Researchers test the conventional wisdom on work-hour restrictions

Thousands of new doctors at several healthcare organizations around the nation are working 30 continuous hours to test whether such lengthy shifts cause fatigue and jeopardize patient and provider safety, according to the Washington Post.

Years ago, a 16-hour ceiling was imposed on resident work-hours, but a research project funded in part by the National Institutes of Health hopes to find the balance between preserving patient safety and efficiently training physicians. While proponents of work-hour limits argue the restrictions help to avert fatigue and improve safety, research indicates they are not associated with any particular improvement in outcomes. Moreover, the researchers argue the limits create their own patient safety risks, such as forcing increased handoffs.

The researchers got an exemption from the work-hour ceiling, as well as a ruling from the University of Pennsylvania's ethics panel deeming the study's risk to patients and residents to be minimal.

"We haven't really studied whether [restrictions on work hours] made a difference or not, not in this kind of rigorous way," Mildred Solomon, president of the Hastings Center, a healthcare ethics think tank, told the Post. "We need to find out."

Since the ceiling was imposed in 2011, many hospital residents say it has needlessly complicated staffing and schedules, and that new doctors are much better served if they have the opportunity to follow a patient's progress through the first 36 hours after admission.

"Duty hour rules were born out of a concern for patient safety [but] they have greatly increased handoffs," lead researcher David Asch, director of the University of Pennsylvania's Center for Health Care Innovation, told the Post. "And we already know that handoffs affect patient safety."

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