The Effect of Resident Duty Hour Restriction on Trauma Center Outcomes in Teaching Hospitals in the State of Pennsylvania

Abstract

Decreases in mortality and LOS during the study periods were likely not related to resident work hour restriction but rather to overall improvement in outcomes seen at Level II (no residents) and Level I (residents) TCs. Resident work hour restrictions had no discernible effect on patient care (noninferiority).

Systematic review and meta-analysis of the effect of North American working hours restrictions on mortality and morbidity in surgical patients

“…Two studies with mortality information were published after September 200935, 36. Addition of these two studies to the meta‐analysis resulted in the same mortality odds ratio in the QE model (1·28) but a widening of the c.i.…”

Academic Time at a Level 1 Trauma Center: No Resident, No Problem?

“…The PTOS data include all trauma patients who are admitted for longer than 48 hours, intensive care unit admission, transfer cases, and mortality cases. 11 The patients with solitary hip fracture, asphyxiation, drowning, hypothermia, or hyperthermia are excluded from PTOS data. Also burn patients were excluded from this study.…”

“…[2][3][4][5][6][7] By contrast, contradictory results have been demonstrated in the literatures of surgical subspecialty, including trauma. [6][7][8][9][10][11][12] To complement the workload uncovered by residents under the work-hour restriction, a large number of surgical program currently hire the advanced practice providers (APPs), physician assistant (PA) and nurse practitioner (NP). [13][14][15][16] A recent survey conducted by Pezzi et al 14 showed that 79% of general surgery program use APPs, and significant increase of the number of APPs after implementation of work-hour restriction.…”