Restricting resident work hours: The good, the bad, and the ugly

Critical Care Medicine

Volumn 40, Issue 3, 2012, Pages 960-966

  Peets, Adam ^a,b   Ayas, Najib T ^a,b  

^a UNIVERSITY OF BRITISH COLUMBIA   (Canada)

^b UNIVERSITY OF BRITISH COLUMBIA   (Canada)

Author keywords

education; graduate fatigue; medical error; resident work hours; sleep deprivation

Indexed keywords

CLINICAL PRACTICE; ECONOMIC ASPECT; FATIGUE; HUMAN; INTENSIVE CARE UNIT; MEDICAL ERROR; OCCUPATIONAL HEALTH; OCCUPATIONAL SAFETY; PRIORITY JOURNAL; PROFESSIONALISM; QUALITY OF LIFE; RESIDENT; REVIEW; RISK ASSESSMENT; SLEEP DEPRIVATION; WORKING TIME; WORKLOAD;

HUMANS; INTERNSHIP AND RESIDENCY; QUALITY OF HEALTH CARE; TIME FACTORS; WORKLOAD;

EID: 84857650520     PISSN: 00903493     EISSN: 15300293     Source Type: Journal    
DOI: 10.1097/CCM.0b013e3182413bc5     Document Type: Review

References (95)

