Medical Error Risk Rises Under Shorter Medical Intern Shifts

Researchers found that handoffs, a known risk factor for medical errors, increased 130% to 200% under rules limiting consecutive hourly duty limits for house staff interns.

2 comments on "Medical Error Risk Rises Under Shorter Medical Intern Shifts"
Steve Spear (4/7/2013 at 7:38 AM)

The key problem is not handoffs per se[INVALID]unless you argue that there should never be a handoff, they will occur[INVALID]it is that the handoff process is poorly designed to preserve hypotheses, data, interpretation, and recommendations one shift to the next. This is not an impossible problem as healthcare is not the only high risk setting (and not even the highest risk of those settings) in which the work progresses with cycle times far beyond human endurance. In other situations[INVALID]Naval nuclear propulsion, space flight, combat outposts, long haul civilian aviation, continuous industrial processes, etc.[INVALID]the handoff problem is well managed. Though risks are high, calamities are rare. The fundamental problem is that healthcare providers (particularly those most senior) continue to view training and treatment solely as expression of individual professional skill rather than recognizing the coordinating routines necessary for success. By the same logic, we would have no ballet or symphonies, only soloists, no relay racers, only individualists, and basketball would look like playground pickup. Steve Spear Sr. Fellow, Institute for Healthcare Improvement Sr. Lecturer MIT
Edward Framer, Ph.D. (3/27/2013 at 6:06 PM)

And there are a lot of us out here who have seen unreasonably long shifts also cause unnecessary injury and death. There is no excuse for 100-120 hour work weeks or for sloppy handoffs.


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