Slide Presentation of the 2007 Annual Meeting of AHRQ

The Path Forward—Changing the 24-hour Paradigm

• Field & lab studies, across disciplines, show consistent performance decline after 12-16h
• Residents' working 24-30 hour shifts make 36% more serious errors, 5 times as many serious, diagnostic errors, have twice the odds of crashing their cars, and suffer 61% more percutaneous injuries post-call
  • Perform at a level commensurate with a blood alcohol of 0.05-0.10%; drop in performance of 1.5 to 2 standard deviations
  • Sleep deprivation impairs learning
• Sign-out systems need to be improved to minimize hand-off errors