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 They believe flexible hours lead to improvements in patient safety,
overall care and trainees' education and wellbeing.
Public concern over residents' work hours led the Accreditation
Council for Graduate Medical Education (ACGME) to impose
restrictions in 2003 and again in 2011. Current policy limits the
work week of trainee doctors, known as residents, to a maximum 80
hours, regulates mandatory time off between shifts and limits
on-call periods.
To see if the restrictions led to improvements in patient safety,
researchers conducted the FIRST Trial from 2014 to 2015. Of the 117
participating U.S. surgical training programs, 59 followed current
restrictions while the other 58 allowed for flexible working hours.
(See Reuters Health story of February 2, 2016 here: http://reut.rs/1RYSja8.)
Overall, patient outcomes were similar in both groups.
For the new study, Dr. Anthony Yang of the Feinberg School of
Medicine at Northwestern University in Chicago and colleagues
collected the perceptions of the surgical faculty who oversaw the
training programs.
Where residents had flexible work hours, program directors said the
trainees used the time to finish operations and the stabilize
patients.
Compared to program directors at hospitals with restricted work
hours, those with flexible hours overwhelmingly reported more
positive effects on patient safety, uninterrupted patient care and
freedom for residents to attend educational activities.
Most doctors in either group also said flexible hours would improve
patient care and resident education and wellbeing, the researchers
report in the Journal of the American College of Surgeons.
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"I didn’t expect it to be so uniform," said Yang.
The researchers caution that the results are subject to a number of
limitations. For example, they surveyed only the 117 program
directors involved in the trial, whereas there are 252 accredited
surgical training programs in the U.S.
Also, the survey was subjective, since it asked for program
directors' perceptions, and not for information like trainee
performance on exams.
The trial was also only one year, and the perceptions of program
directors may change over a longer period of time, they write.
Yang said he hopes the results put people at ease about longer work
hours for residents since these program directors view the flexible
policy as beneficial.
They "haven't seen this as a bad thing," he said.
SOURCE: http://bit.ly/1VZRDBP Journal of the American College of
Surgeons, online April 4, 2016.
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