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Michtalik HJ, Yeh H, Pronovost PJ, Brotman DJ. Impact of Attending Physician Workload on Patient Care: A Survey of Hospitalists. JAMA Intern Med. 2013;173(5):375–377. doi:10.1001/jamainternmed.2013.1864
Author Affiliations: Departments of Medicine (Drs Michtalik, Yeh, and Brotman), Epidemiology (Dr Yeh), and Health Policy & Management (Dr Pronovost), Johns Hopkins University, Baltimore, Maryland.
Up to 98 000 patients die each year in the hospital as a result of preventable medical errors.1 Most errors are caused by well-intentioned individuals working within faulty systems, processes, or conditions. One such condition is excess clinical workload. For resident physicians, workload so heavy as to result in physician fatigue is associated with increased medical errors and has led to the implementation of work-hour restrictions.2,3 For nurses, a recent cross-sectional analysis showed a significant association between patient mortality and low staffing.4 Fourteen states have enacted legislation and/or adopted regulations to address nurse staffing.5
With increased economic pressures on hospitals and limitations on resident physician work hours, attending physician workload has likely increased. There is limited research available on the association between attending physician workload and patient safety. In this study, we examine the perceived impact of average hospitalist workload on patient safety and quality-of-care measures.
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