Hospitals Hazardous in July
July 02, 2008 09:03 AM
by
Erin Harris
A Harvard study found July to be the most dangerous month to visit a hospital, citing the arrival of inexperienced interns. Other recent hospital problems may worsen this annual phenomenon.
30-Second Summary
July 1 marks the beginning of the academic year for medical students. But instead of hitting the books, they’re hitting the hospitals.
With the annual influx of new interns, many experts believe that July is the riskiest time of the year for hospital patients, who are susceptible to the mistakes of new medical staff.
A study of this trend, conducted by the National Bureau of Economic Research, concluded “the July medical-training period is associated with between 1,500 and 2,750 accelerated deaths every year.” Opposing studies, however, have found no clinical evidence for the so-called “July Phenomenon.”
Medical students not only have to deal with their new responsibility of working with patients, but they must also acclimate to the nuances of their assigned hospital and a demanding work schedule.
A study by researchers at Harvard Medical School found that overworked interns’ long hours and extended shifts may be responsible for the high rate of accidents that occur when they join a medical staff.
Fortunately, Jay Bhattacharya, a professor at Stanford Medical School, points out that “the mistakes newbie doctors make by and large involve unnecessary tests and longer hospital stays, errors that aren’t typically life-threatening.”
Regardless of whether or not they pose a serious health risk, “fresh, green interns” may not be the only reason to avoid the hospital this summer.
Methicillin-resistant Staphylococcus aureus (MRSA), an antibiotic-resistant strain of bacteria, killed three children in the United States late last year. Today hospital employees are helping the infection spread even faster by neglecting to wash their hands properly in the workplace.
With the annual influx of new interns, many experts believe that July is the riskiest time of the year for hospital patients, who are susceptible to the mistakes of new medical staff.
A study of this trend, conducted by the National Bureau of Economic Research, concluded “the July medical-training period is associated with between 1,500 and 2,750 accelerated deaths every year.” Opposing studies, however, have found no clinical evidence for the so-called “July Phenomenon.”
Medical students not only have to deal with their new responsibility of working with patients, but they must also acclimate to the nuances of their assigned hospital and a demanding work schedule.
A study by researchers at Harvard Medical School found that overworked interns’ long hours and extended shifts may be responsible for the high rate of accidents that occur when they join a medical staff.
Fortunately, Jay Bhattacharya, a professor at Stanford Medical School, points out that “the mistakes newbie doctors make by and large involve unnecessary tests and longer hospital stays, errors that aren’t typically life-threatening.”
Regardless of whether or not they pose a serious health risk, “fresh, green interns” may not be the only reason to avoid the hospital this summer.
Methicillin-resistant Staphylococcus aureus (MRSA), an antibiotic-resistant strain of bacteria, killed three children in the United States late last year. Today hospital employees are helping the infection spread even faster by neglecting to wash their hands properly in the workplace.
Headline Link: Everyone makes mistakes
A study at Harvard Business School found that “there are 4 percent more incidences of accelerated death in average-sized teaching hospitals in July and August.” Yet health care economist Robert Huckman, who co-conducted the study, admits, “New physicians, just like new people in any profession, are going to make mistakes.” He defends new interns by pointing out, “when you look at it in respect to the other things that go on in hospitals that lead to patient mortality, I wouldn’t say that this is a huge cost. It’s important to put it in context.”
Source: Newsweek
Opinion & Analysis: The ‘July Phenomenon’
Robert S. Huckman and Jason R. Barro conducted a study to observe the effects of cohort turnover in teaching hospitals. They gathered data from roughly seven hundred hospitals per year between 1993 and 2001, and compared monthly trends in length of stay and mortality rates between teaching hospitals, which experience annual turnover, and non-teaching hospitals. Huckman and Barro found that annual staff turnover in July resulted in longer hospital stays and increased patient mortality in teaching hospitals.
Source: National Bureau of Economic Research
A study published by Dr. William A. Barry and Dr. Gary E. Rosenthal of the University of Iowa concluded that there is no validity to the so-called, “July Phenomenon.” Barry and Rosenthal focused on patients in intensive care units, comparing mortality and length of stay admissions between July and September, to admissions during the rest of the year. The study involved over 150,000 subjects and found no evidence to support the theory that July is the worst month to be hospitalized.
Source: PubMed Central
Background: Overworked interns
In 2004 the Harvard Gazette reported, “Interns at an intensive care unit in a large Boston teaching hospital typically work 77 to 81 hours per week, with up to 34 consecutive hours without sleep.” In a study to examine the effects of sleep on interns’ performance, researchers found that “Interns made 36 percent more serious medical errors during a traditional work schedule than during an intervention schedule that eliminated extended work shifts.”
Source: Harvard Gazette
Related Topics: MRSA spreads through hospitals
Studies have suggested that negligent hand washing by medical staffers is aiding the spread of MRSA and C. difficile, two resilient bacterial infections. A lack of standard procedures may be to blame, along with overworked doctors who cannot find time to scrub up between patients. Hospitals are focusing attention on educating their employees about proper hygiene, although it may be difficult to ensure that standards are carried out with staff turnover during the summer, and the arrival of new interns.
Source: findingDulcinea
MRSA was responsible for the deaths of close to 19,000 Americans in 2005—the bacterial infection is most common among people in hospitals, who have weakened immune systems. It generally manifests in the form of skin lesions or boils, and can multiply from one bug to seventeen million over the course of one day.
Source: findingDulcinea
References: Patient safety advice
The World Health Organization’s Joint Commission on Patient Safety advises hospitals to minimize communication gaps during patient handovers, stating that such gaps “can cause serious breakdowns in the continuity of care, inappropriate treatment, and potential harm for the patient.” It also encourages hospitals to improve hand hygiene among staff in order to guarantee patient safety.