1. Moonesinghe SR, Lowery J, Shahi N, et al: Impact of reduction in working hours for doctors in training on postgraduate medical education and patients' outcomes: Systematic review. BMJ 2011;342:d1580
2. Iglehart JK: The ACGME's final duty-hour standards-Special PGY-1 limits and strategic napping. N Engl J Med 2010;363:1589-1591
3. Accreditation Council for Graduate Medical Education: Resident duty hours in the learning and working environment: Comparison of 2003 and 2011 standards. Available at: http://www.acgme.org/acwebsite/dutyhours/dh- ComparisonTable2003v2011.pdf. Accessed August 10, 2011
4. Blum AB, Shea S, Czeisler CA, et al: Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety. Nat Sci Sleep 2011;3:47-85
5. Pastores SM, O'Connor MF, Kleinpell RM, et al: The Accreditation Council for Graduate Medical Education resident duty hour new standards: History, changes, and impact on staffing of intensive care units. Crit Care Med 2011;39:2540-2549
6. Al Lawati NM, Patel SR, Ayas NT: Epidemiology, risk factors, and consequences of obstructive sleep apnea and short sleep duration. Prog Cardiovasc Dis 2009;51:285-293
7. Alhola P, Polo-Kantola P: Sleep deprivation: Impact on cognitive performance. Neuropsychiatr Dis Treat 2007;3:553-567
8. Pilcher JJ, Huffcutt AI: Effects of sleep deprivation on performance: A meta-analysis. Sleep 1996;19:318-326
9. Dorrian J, Lamond N, Dawson D: The ability to self-monitor performance when fatigued. J Sleep Res 2000;9:137-144
10. Dawson D, Reid K: Fatigue, alcohol and performance impairment. Nature 1997;388:235
11. Sharpe R, Koval V, Ronco JJ, et al: The impact of prolonged continuous wakefulness on resident clinical performance in the intensive care unit: A patient simulator study. Crit Care Med 2010;38:766-770
12. Van Dongen HP, Maislin G, Mullington JM, et al: The cumulative cost of additional wakefulness: Dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep 2003;26:117-126
13. Downey R, Bonnet MH: Performance during frequent sleep disruption. Sleep 1987;10:354-363
14. Jewett MF, Wyatt JK, Ritz-De Cecco A, et al: Time course of sleep inertia dissipation in human performance and alertness. J Sleep Res 1999;8:1-8
15. Wertz AT, Ronda JM, Czeisler CA, et al: Effects of sleep inertia on cognition. JAMA 2006;295:163-164
16. Bjerner B, Holm A, Swensson A: Diurnal variation in mental performance; A study of three-shift workers. Br J Ind Med 1955;12:103-110
17. Santhi N, Horowitz TS, Duffy JF, et al: Acute sleep deprivation and circadian misalignment associated with transition onto the first night of work impairs visual selective attention. PLoS ONE 2007;2:e1233
18. Dembe AE, Delbos R, Erickson JB, et al: Associations between employees' work schedules and the vocational consequences of workplace injuries. J Occup Rehabil 2007;17:641-651
19. Matchock RL: Circadian and sleep episode duration influences on cognitive performance following the process of awakening. Int Rev Neurobiol 2010;93:129-151
20. Webb JR, Thomas JW, Valasek MA: Contemplating cognitive enhancement in medical students and residents. Perspect Biol Med 2010;53:200-214
21. Howard SK, Rosekind MR, Katz JD, et al: Fatigue in anesthesia: Implications and strategies for patient and provider safety. Anesthesiology 2002;97:1281-1294
22. Mitler MM, Carskadon MA, Czeisler CA, et al: Catastrophes, sleep, and public policy: Consensus report. Sleep 1988;11:100-109
23. Federal Aviation Administration: Title 14: Aeronautics and Space?Part 121-Operating requirements: Domestic, flag, and supplemental operations subpart S-Flight time limitations: Supplemental operations. Available at: http://ecfr.gpoaccess.gov/cgi/t/text/textidx? c=ecfr&sid= 2eeb6725d2a55d873b499069 8ee10d6e&rgn=div8&view=text&node=14:3. 0.1.1.5.19.3.2&idno=14. Accessed August 10, 2011
24. Hester CM: The Civil Aeronautics law of 1938. J Air Law 1938;9:451-454
25. Ulmer C, Miller Wolman D, Johns M M E (Eds): Resident Duty Hours: Enhancing Sleep, Supervision, and Safety. Washington DC, The National Academies Press, 2009
26. Pickersgill T: The European working time directive for doctors in training. BMJ 2001;323:1266
27. Levine AC, Adusumilli J, Landrigan CP: Effects of reducing or eliminating resident work shifts over 16 hours: A systematic review. Sleep 2010;33:1043-1053
28. Shetty KD, Bhattacharya J: Changes in hospital mortality associated with residency work-hour regulations. Ann Intern Med 2007;147:73-80
29. Volpp KG, Rosen AK, Rosenbaum PR, et al: Mortality among hospitalized Medicare beneficiaries in the first 2 years following ACGME resident duty hour reform. JAMA 2007;298:975-983
30. Landrigan CP, Rothschild JM, Cronin JW, et al: Effect of reducing interns' work hours on serious medical errors in intensive care units. N Engl J Med 2004;351:1838-1848
31. Afessa B, Kennedy CC, Klarich KW, et al: Introduction of a 14-hour work shift model for housestaff in the medical ICU. Chest 2005;128:3910-3915
