Patient Outcomes when Housestaff Exceed 80 Hours per Week

Area of Science:

• Internal Medicine
• Healthcare Quality
• Patient Safety

Background:

• High resident workload and long work hours may compromise patient care quality and efficiency.
• Duty hour restrictions aim to balance patient education with optimal patient care.
• This study examines the impact of housestaff working over 80 hours weekly on patient outcomes.

Purpose of the Study:

• To investigate the effect of housestaff working more than 80 hours per week on patient care quality.
• To analyze patient outcomes including length of stay, mortality, ICU transfers, and readmissions.
• To assess the relationship between resident duty hours and patient safety metrics.

Main Methods:

• Retrospective cohort study of inpatient general medicine service admissions.
• Data collected from June 2013 to June 2014 at an academic medical center.
• Housestaff duty hours determined via electronic health record audit; patient outcomes analyzed.

Main Results:

• 40.9% of hospitalizations involved housestaff working over 80 hours/week.
• Patients admitted by housestaff working >80 hours/week had a higher composite outcome rate (19.2% vs 16.7%).
• Significantly higher length of stay (5.12 vs 4.66 days) and ICU transfer rates (3.53% vs 2.38%) were observed.

Conclusions:

• Housestaff working over 80 hours per week were associated with increased patient length of stay and ICU transfers.
• No significant association found between resident work hours and in-hospital mortality or 30-day readmission rates.
• Findings suggest specific patient care metrics are affected by extended resident duty hours, while others are not.