“The 13,000 resident physicians of CIR/SEIU Healthcare are glad that the Institute of Medicine (IOM) has taken on the important issue of resident work hours,” said CIR President L. Toni Lewis, MD, a geriatrician in Queens, New York. “The recommendations in this new report are an important corroboration of our advocacy over the course of many years about the dangers of long hours to patient care and to resident well-being. In this precedent-setting report by the Institute of Medicine, 16 hours are the new limit for quality patient care.”
Today’s IOM report recommends reducing the maximum number of hours that residents can work without time for sleep to 16. However, it allows a 30-hour limit if it includes a five-hour protected sleep period – a recommendation that CIR disputes. “We know from experience that being fatigued leads to impaired performance and deterioration of skills,” Dr. Lewis said. “No other profession is scheduled to work 30 hours at a stretch. A five-hour ‘protected sleep’ time should not be used to continue the practice of 30-hour shifts – we should focus on the bigger picture – work beyond 16 hours detracts from an appropriate and safe standard of care for our patients.”
“This panel supports a more reasonable 16-hour limit,” Dr. Lewis said, “we are ready to get started with the next steps – making these historic recommendations a reality.”
CIR also welcomes the IOM report’s recommendations for an increase in mandatory days off following a schedule of four consecutive in-hospital night shifts, as well as for additional funding for teaching hospitals to accommodate the additional personnel necessary to implement safer resident work hours.
“With an estimated 98,000 patient deaths a year due to medical errors, anything that can be done to bring that number down should be done. It is the rare resident who has not made a medication error, fallen asleep while on duty, or forgotten to order or check on the results of an important diagnostic test when chronically sleep-deprived. Scheduling resident physicians so that we are well-rested is an important element in improving our healthcare system,” Dr. Lewis said. “We are encouraged by this important report, even as we had hoped it would have made a stronger commitment to the evidence-based argument for an absolute 16-hour limit.”