A bridge too far: A critique of the new ACGME duty hour requirements

摘要

The issue of resident work hours has been discussed extensively for more than 25 years. Errors and signs of sleep deprivation in residents have been catalogued in a few single institution studies with a limited number of residents and a modest number of observations. The results have been contradictory with some studies showing fewer errors with more mandated sleep time and one recent study showing increased length of stay and lower quality of care for patients with shorter duty shifts. Over recent years, resident on-call duty hours spent in the hospital have been progressively reduced in response to requirements imposed by the Accreditation Council for Graduate Medical Education (ACGME), a non-governmental regulatory agency. These mandated changes in residency hours are being strictly enforced even though there is a remarkable paucity of outcomes data supporting these new rules.