Background:
Recent limitations on resident duty hours aim, in part, to reduce medical errors. Residents' perceptions of the impact of decreased hours on errors are unknown.
Method:
We surveyed internal medicine residents at the University of California, San Francisco after duty hours were reduced. Residents were asked to report the frequency and causes of sub‐optimal care practices and medical errors, and how decreased duty hours impacted these practices and aspects of resident work‐life.
Summary of Results:
One hundred twenty‐five residents (76%) responded. The most common sub‐optimal care practices were working while impaired by fatigue and forgetting to transmit information during signout. In multivariable models, residents who felt overwhelmed with work (p = 0.02) and who reported spending >50% of their time in non‐MD tasks (p = 0.002) were more likely to report engaging in sub‐optimal care practices. Residents reported work‐stress (defined as a composite of fatigue, excessive workload, distractions, stress, and inadequate time) as the most frequent cause of medical errors. In multivariable models, only reports of engaging in sub‐optimal practices were associated with self‐reports of medical errors (p < 0.001); working more than 80 hours per week was not associated with sub‐optimal care or errors.
Statement of Conclusions:
In this academic internal medicine training program, administrative load and work stressors were more closely associated with reports of medical errors than the number of hours worked. Efforts to reduce resident duty hours may also need to address the nature of residents' work in order to reduce medical errors.
Author Disclosure Block:
A.R. Vidyarthi, None; A.D. Auerbach, None; R. Wachter, None; P. Katz, None.