The effect of a rotating night-float coverage scheme on preventable and potentially preventable morbidity at a level 1 trauma center

Am J Surg. 2005 Jul;190(1):147-52. doi: 10.1016/j.amjsurg.2005.03.026.


Background: The effect of resident work-hour restriction on patient outcome remains controversial.

Methods: Demographic data, mechanism of injury, length of hospital stay length of intensive care unit (ICU) stay, ventilator days, mortality, and complication data were prospectively collected for 11 months before and 11 months after institution of a rotating night-float system. Seven attending surgeons reviewed all complications and categorized each as preventable, potentially preventable, or nonpreventable.

Results: Both study periods were comparable with respect to demographic data, mean Injury Severity Score, mechanism of injury, and admissions. Limitation of resident work hours had no effect on length of hospital or ICU stay, ventilator days, or mortality. Work-hour restrictions did not increase or decrease the total number of complications nor did it alter the distribution of those determined to be preventable or potentially preventable.

Conclusions: Resident work-hour restrictions were not associated with significant improvement or deterioration in patient outcome.

Publication types

  • Comparative Study

MeSH terms

  • Burnout, Professional*
  • Emergency Service, Hospital* / standards
  • Emergency Service, Hospital* / trends
  • Female
  • Health Care Surveys
  • Hospital Mortality / trends*
  • Humans
  • Internship and Residency*
  • Male
  • Night Care* / standards
  • Night Care* / trends
  • North Carolina / epidemiology
  • Outcome Assessment, Health Care
  • Personnel Staffing and Scheduling / trends*
  • Risk Assessment
  • Risk Management
  • Survival Analysis
  • Trauma Centers*
  • Work Schedule Tolerance*
  • Workforce
  • Workload*