Surgical Residents' Perception of the 16-Hour Work Day Restriction: Concern for Negative Impact on Resident Education and Patient Care

2012 ◽  
Vol 215 (6) ◽  
pp. 868-877 ◽  
Author(s):  
David Y. Lee ◽  
Elizabeth A. Myers ◽  
Sadiq S. Rehmani ◽  
Barbara A. Wexelman ◽  
Ronald E. Ross ◽  
...  
Keyword(s):  
Patient Care ◽  
Resident Education ◽  
Negative Impact ◽  
Surgical Residents

scholarly journals Perceived Quality Improvements Using Daily Allocation of Surgical Residents to the Operating Room and Outpatient Clinics

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Keith Wirth ◽  
Patricia Leung ◽  
Prasanth Patcha ◽  
Aliu Sanni
Keyword(s):  
Patient Care ◽  
Resident Education ◽  
Educational Experience ◽  
Surgical Residents ◽  
Quality Of Patient Care ◽  
Tertiary Center ◽  
Significant Difference ◽  
Busy Clinical Setting ◽  
Balancing Efficiency

Introduction. Balancing efficiency and quality in resident education and clinical care is challenging, particularly in a large tertiary center with resident work hour restrictions. This study investigates the use of daily allocation of surgical residents to operative cases and clinics with the goal of improving patient care, resident education, and coverage. Methods. Surgical residents were allocated to cases and clinic activities a day ahead, with a central email generated and sent to all surgical staff the day prior to the procedures and duties. A ten-item questionnaire was administered to the staff on the surgery service before and after this intervention, evaluating perceptions of educational experience, patient care, and coverage of operative cases, clinic, and floor duty. Results. A total of 28 staff members participated. No significant difference was found in the perception of stress at work, coverage of OR cases, or clinic attendance after the intervention. However, a statistically significant increase () was noted in the perception of resident’s educational experience in the clinic (39% vs. 94%), appropriate case distribution (54% vs. 94%), and quality of patient care (50% vs. 100%). Conclusions. Daily allocation of surgical residents to operative cases and clinic activities improves perceptions of resident educational experience and quality of patient care in a busy clinical setting.

scholarly journals The Effect of Restricting Residents' Duty Hours on Patient Safety, Resident Well-Being, and Resident Education: An Updated Systematic Review

2015 ◽  
Vol 7 (3) ◽  
pp. 349-363 ◽  
Author(s):  
Lauren Bolster ◽  
Liam Rourke
Keyword(s):  
Systematic Review ◽  
Patient Care ◽  
Resident Education ◽  
Negative Impact ◽  
Well Being ◽  
Duty Hours ◽  
Night Float ◽  
Protected Time ◽  
Resident Wellness ◽  
The Impact

ABSTRACT Background Despite 25 years of implementation and a sizable amount of research, the impact of resident duty hour restrictions on patients and residents still is unclear. Advocates interpret the research as necessitating immediate change; opponents draw competing conclusions. Objective This study updates a systematic review of the literature on duty hour restrictions conducted 1 year prior to the implementation of the Accreditation Council for Graduate Medical Education's 2011 regulations. Methods The review draws on reports catalogued in MEDLINE and PreMEDLINE from 2010 to 2013. Interventions that dealt with the duty hour restrictions included night float, shortened shifts, and protected time for sleep. Outcomes were patient care, resident well-being, and resident education. Studies were excluded if they were not conducted in patient care settings. Results Twenty-seven studies met the inclusion criteria. Most frequently, the studies concluded that the restrictions had no impact on patient care (50%) or resident wellness (47%), and had a negative impact on resident education (64%). Night float was the most frequent means of implementing duty hour restrictions, yet it yielded the highest proportion of unfavorable findings. Conclusions This updated review, including 27 recent applicable studies, demonstrates that focusing on duty hours alone has not resulted in improvements in patient care or resident well-being. The added duty hour restrictions implemented in 2011 appear to have had an unintended negative impact on resident education. New approaches to the issue of physician fatigue and its relationship to patient care and resident education are needed.

scholarly journals A Systematic Literature Review of Empirical Studies on Decentralized Nursing Stations

2018 ◽  
Vol 12 (1) ◽  
pp. 44-68 ◽  
Author(s):  
Lindsey Fay ◽  
Hui Cai ◽  
Kevin Real
Keyword(s):  
Systematic Review ◽  
Patient Care ◽  
Patient Experience ◽  
Negative Impact ◽  
Evaluation Framework ◽  
Positive Trend ◽  
Review Of Literature ◽  
Related Factors ◽  
Healthcare Design ◽  
The Past

Objectives: The objective of this systematic review of literature was to critically evaluate peer-reviewed evidence regarding the effectiveness of decentralized nurse stations (DNSs). Background: The DNS has become an important topic in healthcare design research and practice over the past decade with aims of improving staff efficiency and patient experience. Research has shown to be inconclusive, with studies reporting an assortment of mixed findings. Method: A systematic review of literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses search process of electronic databases, citation tracking, and manual searches of references. All authors evaluated the studies independently. Studies included were empirical, peer-reviewed investigations of DNS in hospitals over the past 15 years. Each study was evaluated using an accepted healthcare design evaluation framework. Results: Over 200 studies were identified. After exclusions, 21 studies published since 2003 were available for full evaluation. Key findings from this review include (a) there is a positive trend toward patient experience in units with DNS, (b) nursing teamwork was perceived to decline in units with DNS, (c) methodological issues may be responsible for the mixed and inconsistent findings, and (d) there is no consistent categorization of nurse station typology or standard definition for DNS. Conclusions: Based on the evaluation framework, DNS are supportive of the patient experience yet have a negative impact on nursing teamwork. Higher quality studies are needed to classify specific typologies of DNS and account for elements such as patient care models, communication, visibility, and other patient care–related factors.