32. Prasad M, Iwashyna TJ, Christie JD, et al: Effect of work-hours regulations on intensive care unit mortality in United States teaching hospitals. Crit Care Med 2009;37:2564-2569
33. Landrigan CP, Barger LK, Cade BE, et al: Interns' compliance with accreditation council for graduate medical education workhour limits. JAMA 2006;296:1063-1070
34. Sawyer RG, Tribble CG, Newberg DS, et al: Intern call schedules and their relationship to sleep, operating room participation, stress, and satisfaction. Surgery 1999;126:337-342
35. Landrigan CP, Fahrenkopf AM, Lewin D, et al: Effects of the accreditation council for graduate medical education duty hour limits on sleep, work hours, and safety. Pediatrics 2008;122:250-258
36. Gottlieb DJ, Peterson CA, Parenti CM, et al: Effects of a night float system on housestaff neuropsychologic function. J Gen Intern Med 1993;8:146-148
37. Hutter MM, Kellogg KC, Ferguson CM, et al: The impact of the 80-hour resident workweek on surgical residents and attending surgeons. Ann Surg 2006;243:864-875
38. Goldstein MJ, Kim E, Widmann WD, et al: A 360 degrees evaluation of a night-float system for general surgery: A response to mandated work-hours reduction. Curr Surg 2004;61:445-451
39. Kort KC, Pavone LA, Jensen E, et al: Resident perceptions of the impact of work-hour restrictions on health care delivery and surgical education: Time for transformational change. Surgery 2004;136:861-871
40. Knutson KL, Spiegel K, Penev P, et al: The metabolic consequences of sleep deprivation. Sleep Med Rev 2007;11:163-178
41. Zheng H, Patel M, Hryniewicz K, et al: Association of extended work shifts, vascular function, and inflammatory markers in internal medicine residents: A randomized crossover trial. JAMA 2006;296:1049-1050
42. Parshuram CS, Dhanani S, Kirsh JA, et al: Fellowship training, workload, fatigue and physical stress: A prospective observational study. CMAJ 2004;170:965-970
43. Mulgrew AT, Nasvadi G, Butt A, et al: Risk and severity of motor vehicle crashes in patients with obstructive sleep apnoea/hypopnoea. Thorax 2008;63:536-541
44. Kowalenko T, Kowalenko J, Gryzbowski M: Emergency resident related auto accidents-Is sleep deprivation a risk factor? Acad Emerg Med 2000;7:1171
45. Barger LK, Cade BE, Ayas NT, et al: Extended work shifts and the risk of motor vehicle crashes among interns. N Engl J Med 2005;352:125-134
46. Locallo DM: Decision on Brewster vs Rush Presbyterian Medical Center. Available at: http://www.state.il.us/court/opinions/appellatecourt/2005/ 1stdistrict/september/html/1033192.htm. Accessed July 30, 2011
47. Ayas NT, Barger LK, Cade BE, et al: Extended work duration and the risk of self-reported percutaneous injuries in interns. JAMA 2006;296:1055-1062
48. Haggerty JL, Reid RJ, Freeman GK, et al: Continuity of care: A multidisciplinary review. BMJ 2003;327:1219-1221
49. Petersen LA, Brenna TA, O'Neil AC, et al: Does housestaff discontinuity of care increase the risk for preventable adverse events? Ann Intern Med 1994;121:866-72
50. Shojania KG, Fletcher KE, Saint S: Graduate medical education and patient safety: A busy-and occasionally hazardous-intersection. Ann Intern Med 2006;145:592-598
51. Landrigan CP, Czeisler CA, Barger LK, et al: Effective implementation of work-hour limits and systemic improvements. Jt Comm J Qual Patient Saf 2007;33(Suppl 11):19-29
52. Riesenberg LA, Leitzsch J, Massucci JL, et al: Residents' and attending physicians' handoffs: A systematic review of the literature. Acad Med 2009;84:1775-1787
53. Pennell NA, Liu JF, Mazzini MJ: Interns' work hours: Correspondence. N Engl J Med 2005;352:726
54. Dwyer JP, Cohen MD: Interns' work hours: Correspondence. N Engl J Med 2005;352:727
55. Schneider JR, Coyle JJ, Ryan ER, et al: Implementation and evaluation of a new surgical residency model. J Am Coll Surg 2007;205:393-404
56. Coverdill JE, Adrales GL, Finlay W, et al: How surgical faculty and residents assess the first year of the Accreditation Council for Graduate Medical Education duty-hour restrictions: Results of a multi-institutional study. Am J Surg 2006;191:11-16
57. Reed DA, Levine RB, Miller RG, et al: Effect of residency duty-hour limits: Views of key clinical faculty. Arch Intern Med 2007;167:1487-1492
58. Winslow ER, Berger L, Klingensmith ME: Has the 80-hour work week increased faculty hours? Curr Surg 2004;61:602-608
59. Klingensmith ME, Winslow ER, Hamilton BH, et al: Impact of resident duty-hour reform on faculty clinical productivity. Curr Surg 2006;63:74-79
60. Vanderveen K, Chen M, Scherer L: Effects of resident duty-hours restrictions on surgical and nonsurgical teaching faculty. Arch Surg 2007;142:759-766
61. Goitein L, Shanafelt TD, Nathens AB, et al: Effects of resident work hour limitations on faculty professional lives. J Gen Intern Med 2008;23:1077-1083
62. Laine C, Goldman L, Soukup JR, et al: The impact of a regulation restricting medical house staff working hours on the quality of patient care. JAMA 1993;269:374-378
