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Institute of Medicine recommends stricter duty-hour regulations for residents
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At the request of the House Committee on Energy and Commerce as part of an investigation into preventable medical errors, the Institute of Medicine has issued a report recommending further restrictions regarding duty hours for resident physicians.
According to an article published in the January issue of the Journal of the American College of Radiology, the Institute of Medicine (IOM) also recommended other actions to reduce resident fatigue and ensure patient safety.
The new IOM recommendations focus on reducing fatigue-related errors by ensuring that residents get regular opportunities to sleep each day.
The change does not come at the expense of a reduction in maximum weekly work hours, according to an American College of Radiology press release. Current Accreditation Council for Graduate Medical Education (ACGME) duty-hour requirements hold that residents must not work more than 80 hours per week averaged during 4 weeks, and residents must be provided 1 day per week free from all educational and clinical responsibilities.
In 2003, the ACGME set duty-hour limits across all medical specialties nationally in order to promote safe patient care and resident well-being. The new requirements came as a result of the increasing acuity and intensity of medical care in teaching institutions and growing scientific evidence indicating the negative effect of sleep deprivation on performance, according to the release.
“Compliance with the current [ACGME] duty-hour requirements is assessed by an anonymous annual resident survey in addition to periodic site visits,” Martha B. Mainiero, MD, a lead author of the article, stated in the release.
“The radiology community supports the current ACGME requirements but recognizes that there has been inadequate study of the outcomes of the current duty-hour regulations and that there continues to be issues with compliance with those regulations,” she added. “Therefore, we feel these issues should be addressed with more rigorous monitoring of duty hours before implementing new duty hour requirements.”
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