Institute of Medicine Studies Link between Resident Work Hours & Patient Safety
At the behest of Congress (specifically the House Energy and Commerce Committee) and the Agency for Healthcare Research and Quality (AHRQ), the venerable Institute of Medicine has convened a Committee of experts to “synthesize current evidence on medical resident schedules and healthcare safety” and “develop strategies to enable optimization of work schedules to improve safety in the healthcare work environment.”
CIR President L. Toni Lewis, MD was asked to present at the Committee’s first public hearing in Washington DC on December 3, 2007, and CIR Exec. Vice President Nailah Thompson, DO testified during the second public hearing on March 4, 2008 in Irvine, CA.
Supporters of the current ACGME (Accreditation Council for Graduate Medical Education) resident work hours limits have made their views clear to the Committee, with a clear majority urging the IOM not to reduce work hours below the current limit of 24+6 hour consecutive on-call shift and 80 hours per week (averaged over four weeks).
Those testifying for stricter work hour limits (including CIR, the American Medical Student Association, Public Citizen, the Consumers Union of the United States, Inc., and sleep scientists Charles Czeisler, MD PhD and Christopher Landrigan, MD, MPH) have urged the IOM to make recommendations based on the available scientific evidence. This evidence clearly links acute and chronic sleep deprivation to attention deficits, a deterioration of performance, increased errors and accidents.
The IOM Committee’s report is due out at the end of 2008 or early 2009.
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