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Deaths Up, Care Levels Down at Teaching Hospitals in July
Date:7/12/2011

dical trainees are pouring in. Such changeovers involve about 100,000 medical staff in the United States and 32,000 in Europe each year, Young and his team noted.

Concerns revolve around the new staff's general unfamiliarity with the intricate workings of a complex hospital environment, as well as their relative lack of experience that may leave them unprepared for the demands of a high-paced clinical setting.

Analyzing the possible consequences to patient health, the study team sifted through the results of 39 English-language studies (mostly American) that were conducted between 1989 and 2010.

The team focused on the July rate of fatalities, medical complications and medical errors at teaching hospitals, as well as overall hospital efficiency variables such as patient hospitalization times, medical costs and operating room time, compared to other months.

The results: Patient fatality rates tended to go up during July staff changeovers, while care efficiency went down. And that, the research team concluded, means that the "July Effect" is real.

However, differences in the way the 39 studies were conducted made it impossible for the authors to determine the exact causes for such trends, and the degree to which patient care might be compromised. In addition, they could not pinpoint which types of teaching hospitals are the most vulnerable to staff turnover.

"There really needs to be more and better studies of this issue -- ones that control for the important variables and factors involved, and that look at things like morbidity, surgical complications, infections, that sort of thing," Young said.

"But I would say that hospitals themselves already take this problem quite seriously," Young added, "and many take specific steps to deal with the risks. [These include] testing the competency and clinical skills of new residents when they take up new positions, and making sure that the level of responsibility they are given is appro
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