The Association Between Resident Physician Work-Hour Regulations and Physician Safety and Health

Details

• Personal Author:
  Barger LK ; Czeisler, Charles A. ; Landrigan CP ; O'Brien CS ; Qadri S ; Sullivan JP ; Vetter C ; Viyaran N ; Wang W ; Weaver MD
• Description:
  Background: In 2011, the Accreditation Council for Graduate Medical Education (ACGME) instituted a 16-h limit on consecutive hours for first-year resident physicians. We sought to examine the effect of these work-hour regulations on physician safety. Methods: All medical students matched to a United States residency program from 2002-2007 and 2014-2017 were invited to participate in prospective cohort studies. Each month participants reported hours of work, extended duration shifts, and adverse safety outcomes; including motor vehicle crashes, percutaneous injuries, and attentional failures. The incidence of each outcome was compared before and after the 2011 ACGME work-hour limit. Hypotheses were tested using generalized linear models adjusted for potential confounders. Results: 13% of all first-year resident physicians nationwide participated in the study, with 80,266 monthly reports completed by 15,276 first-year resident physicians. Following implementation of the 16-h 2011 ACGME work-hour limit, the mean number of extended duration (>/=24-h) shifts per month decreased from 3.9 to 0.2. The risk of motor vehicle crash decreased 24% (RR 0.76; 0.67-0.85), percutaneous injury risk decreased more than 40% (RR 0.54; 0.48-0.61), and the rate of attentional failures was reduced 18% (IRR 0.82; 0.78-0.86). Extended duration shifts and prolonged weekly work hours were associated with an increased risk of adverse safety outcomes independent of cohort. Conclusions: The 2011 ACGME work-hour limit was associated with meaningful improvements in physician safety and health. Surveillance is needed to monitor the ongoing impact of work hours on physician safety, health, and well-being. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Health Personnel Occupational Health Safety Sleep Sleep Initiation And Maintenance Disorders
• Keywords:
  Author Keywords: Physicians Cohort Studies Health Care Personnel Long Work Hours Physicians Safety Sleep Sleep Deprivation Work Hours Work Schedules
• ISSN:
  0002-9343
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Colorado ; Massachusetts ; OSHA Region 1 ; OSHA Region 8
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  133
• Issue:
  7
• NIOSHTIC Number:
  nn:20059103
• Citation:
  Am J Med 2020 Jul; 133(7):e343-e354
• Contact Point Address:
  Matthew D. Weaver, PhD, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Division of Sleep Medicine, Harvard Medical School, 401 Park Drive, Suite 3W, Boston, MA 02215
• Email:
  mdweaver@bwh.harvard.edu
• Federal Fiscal Year:
  2020
• NORA Priority Area:
  Healthcare and Social Assistance
• Performing Organization:
  Brigham and Women's Hospital, Boston, Massachusetts
• Peer Reviewed:
  True
• Start Date:
  20130901
• Source Full Name:
  The American Journal of Medicine
• End Date:
  20180831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:c3d481820dc73d5f2cf70ec98cf641710712a493800c90ffe8deefed8e3ff377ebc393c5f0ddd2e14cc68867959e80101a53ba79307cdf83ec45fb34f88848de
• Download URL:
  https://stacks.cdc.gov/view/cdc/223419/cdc_223419_DS1.pdf
• File Type:
  [PDF - 648.48 KB ]