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APHA Scientific Session and Event Listing

Recorded presentation

Charles A. Czeisler, PhD, MD, Division of Sleep Medicine, Harvard Medical School, 221 Longwood Avenue, Suite BL438, Brigham and Women's Hospital, Boston, MA 02115, 617.732.4013, caczeisler@rics.bwh.harvard.edu, Christopher P. Landrigan, MD, MPH, Sleep and Patient Safety Program, Harvard Medical School, 221 Longwood Avenue, Suite BL438, Brigham and Women's Hospital, Boston, MA 02115, Ann E. Rogers, PhD, RN, FAAN, School of Nursing, University of Pennsylvania, 420 Guardian Way, Philadelphia, PA 19104-6096, Simon Ahtaridis, MD, Department of Internal Medicine, Cambridge Health Alliance, 1493 Cambridge Street, The Cambridge Hospital, Cambridge, MA 02139, Richard Moore, Senator, MA, Joint Committee on Health Care Financing, State Senate -- State of Massachusetts, State House, Room 312-D, Boston, MA 02139, and Mark Levy, CIR/SEIU, 520 Eighth Ave, Suite 1200, New York City, NY 10018.

In 2003, the Accreditation Council on Graduate Medical Education (ACGME) adopted limits of 30-continuous hours (24 + 6) for resident physicians and a weekly limit of 80. Should those continue to be acceptable hours for the 100,000 resident physicians working in US teaching hospitals? Most familiar with residency training agree that those limits were derived not from scientific principles but rather as a compromise (in an environment where federal regulatory action was being considered) among medical educators and those concerned with the effects of sleep on safety. Charles Czeisler, MD, introduces the science of circadian rhythms and sleep deprivation and their effects on human performance. Christopher Landrigan, MD, reviews current evidence regarding the adverse effects of 24-hour work shifts on provider and patient safety and presents the data-driven case for a 16-hour limit for residents. Ann Rogers, PhD, RN, presents research that registered nurse shifts of 12 hours or longer nearly triple the risk of making errors and create difficulties remaining alert on duty and driving home. Simon Ahtaridis, MD, details a resident's perspective on making medical assessments and decisions, dealing with patients, families, and co-workers, learning, studying, doing sign-outs and handovers, and then driving home – all while acutely and chronically sleep deprived. Massachusetts State Senator Richard Moore defines fatigue as a significant public health hazard and describes his proposed state legislation to regulate resident work hours. Errors and fatigue-related accidents are a problem commonly identified in other industries. Are doctors and nurses and their work so different?

Learning Objectives: