Implementing Reduced Work Hours to Improve Patient Safety

Partnerships in Implementing Patient Safety (PIPS)

Christopher Landrigan, M.D., M.P.H., Brigham and Women's Hospital, Boston, MA AHRQ Grant No. HS015906-01


This project implements evidence-based work schedules to help reduce work hours for extended shifts for residents to reduce errors from sleep and fatigue and also from a lack of continuity of care. Toolkit resources include:

  • Ready-to-implement circadian-based work schedules.
  • Evidence-based guidelines for successful shift changes and safe handovers.

Target Audience

Supervisors of medical residents, medical residents, health care executives and administrators, quality and safety professionals, medical accreditation organizations.

Health Care Setting

Teaching hospitals, hospital care units.

Toolkit Web Site


To Err is Human: Building a Safer Health System

Press Releases

National Study of Medical Interns Finds Majority Exceed Work Hour Limits; Link Made Between Needle Stick Injuries and Long Shifts
September 6, 2006

Limiting Medical Interns' Work to 16 Consecutive Hours Can Substantially Reduce Serious Medical Errors in Intensive Care Units
October 27, 2004


Long Hours Worked by Medical Residents Examined

IOM Report on Resident Work Hours

Journal Articles

Effective implementation of work-hour limits and systemic improvements. Landrigan CP, Czeisler CA, Barger LK, Ayas NT, Rothschild JM, Lockley SW; Harvard Work Hours, Health and Safety Group. Jt Comm J Qual Patient Saf. 2007 Nov;33(11 Suppl):19-29.

When policy meets physiology: the challenge of reducing resident work hours. Lockley SW, Landrigan CP, Barger LK, Czeisler CA; Harvard Work Hours Health and Safety Group. Clin Orthop Relat Res. 2006 Aug;449:116-27.

Return to Contents

Current as of October 2004
Internet Citation: Implementing Reduced Work Hours to Improve Patient Safety: Partnerships in Implementing Patient Safety (PIPS). October 2004. Agency for Healthcare Research and Quality, Rockville, MD.