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Medical Errors and One Cause that May Surprise You

By Rheingold Giuffra Ruffo Plotkin & Hellman LLP

With the impending end of Daylight Savings Time on November 1, 2020, a medical journal has published a study that confirms lack of sleep for healthcare workers can lead to an increase in medical errors and medical malpractice. 

In findings were published last month in the Journal of General Internal Medicine, Mayo Clinic researchers report that Daylight Savings Time can increase mistakes by up to 20% after spring and fall time changes.

Researchers conducted a large U.S. based observational study of healthcare organizations across multiple states. They used voluntary safety-related incident reporting occurring seven days prior to and seven days following the spring and fall time changes from 2010 to 2017. This included voluntary reporting of patient incidents caused by defective systems, equipment failure or human error. Researchers focused on incidents likely resulting from human error.

The data suggests safety-related incidents increased after both spring and fall time changes. Differences in incidents overall did not differ before or after daylight savings time when accounting for all types of incidents. But when focusing only on incidents caused by human error, incidents increased by nearly 20%.

That is a significant increase and is an avoidable cause of medical errors. 

Most of the errors involved medications, such as administering the wrong dose or administering the wrong drug.

While increases in medical errors were seen for both spring and fall, increases were much more significant for the fall. In the seven days after the spring Daylight Savings Time change medical errors increased by 5%, but for the fall time change, medical errors increased by 19%.

Daylight Savings Time reduces sleep opportunity by an hour. One hour can make a significant difference for medical professionals who are already working long shifts or may be understaffed. Insufficient sleep in healthcare workers could potentially result in an increase in medical errors.

The study findings demonstrated an increase in medical errors, especially after Daylight Savings Time in the fall compared to the week before the time change.

“Policy makers and healthcare organizations should evaluate delayed start of shifts or other contingency measures to mitigate the increased risk of safety-related incidents during transition to daylight savings time in spring,” wrote study authors.

Part of the problem in resolving human error issues in the practice of medicine concerns the culture in which doctors and nurses are trained.  Their training is rigorous and includes long hours and the ability to work under pressure with little to no sleep is a given for those aspiring to be doctors and nurses.  Perhaps a cultural paradigm shift is in order.  First, acknowledge that sleep deprivation, even a one-hour change, can have a deleterious effect on performance.  Second, take proactive steps to counter such deprivation by shifting work hours, especially during the two periods of time change in the spring and fall.  Human error that causes medical errors is resolvable but the issue has to be acknowledged if there is any hope it can be resolved.  It’s time the medical community recognize this basic fact-medical professionals are humans who are subject to the same weaknesses as the rest of us.  If they are tired, their ability to reason and make vital decisions is impaired when they suffer from sleep deprivation. 

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