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The Impact of Duty Hours on Resident Self Reports of Errors

Journal of General Internal Medicine volume 22, pages 205–209 (2007)Cite this article

Background

Resident duty hour limitations aim, in part, to reduce medical errors. Residents’ perceptions of the impact of duty hours on errors are unknown.

Objective

To determine residents’ self-reported contributing factors, frequency, and impact of hours worked on suboptimal care practices and medical errors.

Design

Cross-sectional survey.

Subjects

164 Internal Medicine Residents at the University of California, San Francisco.

Measurements and Results

Residents were asked to report the frequency and contributing factors of suboptimal care practices and medical errors, and how duty hours impacted these practices and aspects of resident work-life. One hundred twenty-five residents (76%) responded. The most common suboptimal care practices were working while impaired by fatigue and forgetting to transmit information during sign-out. In multivariable models, residents who felt overwhelmed with work (p = 0.02) and who reported spending >50% of their time in nonphysician tasks (p = 0.002) were more likely to report suboptimal care practices. Residents reported work-stress (a composite of fatigue, excessive workload, distractions, stress, and inadequate time) as the most frequent contributing factor to medical errors. In multivariable models, only engaging in suboptimal practices was associated with self-report of higher risk for medical errors (p < 0.001); working more than 80 hours per week was not associated with suboptimal care or errors.

Conclusion

Our findings suggest that administrative load and work stressors are more closely associated with resident reports of medical errors than the number of hours work. Efforts to reduce resident duty hours may also need to address the nature of residents’ work to reduce errors.

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Acknowledgements

We gratefully acknowledge the following for their assistance in conception and compilation of this study: Marla Eisenberg, ScD, David Irby, PhD., and Erin Hartman, MS. Dr. Vidyarthi had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Potential Financial Conflicts of Interests

None Disclosed.

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Authors and Affiliations

  1. Department of Medicine, University of California, 533 Parnassus Avenue, Box 0131, San Francisco, California, 94143-0131, USA

    Arpana R. Vidyarthi MD, Andrew D. Auerbach MD, MPH, Robert M. Wachter MD & Patricia P. Katz PhD

Authors
  1. Arpana R. Vidyarthi MD
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  2. Andrew D. Auerbach MD, MPH
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  3. Robert M. Wachter MD
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  4. Patricia P. Katz PhD
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Corresponding author

Correspondence to Arpana R. Vidyarthi MD.

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Vidyarthi, A.R., Auerbach, A.D., Wachter, R.M. et al. The Impact of Duty Hours on Resident Self Reports of Errors. J GEN INTERN MED 22, 205–209 (2007). https://doi.org/10.1007/s11606-006-0065-4

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  • DOI: https://doi.org/10.1007/s11606-006-0065-4

Key words

  • duty hours
  • medical errors
  • medical education
  • patient safety