A series of reports done on the medical field have revealed serious medical errors. Hospitalization usually gives people a chance to get better, but there are also cases when expectations are not reached or, even worse, people might die while in hospital following medical errors. In April, HealthGrades, a health care ratings organization, released its fifth annual Patient Safety in American Hospitals Study, according to which, from 2004 through 2006, patient safety errors resulted in 238,337 potentially preventable deaths of the US Medicare Patients and cost the Medicare program $8.8 billion.

What were the most common errors? According to the report, they include anesthesia complications, bedsores, failure to rescue (respiratory failure, pulmonary embolism or deep vein thrombosis, sepsis and abdominal wounds that split open after surgery), selected infections due to medical care, as well as many post-operative events.

What were the causes leading to such errors that could jeopardize patients’ lives? Well, sleep appears to be the major cause of all errors. Beginning with 2003, the Accreditation Council for Graduate Medical Education (ACGME), which oversees residency programs, has required that residents work no more than 80 hours a week, averaged over four weeks, and no more than 30 hours straight. Previously, residents often worked 100 hours or more weekly.

Now a new report written by an expert committee convened by the Institute of Medicine at the request of Congress and the Agency for Healthcare Research and Quality said medical and surgical residents in hospitals should work no more than 16 hours without taking a mandatory five-hour sleep break. Moreover, they should get one full day off a week and at least two back-to-back days off a month. IOM, part of the National Academy of Sciences, provides expert advice to Congress.

What was the explanation for this new guideline?

“Our overarching conclusion is that the science clearly shows that fatigue increases the chances of errors, and residents often work long hours without rest and regular time off,” said Dr. Michael M.E. Johns, chancellor of Emory University and chairman of the committee that prepared the report.

Previous studies have shown that fatigue is also hazardous to the residents themselves, increasing the risk of car accidents and depression.

But the new recommendation would add more costs to the medical field, as hiring additional staff to allow residents to work shorter shifts would cost about $1.7 billion annually, according to the same report.

However, the supplementary cost “is a necessary investment in patient safety and better healthcare outcomes,” Dr. Johns said.

The panel also recommended residents get five days off a months – one more than the ACGME requires – so that they can catch up on sleep; moonlighting in any hospital be counted as part of the 80-hour weekly limit; residents work no more than four straight night shifts and get 48 hours off after three of four; hospitals provide a ride for residents too tired to drive home safely.

Moreover, the report recommends limiting residents’ patient loads, relieving them of tasks that don’t add to their education and increasing supervision by experienced doctors.

Whether the guidelines are enforced will be decided by the Accreditation Council for Graduate Medical Education, which is responsible for the accreditation of graduate medical training programs in the United States.