The University of Hawaiʻi Surgical Residency Program was one of 117 General Surgery Residency Programs across the nation that participated in the first-ever prospective randomized trial investigating physician duty hour policies and patient safety.
The results were presented this month at the Academic Surgical Congress, held in Jacksonville, Florida, and simultaneously published in the New England Journal of Medicine.
The study was conducted in response to a fundamental observation that a firm restriction limiting duty hours to 80-hours per week, implemented in 2011 by the Accreditation Council for Graduate Medical Education (ACGME), did not appear to result in improved patient care. Instead, there was compelling evidence that suggested that patients and the education of physician trainees actually worsened.
Surgeon Danny Takanishi, MD, and Gary Belcher, M.Ed, headed the UH surgery residency program’s part in the study. Dr. Takanishi said duty hour policies have resulted in more frequent “handoffs” of patients between physicians, compromising continuity of patient care, potentially jeopardizing patient safety, and diminishing the quality of resident education by forcing residents to leave at crucial times, such as during an ongoing operation or stabilization of a critically-ill patient.
Nearly all eligible institutions agreed to participate in this national trial, which was funded by the American College of Surgeons, the American Board of Surgery, and the ACGME. The 117 General Surgery Residency Programs were randomized to comply with either the standard duty hour policy currently in place (a strict 80-hour per week limit), or a more flexible policy, called “intervention arm”, which allows more flexibility in adjusting work hours to comply with the 80-hour limit.
The University of Hawaiʻi Surgical Residency Program was chosen randomly to evaluate the “flexible arm” policy during the trial.
