Erschienen in:
29.05.2020 | Perspective
Why Residencies Should Fly: Towards a Logical Approach to Duty Hour Reform
verfasst von:
Gina Luciano, MD, FACP, Lydia Hambour, BTech, BBus, Paul Luciano, MBA, Eric Holmboe, MD, Sudeep Aulakh, MD, Simon Fleming, MRCS, M.Sc, Michael Rosenblum, MD
Erschienen in:
Journal of General Internal Medicine
|
Ausgabe 11/2020
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Abstract
Since 2011, aviation has revolutionized their approach to safety. The aviation industry has adopted a multi-faceted approach to improve safety through decreasing duty hour limits and implementing processes to mitigate fatigue-related errors as well as creating cultural shifts in responsibility for safety. These changes have been guided by data generated by quality-improvement methodology. In contrast, duty hour limits in graduate medical education have not yet seen dramatic data-driven reform. Key advancements in aviation fatigue mitigation and implications for residency education are explored in this article. Scientifically based processes to optimize duty hours, quality-improvement strategies to iteratively monitor and reform duty limits, systematic change focusing on a just culture, and financial disincentives and incentives as a catalyst for change are discussed.