Resident Burnout Declines Following Duty Hour Standard

August 5, 2008

While resident burnout declined following implementation of the Accreditation Council for Graduate Medical Education standards, duty hour restrictions, total work or sleep hours, medical error rates and occupational injury rates did not significantly change, researchers report in the August issue of Pediatrics.

TUESDAY, Aug. 5 (HealthDay News) -- While resident burnout declined following implementation of the Accreditation Council for Graduate Medical Education (ACGME) standards, duty hour restrictions, total work or sleep hours, medical error rates and occupational injury rates did not significantly change, researchers report in the August issue of Pediatrics.

Christopher P. Landrigan, M.D., of Harvard Medical School in Boston, and colleagues conducted a prospective cohort study of residents from three pediatric training programs who provided daily reports of work hours, sleep, motor vehicle crashes, occupational exposures, self-reported medical errors and ratings of educational experiences. Residents were also screened for depression and burnout.

Overall, daily work hours and sleep habits were recorded for 220 residents, and 16,158 medication orders were reviewed. While accommodations were made to stay within ACGME duty hour restrictions, call frequency did not significantly change and 24- to 30-hour work shifts remained common. Residents' total work hours or sleep time habits did not change, but average length of long call shifts declined 2.7 percent to 28.5 hours, the investigators found. While the study found no change in the overall rate of medication errors, a small increase was noted with physician ordering errors. The study found no significant changes in rates of motor vehicle crashes, occupational exposures, depression or self-reported medical errors. Global ratings of work and educational experience were not altered due to the ACGME duty hour restrictions, but resident burnout decreased significantly (from 75.4 to 57 percent).

"Total hours of work and sleep did not change after implementation of the duty hour standards," the authors conclude. "Although fewer residents were burned out, rates of medication errors, resident depression, and resident injuries and educational ratings did not improve."

A number of the authors have received honoraria for speeches related to sleep and safety.

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