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dc.contributor.authorLandrigan, Christopher
dc.contributor.authorRothschild, Jeffrey
dc.contributor.authorCronin, John W.
dc.contributor.authorKaushal, Rainu
dc.contributor.authorBurdick, Elisabeth
dc.contributor.authorKatz, Joel
dc.contributor.authorLilly, Craig M.
dc.contributor.authorStone, Peter
dc.contributor.authorLockley, Steven
dc.contributor.authorBates, David
dc.contributor.authorCzeisler, Charles
dc.date.accessioned2022-06-29T16:34:08Z
dc.date.issued2004-10-28
dc.identifier.citationLandrigan, Christopher, Jeffrey Rothschild, John W. Cronin, Rainu Kaushal, Elisabeth Burdick, Joel Katz, Craig M. Lilly et al. "Effect of Reducing Interns' Work Hours on Serious Medical Errors in Intensive Care Units." New England Journal of Medicine 351, no. 18 (2004): 1838-1848. DOI: 10.1056/nejmoa041406
dc.identifier.issn0028-4793en_US
dc.identifier.issn1533-4406en_US
dc.identifier.urihttps://nrs.harvard.edu/URN-3:HUL.INSTREPOS:37372449*
dc.description.abstractBACKGROUND Although sleep deprivation has been shown to impair neurobehavioral performance, few studies have measured its effects on medical errors. METHODS We conducted a prospective, randomized study comparing the rates of serious medical errors made by interns while they were working according to a traditional schedule with extended (24 hours or more) work shifts every other shift (an “every third night” call schedule) and while they were working according to an intervention schedule that eliminated extended work shifts and reduced the number of hours worked per week. Incidents were identified by means of a multidisciplinary, four-pronged approach that included direct, continuous observation. Two physicians who were unaware of the interns' schedule assignments independently rated each incident. RESULTS During a total of 2203 patient-days involving 634 admissions, interns made 35.9 percent more serious medical errors during the traditional schedule than during the intervention schedule (136.0 vs. 100.1 per 1000 patient-days, P<0.001), including 56.6 percent more nonintercepted serious errors (P<0.001). The total rate of serious errors on the critical care units was 22.0 percent higher during the traditional schedule than during the intervention schedule (193.2 vs. 158.4 per 1000 patient-days, P<0.001). Interns made 20.8 percent more serious medication errors during the traditional schedule than during the intervention schedule (99.7 vs. 82.5 per 1000 patient-days, P=0.03). Interns also made 5.6 times as many serious diagnostic errors during the traditional schedule as during the intervention schedule (18.6 vs. 3.3 per 1000 patient-days, P<0.001). CONCLUSIONS Interns made substantially more serious medical errors when they worked frequent shifts of 24 hours or more than when they worked shorter shifts. Eliminating extended work shifts and reducing the number of hours interns work per week can reduce serious medical errors in the intensive care unit.en_US
dc.language.isoen_USen_US
dc.publisherMassachusetts Medical Societyen_US
dc.relation.isversionofdoi:10.1056/NEJMoa041406en_US
dash.licenseLAA
dc.titleEffect of Reducing Interns' Work Hours on Serious Medical Errors in Intensive Care Unitsen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalNew England Journal of Medicineen_US
dash.depositing.authorRothschild, Jeffrey
dc.date.available2022-06-29T16:34:08Z
dc.identifier.doi10.1056/nejmoa041406
dc.source.journalYearbook of Critical Care Medicine
dash.source.volume351en_US
dash.source.page1838-1848en_US
dash.source.issue18en_US
dash.contributor.affiliatedLockley, Steven
dash.contributor.affiliatedStone, Peter
dash.contributor.affiliatedKatz, Joel
dash.contributor.affiliatedRothschild, Jeffrey
dash.contributor.affiliatedCzeisler, Charles
dash.contributor.affiliatedLandrigan, Christopher
dash.contributor.affiliatedBates, David


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