From Modern Healthcare:
In order to enhance patient safety as well as physician training, the Institute of Medicine is calling for keeping the current 80-hour per week limit for medical residents; restricting residents to 16-hour daily shifts, unless a continuous five-hour sleep break is allowed; curbing residents’ off-hours “moonlighting” at other jobs; and providing for safe transport home in case a resident is too tired to drive safely.
The 324-page report, Resident Duty Hours: Enhancing Sleep, Supervision, and Safety, also stated that current work-limit violations are underreported so more frequent and unannounced inspections by the Accreditation Council for Graduate Medical Education are needed. The report acknowledged that there are financial barriers to implementing further revisions to work-hour limits, and it included an estimate that the 80-hour limit, set in 2003, adds about $1.7 billion in extra labor costs annually as others must handle duties that had traditionally been performed by residents.
Citing the examples of 48- and 72-hour limits in Europe and New Zealand, respectively, the report concluded that it is not possible to determine the ideal workload for physicians in training and that the amount of duty hours may not be the greatest factor affecting quality of care. Nevertheless, it stated that there is much evidence that links fatigue to decreased performance so resident fatigue must be mitigated in order to reduce the conditions that lead to medical errors
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