The effect of a rotating night-float coverage scheme on preventable and potentially preventable morbidity at a level 1 trauma center

Paul Schenarts, Josie Bowen, Michael Bard, Scott Sagraves, Eric Toschlog, Claudia Goettler, Susan Cromwell, Michael Rotondo
American Journal of Surgery 2005, 190 (1): 147-52

BACKGROUND: The effect of resident work-hour restriction on patient outcome remains controversial.

METHODS: Demographic data, mechanism of injury, length of hospital stay length of intensive care unit (ICU) stay, ventilator days, mortality, and complication data were prospectively collected for 11 months before and 11 months after institution of a rotating night-float system. Seven attending surgeons reviewed all complications and categorized each as preventable, potentially preventable, or nonpreventable.

RESULTS: Both study periods were comparable with respect to demographic data, mean Injury Severity Score, mechanism of injury, and admissions. Limitation of resident work hours had no effect on length of hospital or ICU stay, ventilator days, or mortality. Work-hour restrictions did not increase or decrease the total number of complications nor did it alter the distribution of those determined to be preventable or potentially preventable.

CONCLUSIONS: Resident work-hour restrictions were not associated with significant improvement or deterioration in patient outcome.

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