not been intercepted by the hospital staff, some patients would have been seriously injured.”
The Accreditation Council for Graduate Medical Education reduced the duty hours for interns and residents to 80 per week, with unbroken stretches up to 30 hours. Drs. Czeisler, Landrigan and Lockley, authors of the study, indicate that their results have “important implications for health policy, since more than 100,000 physicians are currently in training in the United States.” They further note that, “our findings may apply not only to residents working in critical care units but also to more senior residents, physicians, nurses and others, including surgeons.”
In another study reported in the Boston Globe, hospital staff are so fatigued that not only are their patients at risk, but the medical professionals themselves are at risk for burnout, depression, and a reduced ability to empathizes with patients and one another.