作者
Karl Y Bilimoria, Jeanette W Chung, Larry V Hedges, Allison R Dahlke, Remi Love, Mark E Cohen, David B Hoyt, Anthony D Yang, John L Tarpley, John D Mellinger, David M Mahvi, Rachel R Kelz, Clifford Y Ko, David D Odell, Jonah J Stulberg, Frank R Lewis
发表日期
2016/2/25
期刊
New England Journal of Medicine
卷号
374
期号
8
页码范围
713-727
出版商
Massachusetts Medical Society
简介
Background
Concerns persist regarding the effect of current surgical resident duty-hour policies on patient outcomes, resident education, and resident well-being.
Methods
We conducted a national, cluster-randomized, pragmatic, noninferiority trial involving 117 general surgery residency programs in the United States (2014–2015 academic year). Programs were randomly assigned to current Accreditation Council for Graduate Medical Education (ACGME) duty-hour policies (standard-policy group) or more flexible policies that waived rules on maximum shift lengths and time off between shifts (flexible-policy group). Outcomes included the 30-day rate of postoperative death or serious complications (primary outcome), other postoperative complications, and resident perceptions and satisfaction regarding their well-being, education, and patient care.
Results
In an analysis of data from 138,691 patients, flexible, less …
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KY Bilimoria, JW Chung, LV Hedges, AR Dahlke… - New England Journal of Medicine, 2016