scholarly journals Impact of Proposed Institute of Medicine Duty Hours: Family Medicine Residency Directors' Perspective

2009 ◽  
Vol 1 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Peter J. Carek ◽  
Joseph W. Gravel ◽  
Stanley Kozakowski ◽  
Perry A. Pugno ◽  
Gerald Fetter ◽  
...  
Keyword(s):  
Family Medicine ◽  
Patient Care ◽  
Residency Program ◽  
Detrimental Effect ◽  
Resident Education ◽  
Program Directors ◽  
Institute Of Medicine ◽  
Family Medicine Residency ◽  
Potential Impact ◽  
Residency Program Directors

Abstract Purpose To examine the opinions of family medicine residency program directors concerning the potential impact of the Institute of Medicine (IOM) resident duty hour recommendations on patient care and resident education. Methods A survey was mailed to 455 family medicine residency program directors. Data were summarized and analyzed using Epi Info statistical software. Significance was set at the P < .01 level. Results A total of 265 surveys were completed (60.9% response rate). A majority of family medicine residency program directors disagreed or strongly disagreed that the recent IOM duty hour recommendations will, in general, result in improved patient safety and resident education. Further, a majority of respondents disagreed or strongly disagreed that the proposed IOM rules would result in residents becoming more compassionate, more effective family physicians. Conclusion A majority of family medicine residency program directors believe that the proposed IOM duty hour recommendations would have a primarily detrimental effect on both patient care and resident education.

The residency 80-hour workweek: A survey of surgical residents assessing quality of patient care and medical errors

2006 ◽  
Vol 130 (2) ◽  
pp. 187
Author(s):  
C.K. Biller ◽  
A.C. Antonacci ◽  
S. Pelletier ◽  
P. Home ◽  
C. Spann ◽  
...  
Keyword(s):  
Patient Care ◽  
Medical Errors ◽  
Surgical Residents ◽  
Quality Of Patient Care

Transsex Patient Care in Surgical Resident Education: A National Survey of Plastic Surgery and Urology Residency Programs

2017 ◽  
Vol 225 (4) ◽  
pp. e162
Author(s):  
Shane Morrison ◽  
Geolani W. Dy ◽  
H. Jonathan Chong ◽  
Nathan C. Osbun ◽  
Sarah Holt ◽  
...  
Keyword(s):  
Patient Care ◽  
Plastic Surgery ◽  
National Survey ◽  
Resident Education ◽  
Surgical Resident ◽  
Residency Programs ◽  
Urology Residency

Implementing a resident acute care surgery service: Improving resident education and patient care

Surgery ◽  
2017 ◽  
Vol 161 (3) ◽  
pp. 876-883 ◽  
Author(s):  
Olga Kantor ◽  
Andrew B. Schneider ◽  
Marko Rojnica ◽  
Andrew J. Benjamin ◽  
Nancy Schindler ◽  
...  
Keyword(s):  
Patient Care ◽  
Acute Care ◽  
Resident Education ◽  
Acute Care Surgery ◽  
Care Surgery

A feasibility study using a touchscreen tool in the AYA population.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9575-9575
Author(s):  
Jonathan R. Espenschied ◽  
Julie Anna Wolfson ◽  
Alicia Bogardus ◽  
Yanjun Chen ◽  
Jeanelle Folbrecht ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Feasibility Study ◽  
Negative Impact ◽  
Support Staff ◽  
Ease Of Use ◽  
Completion Rate ◽  
Care Team ◽  
Care Needs ◽  
Clinical Support

9575 Background: Adolescent and young adults (AYA) 15 to 39 years present unique health care needs; however, barriers to communication of treatment-related and psychosocial difficulties exist. We hypothesized that a tailored AYA Touchscreen Tool (AYATT) in cancer patients/survivors would facilitate patient-provider communication, toward the larger goal of timely intervention. As a first step, we evaluated the feasibility of such a tool, operationally defined as an 80% acceptance and completion rate. Methods: Eligible City of Hope AYA patients receiving treatment and follow up care for oncologic or hematologic disease were systematically approached for study participation. Target accrual to assess feasibility was set at 50 participants. Consented patients completed a concise AYATT battery, mostly standardized measures, assessing access to care (CHIS), needs, neurocognitive function (BRIEF-A, CogState), and other quality of life (PedsQL) issues. Patients and clinical/support staff completed satisfaction and ease-of-use surveys to further evaluate feasibility. Results: 54 participants were accrued over 8 weeks, with a 96% completion rate exceeding our primary feasibility criteria. At the time of participation: Mean age=26.2 years; Range 15.3 to 38.9 years. Acceptability was high with positive responses throughout the survey. Based on patient responses, the AYATT helped 52% remember issues they had, or have, with their care or treatment; 39% were encouraged to discuss medical issues with their care team that they might not have discussed; 92% found it a useful way to communicate with their health care team; and 98% would recommend that other patients use AYATT. A separate survey from 31/36 clinical/support staff reported AYATT had minimal negative impact in clinic or patient care, increased communication, and was useful in maintaining/improving care. Conclusions: The aggregate findings from this feasibility study support utilizing a tailored touchscreen device in the AYA oncology population. Predictably, high levels of computer knowledge in our AYA cohort may account for the success and acceptance of using such a tool. These results provide evidence for further exploration and continued use in the AYA clinic and patient care setting.

Sign in / Sign up

Export Citation Format

Share Document