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Hospitalized Patients' Perceptions of Resident Fatigue, Duty Hours, and Continuity of Care.

Drolet, Brian C; Hyman, Charles H; Ghaderi, Kimeya F; Rodriguez-Srednicki, Joshua; Thompson, Jordan M; Fischer, Staci A.
J Grad Med Educ; 6(4): 658-63, 2014 Dec.
Artigo em Inglês | MEDLINE | 2014 | ID: mdl-26140114
Resumo: BACKGROUND: Physicians' perceptions of duty hour regulations have been closely examined, yet patient opinions have been largely unstudied to date. OBJECTIVE: We studied patient perceptions of residency duty hours, fatigue, and continuity of care following implementation of the Accreditation Council for Graduate Medical Education 2011 Common Program Requirements. METHODS: A cross-sectional survey was administered between June and August 2013 to inpatients at a large academic medical center and an affiliated community hospital. Adult inpatients on teaching medical and surgical services were eligible for inclusion in the study. RESULTS: Survey response rate was 71.3% (513 of 720). Most respondents (57.1%, 293 of 513) believed residents should not be assigned to shifts longer than 12 hours, and nearly half (49.7%, 255 of 513) wanted to be notified if a resident caring for them had worked longer than 12 hours. Most patients (63.2%, 324 of 513) believed medical errors commonly occurred because of fatigue, and fewer (37.4%, 192 of 513; odds ratio, 0.56; P < .01) believed medical errors commonly occurred as a result of transfers of care. Given the choice between a familiar physician who "may be tired from a long shift" or a "fresh" physician who had received sign-out, more patients chose the fresh but unfamiliar physician (57.1% [293 of 513] versus 42.7% [219 of 513], P < .01). CONCLUSIONS: In a survey about physician attributes relevant to medical errors and patient safety, adult inpatients in a large and diverse sample reported greater concern about fatigue and working hours than about continuity of care.