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• W2008300620 abstract "The ACGME-released revisions to the 2003 duty hour standards.To review the impact of the 2003 duty hour reform as it pertains to resident and patient outcomes.Medline (1989-May 2010), Embase (1989-June 2010), bibliographies, pertinent reviews, and meeting abstracts.We included studies examining the relationship between the pre- and post-2003 time periods and patient outcomes (mortality, complications, errors), resident education (standardized test scores, clinical experience), and well-being (as measured by the Maslach Burnout Inventory). We excluded non-US studies.One rater used structured data collection forms to abstract data on study design, quality, and outcomes. We synthesized the literature qualitatively and included a meta-analysis of patient mortality.Of 5,345 studies identified, 60 met eligibility criteria. Twenty-eight studies included an objective outcome related to patients; 10 assessed standardized resident examination scores; 26 assessed resident operative experience. Eight assessed resident burnout. Meta-analysis of the mortality studies revealed a significant improvement in mortality in the post-2003 time period with a pooled odds ratio (OR) of 0.9 (95% CI: 0.84, 0.95). These results were significant for medical (OR 0.91; 95% CI: 0.85, 0.98) and surgical patients (OR 0.86; 95% CI: 0.75, 0.97). However, significant heterogeneity was present (I(2) 83%). Patient complications were more nuanced. Some increased in frequency; others decreased. Outcomes for resident operative experience and standardized knowledge tests varied substantially across studies. Resident well-being improved in most studies.Most studies were observational. Not all studies of mortality provided enough information to be included in the meta-analysis. We used unadjusted odds ratios in the meta-analysis; statistical heterogeneity was substantial. Publication bias is possible.Since 2003, patient mortality appears to have improved, although this could be due to secular trends. Resident well-being appears improved. Change in resident educational experience is less clear." @default.
• W2008300620 created "2016-06-24" @default.
• W2008300620 creator A5009429583 @default.
• W2008300620 creator A5038649068 @default.
• W2008300620 creator A5070778639 @default.
• W2008300620 date "2011-03-03" @default.
• W2008300620 modified "2023-09-28" @default.
• W2008300620 title "Patient Safety, Resident Education and Resident Well-Being Following Implementation of the 2003 ACGME Duty Hour Rules" @default.
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• W2008300620 doi "https://doi.org/10.1007/s11606-011-1657-1" @default.
• W2008300620 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/3138977" @default.
• W2008300620 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/21369772" @default.

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