In 2011, new regulations were introduced to restrict the amount of hours first-year residents could spend at the hospital from 24 to 16. Medical malpractice lawyers at Pintas & Mullins Law Firm highlight the most recent data showing that medical interns are actually reporting more mistakes after these new regulations.
The study was published in JAMA Internal Medicine, and took information from 2,300 doctors from over a dozen hospitals in the U.S for a period of three months. Researchers compared this information to that of interns working before the 2011 regulations were implemented. Those at the hospital after the 2011 regulations worked no longer than 16 hours during any given shift, while those working before the new rules were on call for a maximum of 30 hours. The data was all self-reported, as interns recorded their on-duty and sleeping hours, symptoms of depression and fatigue, well-being, and medical errors.
The findings are somewhat disconcerting. Although interns working after the new regulations spent fewer hours at the hospital, they were not reporting sleeping any more on average than those residents working before the new rules. The risk of depression between the two groups remained the same, at about 20%. Most alarmingly, the number of reported medical mistakes in the post-2011 group was higher than the pre-2011 interns – an increase of about 15 to 20%.
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How could this be possible? Interns reported many problems with the new system, perhaps the most significant being that they were still expected to complete the same amount of duties as the pre-2011 class, despite having about half the hours to accomplish them in. Overworked employees at any job site will simply not perform as well as those who are allocated a fair number of tasks. This type of work compression is a major factor in the majority of nursing home abuse and neglect cases, for example, as overworked nurses fail to meet the needs of each resident in a proper manner.
Similarly, the more interns are pressed for time, the more likely they are to make mistakes and errors. For most of the dozen programs studied, the reduction in work time did not also include any increase in funding to hire additional staff, which results in understaffing and, ultimately, more errors.
The decrease in working hours also leads to an increase in the amount of times the duties are handed off between interns. In the pre-2011 group, the average of hand-offs was about three in a single shift; in the post-2011 group, the average shot to nine. Every time a doctor hands off his case to another there is a significant chance for error. Miscommunications can occur in explaining potential complications, allergies, aspects of the patient’s medical history, or other contributing factors. When a switch occurs nine times in one shift, the chances that an error will occur skyrocket.
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In 2011, two doctors wrote in TIME that handoffs of this kind are notoriously fraught with dangerous miscommunications, creating opportunities for errors to arise, as the new shift workers are entering unfamiliar territory and are often not as emotionally invested in the patient’s care. The doctors went on to suggest that physicians and nurses take breaks to nap while on the job to improve the sleep deprivation problems. Several studies showed that instituting naps did indeed improve this deprivation, in turn improving performance. Tired doctors often fail to recognize that they are fatigued, which leads to more medical mistakes.
Fewer hours on duty also means less time to train and learn real-world skills doctors need to give patients the highest quality of care. It is important now for healthcare professionals to work together to find the best methods to reduce medical errors, not only among interns but in the medical community as a whole.
Our legal team has decades of experience advocating for victims of medical malpractice, and will ensure you receive the best representation and largest settlement possible.