63. Warshaw AL, Sarr MG: The now and future world of restricted work hours for surgeons. Surgery 2003;134:1-2
64. Camins MB, Sutton BH, Daly JM: How will limitations imposed on residents' work hours affect medicine? Bull Am Coll Surg 2004;89:12-16
65. Charap M: Reducing resident work hours: Unproven assumptions and unforeseen outcomes. Ann Intern Med 2004;140:814-815
66. Lesser CS, Lucey CR, Egener B, et al: A behavioral and systems view of professionalism. JAMA 2010;304:2732-2737
67. Wilkinson TJ, Wade WB, Knock LD: A blueprint to assess professionalism: Results of a systematic review. Acad Med 2009;84:551-558
68. Griner D, Menon RP, Kotwall CA, et al: The eighty-hour workweek: Surgical attendings' perspectives. J Surg Educ 2010;67:25-31
69. Antiel RM, Thompson SM, Hafferty FW, et al: Duty hour recommendations and implications for meeting the ACGME core competencies: Views of residency directors. Mayo Clin Proc 2011;86:185-191
70. Blum AB, Raiszadeh F, Shea S, et al: US public opinion regarding proposed limits on resident physician work hours. BMC Med 2010;8:33
71. Coverdill JE, Carbonell AM, Cogbill TH, et al: Professional values, value conflicts, and assessments of the duty-hour restrictions after six years: A multi-institutional study of surgical faculty and residents. Am J Surg 2011;201:16-23
72. Drolet BC, Spalluto LB, Fischer SA: Residents' perspectives on ACGME regulation of supervision and duty hours-A National Survey. N Engl J Med 2010;363:e34
73. Lin GA, Beck DC, Stewart AL, et al: Resident perceptions of the impact of work hour limitations. J Gen Intern Med 2007;22:969-975
74. Carr S: Education of senior house officers: Current challenges. Postgrad Med J 2003;79:622-626
75. Jacques CH, Lynch JC, Samkoff JS: The effects of sleep loss on cognitive performance of resident physicians. J Fam Pract 1990;30:223-229
76. Stickgold R: Sleep-dependent memory consolidation. Nature 2005;27:1272-1278
77. Jamal MH, Rousseau MC, Hanna WC, et al: Effect of the ACGME duty hours restrictions on surgical residents and faculty: A systematic review. Acad Med 2011;86:34-42
78. Ten Cate O: Trust, competence, and the supervisor's role in postgraduate training. BMJ 2006;333:748-751
79. Norcini JJ: Work based assessment. BMJ 2003;326:753-755
80. Miller GE: The assessment of clinical skills/competence/performance. Acad Med 1990;65:S63-S67
81. Schijven MP, Reznick RK, ten Cate OT, et al: Transatlantic comparison of the competence of surgeons at the start of their professional career. Br J Surg 2010;97:443-449
82. Nuckols TK, Bhattacharya J, Wolman DM, et al: Cost implications of reduced work hours and workloads for resident physicians. N Engl J Med 2009;360:2202-2215
83. Nuckols TK, Escarve JJ: Cost implications of ACGME's 2011 changes to resident duty hours and the training environment. J Gen Intern Med 2011; Jul. 21 [Epub ahead of print]
84. Schwartz A, Pappas C, Bashook PG, et al: Conceptual frameworks in the study of duty hours changes in graduate medical education: A review. Acad Med 2011;86:18-29
85. King AC, Belenky G, Can Dongen H P A: Performance impairment consequent to sleep loss: Determinants of resistance and susceptibility. Curr Opin Pulm Med 2009;15:559-564
86. Czeisler CA: Medical and genetic differences in the adverse impact of sleep loss on performance: ethical considerations for the medical profession. Trans Am Clin Climatol Assoc 2009;120:249-285
87. Satire X Juvenal. Available at: http://en. wikipedia.org/wiki/Satire- X#Satire-X:-Wrong-Desire-is-the-Source-of-Suffering. Accessed November 30, 2011
88. Weaver TE: Outcome measurement in sleep medicine practice and research. Part 1: Assessment of symptoms, subjective and objective daytime sleepiness, health-related quality of life and functional status. Sleep Med Rev 2001;5:103-128
89. Parthasarathy S, Hettiger K, Budhiraja R, et al: Sleep and well-being of ICU housestaff. Chest 2007;131:1685-1693
90. Van Dongen HP, Baynard MD, Maislin G, et al: Systematic interindividual differences in neurobehavioral impairment from sleep loss: Evidence of trait-like differential vulnerability. Sleep 2004;27:423-433
91. Van Dongen H, Vitellaro KM, Dinges DF: Individual differences in adult human sleep and wakefulness: Leitmotif for a research agenda. Sleep 2005;28, 2005:479-496
92. Dorrian J, Lamond N, Holmes AL, et al: The ability to self-monitor performance during a week of simulated night shifts. Sleep 2003;26:871-877
93. Weinstein ND: Optimistic biases about personal risks. Science 1989;246:1232-1233
94. Bismilla Z, Breakey VR, Swales J, et al: Prospective evaluation of residents on call: Before and after duty-hour reduction. Pediatrics 2011;127:1080-1087
95. Task Force on Quality Care and Professionalism Response to Public Comments. Available at: http://www.acgme-2010standards.org/pdf/dh- TaskForceResponsesComments.pdf. Accessed October 12, 2011