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Reduced hours, improved care?
Restrictions in working hours for junior doctors have been introduced in the UK and in the USA. Previous evidence has shown positive effects of reduced working hours, in terms of the rates of motor vehicle crashes, needlestick injuries and mental illness in trainee doctors. However, concerns have been raised about possible adverse effects of these changes on patient care and medical training. A systematic review of 72 studies assessing the impact of the reduction in doctors' working hours in the USA and the UK, on patient outcome, patient safety and postgraduate medical training, has been published in the British Medical Journal (2011;342:d1580). Interestingly, this paper concludes that, although there does not appear to have been a negative effect on postgraduate training or patient care as working hours have reduced, neither has there been a noticeable improvement in patient care. A linked editorial (BMJ 2011;342:d1200) discusses some of the possible reasons for these findings.
Heart failure guidance
New cases of heart failure have significant mortality, with hospitalised patients having a 10% inpatient mortality …