Study finds no difference in patient outcomes among general surgery patients before and after 2011 ACGME duty hours reforms.JAMA. 2014;312:2374-2384.
Association of the 2011 ACGME resident duty hour reform with general surgery patient outcomes and with resident examination performance.
Rajaram R, Chung JW, Jones AT, et al. JAMA. 2014;312:2374-2384.
This observational study analyzed surgical outcomes before and after 2011 ACGME duty hours reform using data from the American College of Surgeons National Surgical Quality Improvement Program. Researchers applied difference-in-differences analysis, which can account for some of the uncertainty of nonrandomized data, a common concern in patient safety research. They assessed changes in surgical mortality and complication rates before and after implementation of duty hours restrictions in teaching hospitals. The authors compared this difference with mortality and complication rates during the same time period in nonteaching hospitals. Any variation between teaching and nonteaching sites could be attributed to the effects of duty hours, since the authors accounted for case mix and comorbidities. No differences in patient outcomes were observed, adding to the evidence that duty hours restrictions do not improve patient outcomes. Researchers also found no change in trainee examination scores, despite concerns that duty hours adversely impact trainee education. An editorial discussing this work and a companion study urge flexibility in duty hours for physicians in training.
The "July phenomenon": is trauma the exception?
Schroeppel TJ, Fischer PE, Magnotti LJ, Croce MA, Fabian TC. J Am Coll Surg. 2009;209:378-384.
Medmarx Data Report: A Chartbook of Medication Error Findings from the Perioperative Settings from 1998-2005.
Rockville, MD: United States Pharmacopeia; 2007.
Surgical management and outcomes of 165 colonoscopic perforations from a single institution.
Iqbal CW, Cullinane DC, Schiller HJ, et al. Arch Surg. 2008;143:701-707.
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Errors with concentrated epinephrine in otolaryngology.
Shah RK, Hoy E, Roberson DW, Nielsen D. Laryngoscope. 2008;118:1928-1930.