A new study in Britain found that doctors who were more rested made fewer mistakes. A pilot study, it adds to the growing body of research that endorses the ergonomic and safety benefits of ensuring adequate rest for employees. Researchers in the United States concluded in a 2005 study that fatigued doctors might as well be drunk.
The University Hospitals Coventry and Warwickshire NHS Trust conducted the new study, which was reported by the BBC.
Nineteen junior doctors working on the endocrinology and respiratory wards at the hospital participated in the 12-week study. Nine were put on a 48-hour per week pattern that met the conditions of the European Working Time Directive (EWTD) and 10 were on a traditional pattern, where they worked up to 56 hours.
The EWTD participants’ sleep time was increased from an average of 6.75 hours to 7.26 hours, and their work hours and the duration of their sleep were recorded every day.
Two senior doctors, who were unfamiliar with the shift patterns of both groups, reviewed their errors by checking case notes.
Doctors working to the EWTD pattern made 33 percent fewer errors than their colleagues on the traditional pattern, and there were fewer potentially life-threatening events.
The United States doctors’ sleep study, featured in September 2005 in The Ergonomics Report®, said many US resident doctors are so sleep-starved they are drunk with fatigue. The research showed that fatigued doctors are unproductive, inefficient and a danger to patients and themselves.
The author, Dr. Judith Owens, director of the pediatric sleep-disorders clinic at Hasbro Children’s Hospital in Providence, Rhode Island, said some of the subjects in her study were so fatigued they didn’t even recognize their judgment was impaired.
For the study, which was published in the September 7 edition of the Journal of the American Medical Association, Dr. Owens followed 34 pediatric residents from Brown University in Providence for over two years. They were tested during two distinct work patterns. On light call – one month of daytime duty with no overnight shift – they averaged 44 hours of work per week and six hours and 37 minutes of sleep a night. On heavy call – overnight duty every fourth night – they averaged 90 hours of work a week and averaged only three hours and 26 minutes of sleep a night.
The heavy schedule figure exceeds the recommended weekly work schedules for doctors-in-training in the United States, which was lowered in 2003 to a maximum of 80 hours. The limit is not legislated.
Sources: Warwickshire NHS Trust; BBC; The Ergonomics Report®