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Resident Working Hour Restrictions Increased the Workload of the Medical Emergency Team: A Retrospective
Kyoung Min Moon1, Jin Won Huh2, Shinhee Park1
1From the Department of Pulmonary, Allergy, and Critical Care Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung.
Background:
Restrictions to residents' working hours have been shown to increase the workload of other medical resources; few studies have measured the effects on medical emergency teams (METs).
Objectives:
This study evaluated how limiting residents' working hours affected the workload of MET in a pulmonology unit.
Methods:
This retrospective observational study analyzed MET activity during periods before and after we limited the working hours of residents in our pulmonary unit to 88 h/wk: Period 1, March 2014 to February 2015; and Period 2, March 2015 to February 2016. Medical emergency team activities, dose (activations/1000 admissions), intensive care unit transfers, and mortality were compared between the two periods for weekdays and for weekends and holidays.
Results:
There were no significant differences between the two periods in MET dose (85.0 in Period 1 versus 91.3 in Period 2, P = 0.675), intensive care unit transfers (P = 0.828), 30-day mortality (P = 0.701), and 60-day mortality (P = 0.531). However, some activities increased significantly or near significantly in Period 2, including portable echocardiography (P < 0.001), arterial line insertion (P = 0.034), mechanical ventilation (P = 0.063), and fluid therapy (P = 0.220). These increases were greater for weekends and holidays than for weekdays.
Conclusions:
Since December 2017, a specific law for improving the training environment and status of residents has been implemented and applied at all hospitals in Korea. This legal restriction to working hours raises concerns regarding other medical personnel and system improvements to ensure patient safety and care continuity.
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