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【社会人文】减少医生的工作时间并不能提高工
Boston (Oct. 2006) -- Research conducted by participants at several medical schools, including co-authors Michael J. Cunningham, M.D., and Roland D. Eavey, M.D., of the Massachusetts Eye and Ear Infirmary Pediatric Otolaryngology Service, Department of Otology and Laryngology, Harvard Medical School, has found that reducing the amount of work hours alone for surgical residents does not appear to improve quality of patient care. The study is published in the October issue of the Journal of Surgical Research.
Research was conducted on a convenience sample of 156 residents from three surgical specialties who completed questionnaires designed to measure subjective impressions about the quality of patient care. The sample consisted of residents who were already regulated by work-hour restriction (maximum 80-hour work week) and residents who had not previously been regulated by work-hour restriction. With a 94.5 percent response rate, more than 88 percent of residents reported that the quality of patient care remained unchanged (63 percent) or was worse (26 percent) after work-hour restrictions had been implemented. This response was particularly true from those residents who had not previously been regulated by work-hour restrictions. Overall, residents reported fewer fatigue-related errors following implementation of work-hour restrictions. However, more errors were perceived to be related to continuity of care, miscommunication and cross-coverage availability.
"The bad news is that a single change to relieve long work schedules of surgical house officers in order to improve quality apparently has 'failed,'" says senior author, Dr. Eavey, Director of Pediatric Otolaryngology at the Massachusetts Eye and Ear Infirmary. "Those same, well-rested house officers perceive that patient care quality unfortunately did not improve. The good news is that the survey has revealed realistic targets for future quality improvement: continuity, cross-coverage and communication ?the 'C' factors." 我认了! 减少医生的工作时间并不能提高工作质量
波士顿（2006年10月）----10月份的外科学研究杂志发表了一项由哈佛大学医学院耳喉科学部马萨诸塞州眼耳医院小儿耳鼻喉科Michael J. Cunningham, M.D博士和Roland D. Eavey博士合作、7所医学院参加的研究成果。研究显示，仅仅减少外科医生的工作时间并不能其提高工作质量。
该研究对156名外科医生进行了工作质量主观印象问卷调查。研究对象包括工作时间已受严格限制的医生（每周最多不超过80小时）和还没有进行工作时间限制的医生。整个调查的应答率为94.5%。88%的调查对象认为限制了工作时间以后医疗质量没有变化（62%）或变得更糟（26%）。对那些目前还没有进行工作时间管制的医生来讲这个回答是再好不过的了。从总体上讲，限制了工作时间虽然可以减少疲劳相关的过错，但是，医疗保健的连续性、缺乏交流和重复医疗等方面的过失会增加。
该项研究的主要负责人、马萨诸塞州眼耳医院小儿耳鼻喉科主任Eavey博士说：“单纯减少外科医生的工作时间以提高医疗质量是行不通的。同样，那些得到很好休息的医生也不能提高医疗质量。但是，这个研究可以提示我们，将来提高医疗质量的现实目标是医疗的连续性、覆盖率以及增加与病人的交流机会三方面因素。
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作者:admin@医学,生命科学 2010-11-26 17:11
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