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A New Approach to Residency to Protect Patients

There is never a good time to get sick or be injured, but July might be the worst month of all. The month of July is when new medical residents begin working at hospitals, resulting in the “July effect” of increased medical errors that can result in injuries to patients.

Researchers at UCLA and the University of California recently reported that the “July effect,” long dismissed by the health care industry as myth, is in fact quite real. There is “a significant July spike” in medical errors, as reported in the Journal of General Internal Medicine.

Authors of the report said their findings indicate that the medical community needs to reassess duties assigned to residents, as well as increasing supervision and redoubling efforts to educate them about medication safety.

Taking Steps to Reduce Medical Mistakes

The medical community is taking steps to improve both the supervision and education of those incoming residents, recognizing that the medical errors committed by those residents going through on-the-job training do not end after each July.

In June, the Accreditation Council for Graduate Medical Education (ACGME) issued guidelines updating those established in 2003. The 2003 guidelines focused on reducing the hours residents can work in a week to 80. The new guidelines acknowledge that more supervision of first-year residents has long been needed.

The group has committed itself to more rigorous enforcement of the 80-hour workweek and other restrictions on residents.

The Council also said that teaching hospitals and physicians should work to be more aware of both the stresses imposed on first-year residents and of errors that happen due to the effects of fatigue, and work to reduce both.

Other Restrictions in the New Guidelines

Other restrictions in the ACGME guidelines include:

  • Establishing different levels of supervision for residents, including one requiring direct supervision of first-year residents by a physically present physician
  • First-year residents are not allowed to work more than 16 consecutive hours (down from 30 hours that included a five-hour nap)
  • Time spent at home on-call counts toward the 80 hours first-year residents are allowed to work in a week

Health care advocates say there are other important elements to making patients safer throughout the year, including a proactive approach to patient monitoring.

Patients and patients’ families should ask questions regarding not only the diagnosis of the illness or injury, but also to find out who is taking care of them.

The ACGME’s guidelines call for patients to be informed if a first-year resident is to participate in their care. Because some hospitals skirted the previous limitations on the duties and hours that could be assigned first-year residents, it’s best for patients to be vigilant and ask about the first-year status of those doctors participating in care.

It is laudable that elements of the medical community acknowledge the safety risks created by fatigued and inexperienced first-year residents and that the ACGME is working to reduce those risks.

Time will tell to what extent these efforts and guidelines are successful in reducing preventable medical errors and medical malpractice.

In Cases of Medical Malpractice

If you or a family member has been harmed by the negligence or preventable error of a doctor, contact a Florida medical malpractice attorney for an evaluation of your case. A medical malpractice lawyer will examine the facts and inform you of your options.

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