OTTAWA, April 17, 2012 /PRNewswire/ - The Canadian Association of Internes and
Residents (CAIR) today released a position paper, Canadian Patient and Physician Safety and Wellbeing: Resident Duty
Hours, that urges all provinces and regions in Canada to manage resident duty
hours in a manner that ensures patient and resident safety and the best
learning experience for residents.
CAIR recognizes the need to work towards a system that limits residents'
continuous uninterrupted duty hours and allows for adequate time in
between shifts to eliminate the effects of sleep deprivation.
"We understand regional complexities and the difficulties of a "one size
fits all" solution but we have more and more evidence that excessive
duty hours can endanger public and physician safety," said Dr. Adam
Kaufman, CAIR President.
"There needs to be a national dialogue that looks at best practices for
better management of resident duty hours that will enhance residents'
ability to provide safe, high quality patient care, while protecting
their own personal health and safety."
CAIR also recommends that the resident duty hours model must not impair
residents' ability to learn and teach others. The ability to
appropriately transfer care when going off duty is also critical to
patient safety.
The CAIR position paper cites various studies, including a 2009 study
conducted by the Institute of Medicine (IOM) that concluded "…there is
extensive research that shows that fatigue is an unsafe condition that
contributes to reduced wellbeing for residents and increased errors and
accidents." The IOM report also states that the evidence supports the
conclusion that continuous uninterrupted work beyond 16 hours
compromises performance.
Recommendations:
-
Resident physicians' duty hours must be managed such that they do not in
any way endanger their health or the health of patients. In particular,
limits are required on the number of continuous uninterrupted hours
that residents are on duty. In keeping with current evidence, CAIR
urges that all provinces and regions in Canada work towards a system
that limits continuous uninterrupted duty hours to 16 hours or less at
a time. Additionally, the scheduling of duty hours must allow for
adequate time in-between work periods to eliminate the effects of sleep
deprivation. This limitation will enhance residents' ability to provide
safe, high quality patient care, while protecting their own personal
health and safety.
-
Resident duty hours must be such as to allow for an optimal educational
experience. Specifically, trainees' duty hours must not impair their
ability to learn or to train others.
-
Residents must be formally trained in handover skills, the ability to
transfer care appropriately when going off duty.
-
Resident duty hours should be flexible enough to accommodate the
specific context of the resident's role and the service needs on
particular rotations.
-
The management of duty hours should parallel a change in the culture of
medicine that addresses the effects and consequences of uninterrupted
consecutive duty hours for the medical profession as a whole, including
staff physicians and non-resident learners.
-
Where a violation of Federal or Provincial ethical, legislative, or
legal standards has occurred, including but not limited to those
related to the Canadian Charter of Rights and Freedoms, CAIR calls upon
all stakeholders to address and remedy the situation as swiftly as
possible.
For a complete electronic copy of Canadian Patient and Physician Safety and Wellbeing: Resident Duty Hours, visit the News & Releases section of the CAIR website: http://www.cair.ca/en/news/releases/
About CAIR:
CAIR is the national representative body of over 8,000 resident
physicians in Canada. CAIR is a resident-driven organization that works
collaboratively with other national health organizations to
continuously improve patient care and explore new approaches to the
delivery of health care. CAIR works to achieve consensus on policy and
advocacy issues of a national interest. It delivers improvement to the
lives of resident physicians in such areas as personal well-being, the
quality of medical education and professionalism.
SOURCE The Canadian Association of Internes and Residents
