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(Circulation. 2008;117:2580-2582.)
© 2008 American Heart Association, Inc.

Editorial

A Delicate Balance

Physician Work Hours, Patient Safety, and Organizational Efficiency

Kevin G. Volpp, MD, PhD

From the Center for Health Equity Research & Promotion, Philadelphia Veterans Affairs Medical Center; Department of Medicine, University of Pennsylvania School of Medicine; and the Department of Health Care Systems, the Wharton School, University of Pennsylvania, Leonard Davis Institute of Health Economics, Philadelphia, Pa.

Correspondence to Kevin G. Volpp, MD, PhD, 1232 Blockley Hall, 423 Guardian Dr, Philadelphia, PA 19104-6021. E-mail volpp70@wharton.upenn.edu

Key Words: Editorials • internship and residency • medical errors • personnel staffing and scheduling

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The Accreditation Council for Graduate Medical Education (ACGME) recognized the importance of housestaff in the provision of hospital care when it regulated housestaff duty hours to improve patient safety. ACGME intended to create a better balance between the management of resident fatigue and the continuity of patient care, but the shorter hours mandated by duty hour reform have created more frequent patient handoffs, which may interfere with the continuity of care.^1–4 Concern about handoffs and recent work examining how outcomes vary in accordance with organizational factors such as the level of staffing on weekends have bought renewed attention to the issues of the effect of organizational factors in care delivery on outcomes and the efficiency of patient care.^5,6 Two articles, one in Circulation and one in Circulation: Heart Failure, provide information about these concerns.

Article p 2637 See Circ Heart Fail. 2008;1:50–57

Schuberth and colleagues⁷ studied 218 patients with acute heart failure who were admitted to the Nashville VA Medical Center during the 2 years ending in June 2005. They compared the length of stay for patients admitted to short call residents, who admitted patients during the day, handed off these patients to other residents, and left the hospital without spending the night, with the length of stay for patients admitted to long call residents, who admitted patients and spent the night in the hospital. Patients admitted to short-call residents stayed 1.3 days (44%) longer than those admitted to long-call residents. Death rates were not different between the . . . [Full Text of this Article]

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