Factors Affecting Medical Residents’ Decisions to Work After Call

Details

• Personal Author:
  Carr MM ; Foreman AM ; Friedel JE ; O'Brien DC ; Wirth, Oliver
• Description:
  Background: Accreditation Council for Graduate Medical Education (ACGME) work-hour restrictions (WHRs) are intended to improve patient safety by reducing resident fatigue. Compliance with ACGME WHRs is not universal. Purpose: The purpose of this study was to identify factors that influence residents' decisions to take a postcall day (PCD) off according to ACGME WHRs. Methods: Residents (N = 433) at one university were emailed a link to a survey in 2019. The survey included demographic details and a Discrete Choice Experiment examining influences on resident decisions to take a PCD off. Results: One hundred seventy-five residents (40.4%) responded to the survey; 113 residents (26%) completed the survey. Positive feedback from attending physicians about taking PCDs off in the past had the greatest impact on respondents' decisions to take a PCD off, increasing the probability by 27.3%, followed by chief resident comments about the resident looking tired (16.6% increase), and having never heard their attendings comment about PCDs off as either positive or negative (13.9% increase). Factors that had the largest effect on decreasing the probability of taking a PCD were negative feedback about taking PCDs off (14.3% decrease), continuity of care concerns (10.8% decrease), and whether the resident was looking forward to an assignment (7.9% decrease). Conclusions: The most important influencer of residents' decisions to take a PCD off was related to feedback from their attending physicians, suggesting that compliance with WHRs can be improved by focusing on the residency program's safety culture. [Description provided by NIOSH]
• Subjects:
  Fatigue Health Personnel Occupational Health Safety
• Keywords:
  ACGME Author Keywords: Resident Education Duty Hours Long Work Hours Physician Fatigue Physicians Professionalism Safety Culture Work Hours Work Schedules
• ISSN:
  1549-8417
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Georgia ; New York ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 4 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  HELD - Health Effects Laboratory Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  16-21
• Volume:
  20
• Issue:
  1
• NIOSHTIC Number:
  nn:20069057
• Citation:
  J Patient Saf 2024 Jan; 20(1):16-21
• Contact Point Address:
  Michele M. Carr, DDS, MD, PhD, FRCSC, Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, 1278 Delaware Avenue, Buffalo NY 14209
• Email:
  mcarr@buffalo.edu
• Federal Fiscal Year:
  2024
• NORA Priority Area:
  Healthcare and Social Assistance ; Transportation, Warehousing and Utilities
• Peer Reviewed:
  True
• Source Full Name:
  Journal of Patient Safety
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:76865f00fafc67799c5624dbf2e3f2a2ad91e33ff76cb8e4d947ed20a7573b431728e7533812e717a0d17a574b477b927bed60b9843230be10607b6aec7c5726
• Download URL:
  https://stacks.cdc.gov/view/cdc/207606/cdc_207606_DS1.pdf
• File Type:
  [PDF - 1.01 MB ]