The effect of a rotating night-float coverage scheme on preventable and potentially preventable morbidity at a level 1 trauma center.
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.
Center for Excellence in Trauma and Surgical Critical Care, Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC 27858-4354, USA. pschenar@pcmh.com
Paul
P
Schenarts
Josie
J
Bowen
Michael
M
Bard
Scott
S
Sagraves
Eric
E
Toschlog
Claudia
C
Goettler
Susan
S
Cromwell
Michael
M
Rotondo
D002055:Burnout, Professional; D004636:Emergency Service, Hospital / Q000592:standards / Q000639:trends; D005260:Female; D019538:Health Care Surveys; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009551:Night Care / Q000592:standards / Q000639:trends; D009657:North Carolina / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D010561:Personnel Staffing and Scheduling / Q000639:trends*; D018570:Risk Assessment; D012308:Risk Management; D016019:Survival Analysis; D014193:Trauma Centers; D014940:Work Schedule Tolerance; D000078329:Workforce; D016526:Workload