The Effect of New Duty Hours on Resident Academic Performance and Adult Resuscitation Outcomes.
Am J Med. 2013 Dec 16;
Authors: Pepper DJ, Schweinfurth M, Herrin VE
BACKGROUND: From July 2011, the Accreditation Council for Graduate Medical Education (ACGME) implemented new resident duty hours throughout the United States. This study aimed to determine whether changes to call schedules due to these new duty hours achieved the intended goals of excellent patient care and improved resident learning.
METHODS: We conducted a retrospective cohort study at an academic hospital. For patient outcomes, we used the hospital registry for code blues and rapid responses to compare the proportion of deaths and transfers to an intensive care unit (July 2010 to June 2011; July 2011 to June 2012). For resident learning, we compared delta percentile scores for annual in-service training examinations (2009 to 2010; 2010 to 2011; 2011 to 2012).
RESULTS: We recorded 187 code blues and 469 rapid responses during the two-year period: 48 (7.3%) deaths, 374 (57.0%) transfers to the intensive care unit and 234 (35.7%) stabilizations on the floor. Of all transfers to the intensive care unit, those due to a code blue decreased after implementation of the new duty hours (36%[63/174] vs. 25%[49/200], P=0.02; aOR=0.59, 95%CI:0.37-0.92). The median [IQR] delta percentile scores for annual in-service training examinations declined significantly from the first time-period (2009 to 2010: 7 [4-11]) to the third time-period (2011 to 2012: 5 [2-8], p=0.02).
CONCLUSION: We observed a reduced proportion of transfers to the intensive care unit with a code blue after implementation of new resident duty hours. Resident academic performance experienced a small but significant decline in in-service training examination delta percentile score. We need large, multicenter studies to corroborate these findings.
PMID: 24355355 [PubMed - as supplied by publisher]