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National Cluster-Randomized Trial of Duty-Hour Flexibility in Surgical Training

by Bilimoria, Karl Y , Hedges, Larry V , Mellinger, John D , Ko, Clifford Y , Hoyt, David B , Odell, David D , Dahlke, Allison R , Cohen, Mark E , Love, Remi , Mahvi, David M , Lewis, Frank R , Chung, Jeanette W , Kelz, Rachel R , Stulberg, Jonah J , Tarpley, John L , Yang, Anthony D

in Accreditation / Clinical outcomes / Continuity of Patient Care / Data processing / Education, Medical, Graduate - standards / Evidence-based medicine / Fatigue / General Surgery - education / Health education / Hospital Administration / Hospitals / Humans / Internship and Residency - organization & administration / Job Satisfaction / Medical residencies / Patient Safety / Personnel Staffing and Scheduling / Physicians / Postoperative Complications - epidemiology / Postoperative Complications - mortality / Surgery / Surgical Procedures, Operative - mortality / United States / Well being / Work Schedule Tolerance / Working hours / Workload - standards

2016

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National Cluster-Randomized Trial of Duty-Hour Flexibility in Surgical Training

2016

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National Cluster-Randomized Trial of Duty-Hour Flexibility in Surgical Training

2016

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Journal Article

National Cluster-Randomized Trial of Duty-Hour Flexibility in Surgical Training

Bilimoria, Karl Y,

Hedges, Larry V,

Mellinger, John D,

Ko, Clifford Y,

Hoyt, David B,

Odell, David D,

Dahlke, Allison R,

Cohen, Mark E,

Love, Remi,

Mahvi, David M,

Lewis, Frank R,

Chung, Jeanette W,

Kelz, Rachel R,

Stulberg, Jonah J,

Tarpley, John L,

Yang, Anthony D

2016

Overview

In this randomized trial comparing ACGME duty-hour policies with more flexible policies for surgical residents, the flexible policies resulted in noninferior patient outcomes and no significant difference in residents' satisfaction with overall well-being and education quality. In response to concerns about patient safety and resident well-being, the Accreditation Council for Graduate Medical Education (ACGME) introduced national regulations in 2003 that limited resident duty periods to 80 hours per week, capped overnight shift lengths, and mandated minimum time off between shifts. 1 , 2 Concerns persisted, 3 and in 2011, the ACGME implemented further restrictions to shorten maximum shift lengths for interns and increase time off after overnight on-call duty for residents. 1 , 4 , 5 Although most observers agree that some duty-hour regulation was necessary, critics cite a weak evidence base for the 2003 and 2011 reforms. 3 , 6 , 7 Several retrospective . . .

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Publisher

Massachusetts Medical Society

Subject

Accreditation

/ Clinical outcomes

/ Continuity of Patient Care

/ Data processing

/ Education, Medical, Graduate - standards

/ Evidence-based medicine

/ Fatigue