TY - JOUR
T1 - Duty hour reform in a shifting medical landscape
AU - Jena, Anupam B.
AU - Prasad, Vinay
N1 - Funding Information:
1Department of Health Care Policy, Harvard Medical School, Boston, MA, USA; 2Massachusetts General Hospital, Boston, MA, USA; 3National Bureau of Economic Research, Cambridge, MA, USA; 4Medical Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
PY - 2013/9
Y1 - 2013/9
N2 - The circumstances that led to the death of Libby Zion in 1984 prompted national discussions about the impact of resident fatigue on patient outcomes. Nearly 30 years later, national duty hour reforms largely motivated by patient safety concerns have demonstrated a negligible impact of duty hour reductions on patient mortality. We suggest that the lack of an impact of duty hour reforms on patient mortality is due to a different medical landscape today than existed in 1984. Improvements in quality of care made possible by computerized order entry, automated medication checks, inpatient pharmacists, and increased resident supervision have, among other systemic changes, diminished the adverse impact that resident fatigue is able to have on patient outcomes. Given this new medical landscape, advocacy towards current and future duty hour reforms may be best justified by evidence of the impact of duty hour reform on resident wellbeing, education, and burnout.
AB - The circumstances that led to the death of Libby Zion in 1984 prompted national discussions about the impact of resident fatigue on patient outcomes. Nearly 30 years later, national duty hour reforms largely motivated by patient safety concerns have demonstrated a negligible impact of duty hour reductions on patient mortality. We suggest that the lack of an impact of duty hour reforms on patient mortality is due to a different medical landscape today than existed in 1984. Improvements in quality of care made possible by computerized order entry, automated medication checks, inpatient pharmacists, and increased resident supervision have, among other systemic changes, diminished the adverse impact that resident fatigue is able to have on patient outcomes. Given this new medical landscape, advocacy towards current and future duty hour reforms may be best justified by evidence of the impact of duty hour reform on resident wellbeing, education, and burnout.
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U2 - 10.1007/s11606-013-2439-8
DO - 10.1007/s11606-013-2439-8
M3 - Review article
C2 - 23568191
AN - SCOPUS:84883190414
SN - 0884-8734
VL - 28
SP - 1238
EP - 1240
JO - Journal of general internal medicine
JF - Journal of general internal medicine
IS - 9
ER -