Decreasing Work Hours versus Patient Care

While probably not going to change anything, a recent study published in the Journal of Surgical Research has shown that decreasing work hours alone does little to perceived patient care.

Note the keyword above – perceived.

The study was conducted among 156 surgical residents and had an excellent 94.5% response rate and consisted of surgical residents already regulated by work-hour restriction (maximum 80-hour work week) and residents who had not previously been regulated by work-hour restrictions.

The problem is not in the decreased work hours. Anybody with any common sense is going to realize that you are more efficient and more on top of your game if you’re well-rested. Just look at pilots in the commercial airline industry – they don’t let those guys work insane hours.

The flaws in patient care were found to be primarily in communication among residents. More precisely, we’re talking about cross-coverage and shit like that. In other words, whenever a resident passes on his census to a covering resident, that communication needs some improvement.

What’s interesting about this study is that it looked at decreased work hours versus patient care. The study found no improvement in patient care with decreased work hours. Now, many will look at this and say “so decreasing work hours doesn’t work.”

Not true. Decreasing work hours is a reasonable method to ensure that residents provide better care to patients. The residents are better rested, have more of a life, and everybody wins.

Another study needs to be done that looks at improving communication among cross-covering teams. That’s the real problem. Sure, it took this study to begin pointing that out, but let’s not give decreasing work hours a bad rap for failure to provide patient care improvements.