Insurance Journal reports on a study in the October 28, 2004, issue of the New England Journal of Medicine on the link between medical intern work schedules and medical errors. Surprisingly to me, the Brigham and Young research is one of the first studies of its kind, and while the study focuses on patient safety, it is but a short step to think of the implications of sleep deprivation for self injury, as well. The study reports:
The rate of serious medical errors committed by first-year doctors in training in two intensive care units (ICUs) at a Boston hospital fell significantly when traditional 30-hour-in-a-row extended work shifts were eliminated and when interns’ continuous work schedule was limited to 16 hours, according to two complementary studies funded by the National Institute for Occupational Safety and Health (NIOSH) and the Agency for Healthcare Research (AHRQ).
Interns made 36 percent more serious medical errors, including five times as many serious diagnostic errors, on the traditional schedule than on an intervention schedule that limited scheduled work shifts to 16 hours and reduced scheduled weekly work from approximately 80 hours to 63. The rate of serious medication errors was 21 percent greater on the traditional schedule than on the new schedule.
It would almost seem to be a no-brainer to link extended work hours to mistakes, stress, and self-injury – yet extened hours have been a time-honored and accepted practice in the medical field.
Here are more resources on extended hours in the medical profession:
NIOSH aggregates 52 research reports in a 50-page booklet entitled Overtime and Extended Work Shifts: Recent Findings on Illnesses, Injuries, and Health Behaviors (PDF). For additional research, visit the Harvard Work Hours and Health Study site with links to studies and educational materials regarding extended hours and sleepiness. It is also a place for medical personnel to report medical errors, needlestick injuries, and motor vehicle crash incidents related to sleep deprivation or long work hours.