Volume 356:2665-2667 June 28, 2007 Number 26
An Elusive Balance — Residents' Work Hours and the Continuity of Care
Susan Okie, M.D.
http://content.nejm.org/cgi/content/full/356/26/2665?query=TOC
....
A recent study surveyed 2737 residents at monthly intervals during their
internship year about medical errors they had made; it found that the odds
of reporting at least one fatigue-related clinically significant medical
error increased by a factor of 7 during months in which they worked five
or more overnight shifts, as compared with months in which they worked
no overnight shifts.
....
The biggest challenge, according to several observers, is teaching residents
that their conscientiousness is best expressed by ensuring that their patients
will be well cared for by colleagues while they are off duty, rather than
by working to exhaustion. "That is a big challenge to the profession," said
Carolyn Clancy, director of the federal Agency for Healthcare Research and
Quality. "I think it has to be addressed head on, and it's a much larger
question than how many hours are enough — or too much."
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