Permitting first-year doctors to work longer shifts does not create chronic sleep loss or reduce patient safety, according to the results of two large national studies.
When medical residents were permitted to work shifts longer than 16 hours, patient mortality was not affected and the doctors themselves did not experience chronic sleep loss, according to a pair of papers published in the New England Journal of Medicine. The study that resulted in the papers follows a 2011 change imposed by the Accreditation Council for Graduate Medical Education (ACGME) to limit the amount of hours first-year residents could work in a single shift—a cap of 16 hours per day and 80 hours per week—which came in response to concerns about the potential for mistakes to be made by young doctors working long shifts. The two NEJM studies (patient safety and sleep/alertness) are accompanied by an editorial.
The results from these studies suggest that those well-intentioned policies were not necessary to protect patients. The work is part of an ongoing research effort—the individualized comparative effectiveness of models optimizing patient safety and resident education (iCOMPARE) study—funded by the NHLBI and ACGME.
“This highlights how well-structured studies can determine barriers to sleep health and if managing sleep can potentially improve performance and outcomes,” said James Kiley, Ph.D., director of the NHLBI’s Division of Lung Diseases.